ACR appropriateness criteria staging and follow-up of ovarian cancer

Donald G. Mitchell, Marcia C. Javitt, Phyllis Glanc, Genevieve L. Bennett, Douglas L. Brown, Theodore Dubinsky, Mukesh G. Harisinghani, Robert D. Harris, Neil S. Horowitz, Pari V. Pandharipande, Harpreet K. Pannu, Ann E. Podrasky, Henry D. Royal, Thomas D. Shipp, Cary Lynn Siegel, Lynn Simpson, Jade J. Wong-You-Cheong, Carolyn M. Zelop

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44 Scopus citations


Imaging is used to detect and characterize adnexal masses and to stage ovarian cancer both before and after initial treatment, although the role for imaging in screening for ovarian cancer has not been established. CT and MRI have been used to determine the resectability of tumors, the candidacy of patients for effective cytoreductive surgery, the need for postoperative chemotherapy if debulking is suboptimal, and the need for referral to a gynecologic oncologist. Radiographic studies such as contrast enema and urography have been replaced by CT and other cross-sectional imaging for staging ovarian cancer. Contrast-enhanced CT is the procedure of choice for preoperative staging of ovarian cancer. MRI without and with contrast may be useful after equivocal CT, but is usually not the best initial procedure for ovarian cancer staging. Fluorine-18-2-fluoro-2-deoxy-D-glucose-PET/CT may not be needed preoperatively, but its use is appropriate for detecting and defining post-treatment recurrence. Ultrasound is useful for evaluating adnexal disease, but has limited utility for staging ovarian cancer. The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every 2 years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances where evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment.

Original languageEnglish
Pages (from-to)822-827
Number of pages6
JournalJournal of the American College of Radiology
Issue number11
StatePublished - Nov 2013


  • Appropriateness criteria
  • CT
  • MRI
  • cancer staging
  • ovarian cancer


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