Skip to main content

2018 | OriginalPaper | Buchkapitel

26. Diagnostischer Einsatz bei Adnextumoren

verfasst von : G. Bogner

Erschienen in: Dopplersonographie in Geburtshilfe und Gynäkologie

Verlag: Springer Berlin Heidelberg

Zusammenfassung

In diesem Kapitel wird der diagnostische Einsatz der Dopplersonographie bei Adnextumoren erläutert. Dazu werden zuerst die Grundlagen der Pathophysiologie, die Eigenschaften von Ovarialtumoren und mögliche Fehlerquellen beleuchtet. Daran schließt sich die Auswertung dopplersonographisch erhobener Daten im Zusammenhang mit Farbdoppler, Abhängigkeit von der Sonomorphologie sowie bezüglich der klinischen Anwendung und Analyse des Malignitätsrisikos an. Anhand von 3 Fallbeispielen wird der Einsatz praktisch dargestellt. Abschließend werden als weitere Adnexerkrankungen entzündliche Prozesse und die Ovaialtorsion erläutert.
Literatur
Zurück zum Zitat Alcázar JL, Rodriguez D (2009) Three-dimensional power Doppler vascular sonographic sampling for predicting ovarian cancer in cystic-solid and solid vascularized masses. J Ultrasound Med 28(3):275–81CrossRef Alcázar JL, Rodriguez D (2009) Three-dimensional power Doppler vascular sonographic sampling for predicting ovarian cancer in cystic-solid and solid vascularized masses. J Ultrasound Med 28(3):275–81CrossRef
Zurück zum Zitat Alcázar, JL, Merce LT, Garcia Manero M (2005) Three-dimensional power Doppler vascular sampling: a new method for predicting ovarian cancer in vascularized complex adnexal masses. J Ultrasound Med. 24(5):689–96CrossRef Alcázar, JL, Merce LT, Garcia Manero M (2005) Three-dimensional power Doppler vascular sampling: a new method for predicting ovarian cancer in vascularized complex adnexal masses. J Ultrasound Med. 24(5):689–96CrossRef
Zurück zum Zitat Alcázar, J. L., Pascual, M. A., Graupera, B., Aubá, M., Errasti, T., Olartecoechea, B., Ruiz-Zambrana, A., Hereter, L., Ajossa, S. and Guerriero, S. (2016) External validation of IOTA simple descriptors and simple rules for classifying adnexal masses. Ultrasound Obstet Gynecol, 48: 397–402CrossRef Alcázar, J. L., Pascual, M. A., Graupera, B., Aubá, M., Errasti, T., Olartecoechea, B., Ruiz-Zambrana, A., Hereter, L., Ajossa, S. and Guerriero, S. (2016) External validation of IOTA simple descriptors and simple rules for classifying adnexal masses. Ultrasound Obstet Gynecol, 48: 397–402CrossRef
Zurück zum Zitat Ameye L, Timmerman D, Valentin L, Paladini D, Zhang J, Van Holsbeke C, Lissoni AA, Savelli L, Veldman J, Testa AC, Amant F, Van Huffel S, Bourne T (2012) Clinically oriented three-step strategy for assessment of adnexal pathology. Ultrasound Obstet Gynecol 2012; 40: 582–591CrossRef Ameye L, Timmerman D, Valentin L, Paladini D, Zhang J, Van Holsbeke C, Lissoni AA, Savelli L, Veldman J, Testa AC, Amant F, Van Huffel S, Bourne T (2012) Clinically oriented three-step strategy for assessment of adnexal pathology. Ultrasound Obstet Gynecol 2012; 40: 582–591CrossRef
Zurück zum Zitat Auslender R, Shen O, Kaufman Y, Goldberg Y, Bardicef M, Lissak A, Lavie O (2009) Doppler and gray-scale sonographic classification of adnexal torsion. Ultrasound Obstet Gynecol. 34(2):208–11CrossRef Auslender R, Shen O, Kaufman Y, Goldberg Y, Bardicef M, Lissak A, Lavie O (2009) Doppler and gray-scale sonographic classification of adnexal torsion. Ultrasound Obstet Gynecol. 34(2):208–11CrossRef
Zurück zum Zitat Bamberger ES, Perrett CW (2002) Angiogenesis in epithelian ovarian cancer. Molecular Pathology 2002;55(6):348–359.CrossRef Bamberger ES, Perrett CW (2002) Angiogenesis in epithelian ovarian cancer. Molecular Pathology 2002;55(6):348–359.CrossRef
Zurück zum Zitat Bogner G, Gruber R, Schaffer H, Staudach A (1996) Analyse farbdopplersonographischer Parameter zur Beurteilung der Dignität von Adnextumoren. Ultraschall Med 17 [Suppl]:17 Bogner G, Gruber R, Schaffer H, Staudach A (1996) Analyse farbdopplersonographischer Parameter zur Beurteilung der Dignität von Adnextumoren. Ultraschall Med 17 [Suppl]:17
Zurück zum Zitat Bogner G, Gruber R, Steiner H, Schaffer H, Lundwall K, Staudach A (1996) Is the assessment of ovarian masses with colour doppler ultrasound dependent on training? Ultrasound Obstet Gynecol 8 [Suppl 1]:152 Bogner G, Gruber R, Steiner H, Schaffer H, Lundwall K, Staudach A (1996) Is the assessment of ovarian masses with colour doppler ultrasound dependent on training? Ultrasound Obstet Gynecol 8 [Suppl 1]:152
Zurück zum Zitat Chen JJ, Chen JJ, Chiang CS, Hong JH, Yeh CK (2011) Assessment of tumor vasculature for diagnostic and therapeutic applications in a mouse model in vivo using 25-MHz power Doppler imaging. Ultrasonics. 2011 Dec;51(8):925–31.CrossRef Chen JJ, Chen JJ, Chiang CS, Hong JH, Yeh CK (2011) Assessment of tumor vasculature for diagnostic and therapeutic applications in a mouse model in vivo using 25-MHz power Doppler imaging. Ultrasonics. 2011 Dec;51(8):925–31.CrossRef
Zurück zum Zitat Genç M, Solak A, Genç B, Sivrikoz ON, Kurtulmus S, Turan A, Sahin N, Gur EB (2015) A diagnostic dilemma for solid ovarian masses: the clinical and radiological aspects with differential diagnosis of 23 cases. Eur J Gynaecol Oncol. 2015;36(2):186–191PubMed Genç M, Solak A, Genç B, Sivrikoz ON, Kurtulmus S, Turan A, Sahin N, Gur EB (2015) A diagnostic dilemma for solid ovarian masses: the clinical and radiological aspects with differential diagnosis of 23 cases. Eur J Gynaecol Oncol. 2015;36(2):186–191PubMed
Zurück zum Zitat Gruber R (1995) Bedeutung der Sonomorphologie und der farbcodierten Dopplersonographie in der Diagnostik von Adnextumoren. Dissertation, Leopold-Franzens-Universität Innsbruck Gruber R (1995) Bedeutung der Sonomorphologie und der farbcodierten Dopplersonographie in der Diagnostik von Adnextumoren. Dissertation, Leopold-Franzens-Universität Innsbruck
Zurück zum Zitat Gruber R, Bogner G, Steiner H, Staudach A (1996) Reproduzierbarkeit farb-/dopplersonographischer Messungen im Rahmen der präoperativen Dignitätseinschätzung von Adnextumoren. Ultraschall Med 17 [Suppl]:17 Gruber R, Bogner G, Steiner H, Staudach A (1996) Reproduzierbarkeit farb-/dopplersonographischer Messungen im Rahmen der präoperativen Dignitätseinschätzung von Adnextumoren. Ultraschall Med 17 [Suppl]:17
Zurück zum Zitat Guerriero S, Ajossa S, Garau N, Piras B, Paoletti AM, Melis GB (2005) Ultrasonography and color Doppler-based triage for adnexal masses to provide the most appropriate surgical approach. Am J Obstet Gynecol.; 192(2):401–6CrossRef Guerriero S, Ajossa S, Garau N, Piras B, Paoletti AM, Melis GB (2005) Ultrasonography and color Doppler-based triage for adnexal masses to provide the most appropriate surgical approach. Am J Obstet Gynecol.; 192(2):401–6CrossRef
Zurück zum Zitat Guerriero S, Alcazar JL, Coccia ME, Ajossa S, Scarselli G, Boi M, Gerada M, Melis GB (2002) Complex pelvic mass as a target of evaluation of vessel distribution by color Doppler sonography for the diagnosis of adnexal malignancies: results of a multicenter European study. J Ultrasound Med. 21(10):1105–11CrossRef Guerriero S, Alcazar JL, Coccia ME, Ajossa S, Scarselli G, Boi M, Gerada M, Melis GB (2002) Complex pelvic mass as a target of evaluation of vessel distribution by color Doppler sonography for the diagnosis of adnexal malignancies: results of a multicenter European study. J Ultrasound Med. 21(10):1105–11CrossRef
Zurück zum Zitat Guerriero S, Ajossa S, Piras B, Gerada M, Floris S, Garau N, Minerba L, Paoletti AMm Melis GB (2007) Three-dimensional quantification of tumor vascularity as a tertiary test after B-mode and power Doppler evaluation for detection of ovarian cancer. J Ultrasound Med. 26(10):1271–8CrossRef Guerriero S, Ajossa S, Piras B, Gerada M, Floris S, Garau N, Minerba L, Paoletti AMm Melis GB (2007) Three-dimensional quantification of tumor vascularity as a tertiary test after B-mode and power Doppler evaluation for detection of ovarian cancer. J Ultrasound Med. 26(10):1271–8CrossRef
Zurück zum Zitat Jacobs IJ, Menon U, Ryan A, et al. (2016) Ovarian cancer screening and mortality in the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS): a randomised controlled trial. Lancet (London, England). 2016;387(10022):945–956CrossRef Jacobs IJ, Menon U, Ryan A, et al. (2016) Ovarian cancer screening and mortality in the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS): a randomised controlled trial. Lancet (London, England). 2016;387(10022):945–956CrossRef
Zurück zum Zitat Jain RK et al. (2005) Normalization of Tumor Vasculature: An Emerging Concept in Antiangiogenic Therapy. Science, 07 Jan 2005:Vol. 307, Issue 5706, pp. 58–62CrossRef Jain RK et al. (2005) Normalization of Tumor Vasculature: An Emerging Concept in Antiangiogenic Therapy. Science, 07 Jan 2005:Vol. 307, Issue 5706, pp. 58–62CrossRef
Zurück zum Zitat Kaijser, J., Bourne, T., Valentin, L., Sayasneh, A., Van Holsbeke, C., Vergote, I., Testa, A. C., Franchi, D., Van Calster, B. and Timmerman, D (2013) Improving strategies for diagnosing ovarian cancer: a summary of the International Ovarian Tumor Analysis (IOTA) studies. Ultrasound Obstet Gynecol, 41: 9–20CrossRef Kaijser, J., Bourne, T., Valentin, L., Sayasneh, A., Van Holsbeke, C., Vergote, I., Testa, A. C., Franchi, D., Van Calster, B. and Timmerman, D (2013) Improving strategies for diagnosing ovarian cancer: a summary of the International Ovarian Tumor Analysis (IOTA) studies. Ultrasound Obstet Gynecol, 41: 9–20CrossRef
Zurück zum Zitat Kalmantis K, Rodolakis A, Daskalakis G, Antsaklis A (2013) Characterization of ovarian tumors and staging ovarian cancer with 3-dimensional power Doppler angiography: correlation with pathologic findings. Int J Gynecol Cancer. 2013 Mar;23(3):469–74CrossRef Kalmantis K, Rodolakis A, Daskalakis G, Antsaklis A (2013) Characterization of ovarian tumors and staging ovarian cancer with 3-dimensional power Doppler angiography: correlation with pathologic findings. Int J Gynecol Cancer. 2013 Mar;23(3):469–74CrossRef
Zurück zum Zitat Liu Z, Yang F, Zhang Y, Yu H, Zhu H, Yang R, Fan L (2016) Conventional, Doppler and Contrast-Enhanced Ultrasonography in Differential Diagnosis of Ovarian Masses. Cell Physiol Biochem 2016;39:2398–2408CrossRef Liu Z, Yang F, Zhang Y, Yu H, Zhu H, Yang R, Fan L (2016) Conventional, Doppler and Contrast-Enhanced Ultrasonography in Differential Diagnosis of Ovarian Masses. Cell Physiol Biochem 2016;39:2398–2408CrossRef
Zurück zum Zitat Mashiach R, Melamed N, Gilad N, Ben-Shitrit G, Meizner I (2011) Sonographic diagnosis of ovarian torsion: accuracy and predictive factors. J Ultrasound Med. 2011 Sep;30(9):1205–10CrossRef Mashiach R, Melamed N, Gilad N, Ben-Shitrit G, Meizner I (2011) Sonographic diagnosis of ovarian torsion: accuracy and predictive factors. J Ultrasound Med. 2011 Sep;30(9):1205–10CrossRef
Zurück zum Zitat Meys EM, Kaijser J, Kruitwagen RF, Slangen BF, Van Calster B, Aertgeerts B, Verbakel JY, Timmerman D, Van Gorp T (2016) Subjective assessment versus ultrasound models to diagnose ovarian cancer: A systematic review and meta-analysis. Eur J Cancer. 2016 May;58:17–29CrossRef Meys EM, Kaijser J, Kruitwagen RF, Slangen BF, Van Calster B, Aertgeerts B, Verbakel JY, Timmerman D, Van Gorp T (2016) Subjective assessment versus ultrasound models to diagnose ovarian cancer: A systematic review and meta-analysis. Eur J Cancer. 2016 May;58:17–29CrossRef
Zurück zum Zitat Molander P, Sjöberg J, Paavonen J, Cacciatore B. (2001) Transvaginal power Doppler findings in laparoscopically proven acute pelvic inflammatory disease. Ultrasound Obstet Gynecol. 17(3):233–8CrossRef Molander P, Sjöberg J, Paavonen J, Cacciatore B. (2001) Transvaginal power Doppler findings in laparoscopically proven acute pelvic inflammatory disease. Ultrasound Obstet Gynecol. 17(3):233–8CrossRef
Zurück zum Zitat Niemi RJ, Saarelainen SK, Luukkaala TH, Mäenpää JU. (2017) Reliability of preoperative evaluation of postmenopausal ovarian tumors. Journal of Ovarian Research. 2017;10:15CrossRef Niemi RJ, Saarelainen SK, Luukkaala TH, Mäenpää JU. (2017) Reliability of preoperative evaluation of postmenopausal ovarian tumors. Journal of Ovarian Research. 2017;10:15CrossRef
Zurück zum Zitat Nizar K, Deutsch M, Filmer S, Weizman B, Beloosesky R, Weiner Z (2009) Doppler studies of the ovarian venous blood flow in the diagnosis of adnexal torsion. J Clin Ultrasound 37(8):436–9CrossRef Nizar K, Deutsch M, Filmer S, Weizman B, Beloosesky R, Weiner Z (2009) Doppler studies of the ovarian venous blood flow in the diagnosis of adnexal torsion. J Clin Ultrasound 37(8):436–9CrossRef
Zurück zum Zitat Roche O, Chavan N, Aquilina J, Rockall A (2012) Radiological appearances of gynaecological emergencies. Insights into Imaging. 2012;3(3):265–275CrossRef Roche O, Chavan N, Aquilina J, Rockall A (2012) Radiological appearances of gynaecological emergencies. Insights into Imaging. 2012;3(3):265–275CrossRef
Zurück zum Zitat Romosan G, Valentin L (2014) The sensitivity and specificity of transvaginal ultrasound with regard to acute pelvic inflammatory disease: a review of the literature. Arch Gynecol Obstet. 2014 Apr;289(4):705–14CrossRef Romosan G, Valentin L (2014) The sensitivity and specificity of transvaginal ultrasound with regard to acute pelvic inflammatory disease: a review of the literature. Arch Gynecol Obstet. 2014 Apr;289(4):705–14CrossRef
Zurück zum Zitat Schelling M, Braun M, Kuhn W, Bogner G, Gruber R, Gnirs J, Schneider KT, Ulm K, Rutke S, Staudach A (2000) Combined transvaginal B-mode and color Doppler sonography for differential diagnosis of ovarian tumors: results of a multivariate logistic regression analysis. Gynecol Oncol. 77(1):78–86CrossRef Schelling M, Braun M, Kuhn W, Bogner G, Gruber R, Gnirs J, Schneider KT, Ulm K, Rutke S, Staudach A (2000) Combined transvaginal B-mode and color Doppler sonography for differential diagnosis of ovarian tumors: results of a multivariate logistic regression analysis. Gynecol Oncol. 77(1):78–86CrossRef
Zurück zum Zitat Silvestre L, Martins WP, Candido-dos-Reis FJ. (2015) Limitations of three-dimensional power Doppler angiography in preoperative evaluation of ovarian tumors. Journal of Ovarian Research. 2015;8:47CrossRef Silvestre L, Martins WP, Candido-dos-Reis FJ. (2015) Limitations of three-dimensional power Doppler angiography in preoperative evaluation of ovarian tumors. Journal of Ovarian Research. 2015;8:47CrossRef
Zurück zum Zitat Sladkevicius P, Valentin L, Marsl K (1995) Transvaginal Doppler examination for the differential diagnosis of solid pelvic tumors. J Ultrasound Med 14:377–380CrossRef Sladkevicius P, Valentin L, Marsl K (1995) Transvaginal Doppler examination for the differential diagnosis of solid pelvic tumors. J Ultrasound Med 14:377–380CrossRef
Zurück zum Zitat Sladkevicius, P. and Valentin, L (2013) Intra- and interobserver agreement when describing adnexal masses using the International Ovarian Tumor Analysis terms and definitions: a study on three-dimensional ultrasound volumes. Ultrasound Obstet Gynecol, 41: 318–327CrossRef Sladkevicius, P. and Valentin, L (2013) Intra- and interobserver agreement when describing adnexal masses using the International Ovarian Tumor Analysis terms and definitions: a study on three-dimensional ultrasound volumes. Ultrasound Obstet Gynecol, 41: 318–327CrossRef
Zurück zum Zitat Testa AC, Timmerman D, Van Belle V, Fruscella E, Van Holsbeke C, Savelli L, Ferrazzi E, Leone FP, Marret H, Tranquart F, Exacoustos C, Nazzaro G, Bokor D, Magri F, Van Huffel S, Ferrandina G, Valentin L (2009) Intravenous contrast ultrasound examination using contrast-tuned imaging (CnTI) and the contrast medium SonoVue for discrimination between benign and malignant adnexal masses with solid components. Ultrasound Obstet Gynecol. 34(6):699–710CrossRef Testa AC, Timmerman D, Van Belle V, Fruscella E, Van Holsbeke C, Savelli L, Ferrazzi E, Leone FP, Marret H, Tranquart F, Exacoustos C, Nazzaro G, Bokor D, Magri F, Van Huffel S, Ferrandina G, Valentin L (2009) Intravenous contrast ultrasound examination using contrast-tuned imaging (CnTI) and the contrast medium SonoVue for discrimination between benign and malignant adnexal masses with solid components. Ultrasound Obstet Gynecol. 34(6):699–710CrossRef
