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Diagnosis and Staging of Ovarian Cancer: Comparative Values of Doppler and Conventional US, CT, and MR Imaging Correlated with Surgery and Histopathologic Analysis—Report of the Radiology Diagnostic Oncology Group1

Alfred B. Kurtz, MD, John V. Tsimikas, PhD 2, Clare M. C. Tempany, MD, Ulrike M. Hamper, MD, Peter H. Arger, MD, Robert L. Bree, MD, Richard J. Wechsler, MD, Isaac R. Francis, MD, Janet E. Kuhlman, MD 3, Evan S. Siegelman, MD, Donald G. Mitchell, MD, Stuart G. Silverman, MD, Douglas L. Brown, MD, Sheila Sheth, MD, Beverly G. Coleman, MD, James H. Ellis, MD, Robert J. Kurman, MD, Daryl J. Caudry, MS 2 and Barbara J. McNeil, MD, PhD 2

1 From the Dept of Radiology, Jefferson Medical College and Thomas Jefferson University Hospital, Gibbon Bldg 3350AB, 111 S 11th St, Philadelphia, PA 19107 (A.B.K., R.J.W., D.G.M.); the Dept of Health Care Policy, Harvard Medical School, Boston, Mass (J.V.T., D.J.C., B.J.M.); the Dept of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston (C.M.C.T., S.G.S., D.L.B.); the Depts of Radiology (U.M.H., S.S., J.E.K.) and Pathology (R.J.K.), Johns Hopkins Hospital, Baltimore, Md; the Dept of Radiology, Hospital of the University of Pennsylvania, Philadelphia (P.H.A., E.S.S., B.G.C.); and the Dept of Radiology, University of Michigan Medical Center, Ann Arbor (R.L.B., I.R.F., J.H.E.). Received Jun 26, 1998; revision requested Aug 6; revision received Oct 15; accepted Dec 16. Supported in part by Public Health Service grant U01 CA59401 from the National Cancer Institute. Address reprint requests to A.B.K. (e-mail: alfred.b.kurtz@mail.tju.edu).



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  		Figure 1a. ROC curves for the overall detection of ovarian cancer by imaging modality: (a) Doppler US, (b) CT, and (c) MR imaging. For each modality, the five institution-specific ROC curves are shown as interrupted or thin lines; the bold, smooth curves are the modality-specific ROC curves obtained by means of an ordinal regression fit to the data from all five institutions.

 


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  		Figure 1b. ROC curves for the overall detection of ovarian cancer by imaging modality: (a) Doppler US, (b) CT, and (c) MR imaging. For each modality, the five institution-specific ROC curves are shown as interrupted or thin lines; the bold, smooth curves are the modality-specific ROC curves obtained by means of an ordinal regression fit to the data from all five institutions.

 


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  		Figure 1c. ROC curves for the overall detection of ovarian cancer by imaging modality: (a) Doppler US, (b) CT, and (c) MR imaging. For each modality, the five institution-specific ROC curves are shown as interrupted or thin lines; the bold, smooth curves are the modality-specific ROC curves obtained by means of an ordinal regression fit to the data from all five institutions.

 


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  		Figure 2a. ROC curves for the detection of malignancy by anatomic region and modality: In a–c, results of analysis of the (a) ovaries, (b) other pelvic sites, and (c) abdomen and beyond with US (left graph), CT (middle graph), and MR imaging (right graph) are shown. For each anatomic region and modality combination, the five institution-specific ROC curves are shown as interrupted or thin lines; the bold, smooth curves are the modality-specific ROC curves obtained by means of an ordinal regression fit to the data from all five institutions.

 


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  		Figure 2b. ROC curves for the detection of malignancy by anatomic region and modality: In a–c, results of analysis of the (a) ovaries, (b) other pelvic sites, and (c) abdomen and beyond with US (left graph), CT (middle graph), and MR imaging (right graph) are shown. For each anatomic region and modality combination, the five institution-specific ROC curves are shown as interrupted or thin lines; the bold, smooth curves are the modality-specific ROC curves obtained by means of an ordinal regression fit to the data from all five institutions.

 


View larger version (15K):

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  		Figure 2c. ROC curves for the detection of malignancy by anatomic region and modality: In a–c, results of analysis of the (a) ovaries, (b) other pelvic sites, and (c) abdomen and beyond with US (left graph), CT (middle graph), and MR imaging (right graph) are shown. For each anatomic region and modality combination, the five institution-specific ROC curves are shown as interrupted or thin lines; the bold, smooth curves are the modality-specific ROC curves obtained by means of an ordinal regression fit to the data from all five institutions.

 




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