Why to question the results of TVUS

[SimplyStar]

Results from previous studies have determined that an ultrasound performed by a technician with greater expertise in the procedure more accurately distinguishes between a benign condition and ovarian cancer. However, it has not been established whether these findings will lead to changes in initial management of patients with symptoms of ovarian cancer.

Researchers from England recently conducted a clinical study including 150 patients who were referred to a gynecological cancer center between 2004 and 2006. These patients were suspected to have an ovarian tumor.  One group of patients underwent routine gynecologic ultrasonography (level II), while the other group underwent an expert-level gynecologic ultrasonography (level III).

Surgery for suspected ovarian cancer was performed on 37% of patients who underwent level II ultrasonography compared with 22% who underwent level III ultrasonography.
The number of days spent in the hospital for surgery was six days for those who underwent level II and five days for those who underwent level III ultrasonography.
Sensitivity and specificity (the ability to accurately detect and provide a diagnosis of cancer versus non-cancerous conditions) was only 40% in patients who underwent level II ultrasonography compared with 100% for those who underwent level III ultrasonography.

[SimplyStar]

A routine TVUS is merely that, done with an annual exam, expert means being read by an expert  in reading the results.  The exams are the same but what they are saying is that there is a difference in ability to read those results correctly.  Just as we say having a debulking surgery done by an Onocologist is better than by a regular surgeon or a GYN surgeon, more exeperience.  The difference I can find in the CA125 and the CA12511 is that the CA12511 has an added feature, something call  LIA-Mat, they call it a "sandwich", developed in Germany, it is quite new and shows some promise of being more accurate.  Hope this answers some for you. I am no expert, just do rersearch on anything I don't know.  I do know that with todays medical practitioners it is always best to try and find the ones with the most experience and to question any reports of tests, scans that seem out of line with your own feelings, trust can no longer be a judgement on qualifications.  For a new problem in your health, if it is serious, go with the specialist and a referral. With labs making 40% mistaken "reads" this is very imp[ortant.   Marty

[lilbubba]

First, I was wondering what the difference between the routine and the expert US are. What does make it an expert US. Also what is HE4 and what is the difference between a CA125 and a CA125II. I am sorry if this is too many questions...just don't know a lot about all these tests.

[SimplyStar]

Tumor Markers Identify Patients with Pelvic Masses at Higher Risk for Malignancy Women diagnosed with epithelial ovarian cancer (EOC) are known to have better outcomes when their initial surgeries are performed by gynecologic oncologists, but knowing who is most likely to need immediate specialty care can be difficult. A current, multicenter prospective blinded clinical trial studied more than 500 women with pelvic masses and measured two blood proteins called HE4 and CA125II to determine whether this test combination can predict the likelihood of cancer. Thirty-four percent of the women studied were found to have cancer. This marker combination performed well in both pre and post-menopausal women and best predicted noncancerous masses (95% negative predictive value). This ability to predict which pelvic masses are less likely to be benign may facilitate patient referral to gynecologic oncologists and ultimately improve the cancer care of these women.