Zurück zum Zitat Timmerman D, Ameye L, Fischerova D, Epstein E, Melis GB, Guerriero S, Van Holsbeke C, Savelli L, Fruscio R, Lissoni AA, Testa AC, Veldman J, Vergote I, Van Huffel S, Bourne T, Valentin L (2010) Simple ultrasound rules to distinguish between benign and malignant adnexal masses before surgery: prospective validation by IOTA group. BMJ. 2010 Dec 14;341:c6839CrossRef Timmerman D, Ameye L, Fischerova D, Epstein E, Melis GB, Guerriero S, Van Holsbeke C, Savelli L, Fruscio R, Lissoni AA, Testa AC, Veldman J, Vergote I, Van Huffel S, Bourne T, Valentin L (2010) Simple ultrasound rules to distinguish between benign and malignant adnexal masses before surgery: prospective validation by IOTA group. BMJ. 2010 Dec 14;341:c6839CrossRef
Zurück zum Zitat Timmerman D, Van Calster B, Testa AC, Guerriero S, Fischerova D, Lissoni A, Van Holsbeke C, Fruscio R, Czekierdowski A, Jurkovic D, Savelli L, Vergote I, Bourne T, Van Huffel S, Valentin L (2010) Ovarian cancer prediction in adnexal masses using ultrasound-based logistic regression models: a temporal and external validation study by the IOTA group. Ultrasound in Obstetrics and Gynecology 35(2);226–234CrossRef Timmerman D, Van Calster B, Testa AC, Guerriero S, Fischerova D, Lissoni A, Van Holsbeke C, Fruscio R, Czekierdowski A, Jurkovic D, Savelli L, Vergote I, Bourne T, Van Huffel S, Valentin L (2010) Ovarian cancer prediction in adnexal masses using ultrasound-based logistic regression models: a temporal and external validation study by the IOTA group. Ultrasound in Obstetrics and Gynecology 35(2);226–234CrossRef
Zurück zum Zitat Timmerman D. The use of mathematical models to evaluate pelvic masses; can they beat an expert operator? Best Pract Res Clin Obstet Gynaecol 2004; 18: 91–104CrossRef Timmerman D. The use of mathematical models to evaluate pelvic masses; can they beat an expert operator? Best Pract Res Clin Obstet Gynaecol 2004; 18: 91–104CrossRef
Zurück zum Zitat Valentin L, Ameye L, Franchi D, Guerriero S, Jurkovic D, Savelli L, Fischerova D, Lissoni A, Van Holsbeke C, Fruscio R, Van Huffel S, Testa A, Timmerman D (2013) Risk of malignancy in unilocular cysts: a study of 1148 adnexal masses classified as unilocular cysts at transvaginal ultrasound and review of the literature. Ultrasound Obstet Gynecol. 2013 Jan;41(1):80–9CrossRef Valentin L, Ameye L, Franchi D, Guerriero S, Jurkovic D, Savelli L, Fischerova D, Lissoni A, Van Holsbeke C, Fruscio R, Van Huffel S, Testa A, Timmerman D (2013) Risk of malignancy in unilocular cysts: a study of 1148 adnexal masses classified as unilocular cysts at transvaginal ultrasound and review of the literature. Ultrasound Obstet Gynecol. 2013 Jan;41(1):80–9CrossRef
Zurück zum Zitat Valentin L, Ameye L, Jurkovic D, Metzger U, Lécuru F, Van Huffel S, Timmerman D (2006) Which extrauterine pelvic masses are difficult to correctly classify as benign or malignant on the basis of ultrasound findings and is there a way of making a correct diagnosis? Ultrasound Obstet Gynecol. 27(4):438–44CrossRef Valentin L, Ameye L, Jurkovic D, Metzger U, Lécuru F, Van Huffel S, Timmerman D (2006) Which extrauterine pelvic masses are difficult to correctly classify as benign or malignant on the basis of ultrasound findings and is there a way of making a correct diagnosis? Ultrasound Obstet Gynecol. 27(4):438–44CrossRef
Zurück zum Zitat Valentin L, Hagen B, Tingulstad S, