This application is in response to RFA CA 92-02 which proposes expansion of the ongoing National Collaborative Diagnostic Imaging Trials project. We are applying for consideration to be a part of the group of institutions which will form the Radiologic Diagnostic Oncology Group to study the utility of newer imaging modalities in the evaluation of ovarian cancer. The collaborative group will be designed to provide a means whereby efficacy studies on newer diagnostic imaging tests can be instituted in a timely fashion and whereby data can be analyzed in an accurate manner. Under the auspices of an operation center and statistical and data management group we will establish an ongoing mechanism to: optimize image quality across all participating sites; obtain consistent and complete data across participating sites; create a film library to allow derivative studies in subsequent years; analyze imaging data for clinical effectiveness and potential algorithm development using appropriate analytical techniques. The techniques employed for analysis will be state-of-the-art involving receiver operating characteristic curve analyses; special care will be taken to ensure correction for a number of biases that might preclude accurate data analyses. This application concerns evaluation of ovarian cancer. We will analyze the usefulness of transabdominal and transvaginal ultrasound including color and spectral Doppler techniques to separate ovarian cancer from other entities having similar clinical and imaging appearances. This is possible due to the inability of imaging and clinical studies to correctly separate stage I or II ovarian carcinoma from its benign counterparts. The absolute value of CT with modem dynamic scanning using high doses of contrast and fast scan techniques and MR utilizing state-of-the-art pulse sequences, phased array surface coils and endovaginal coils and ultrasound utilizing color flow Doppler and spectral analysis in the staging, diagnosis and follow-up of patients with ovarian cancer will be determined. The incremental value of MR over CT or ultrasound will also be assessed. The role of imaging modalities in the non-operative evaluation of tumor recurrence will be compared with current techniques including second-look laparotomy and CA 125.
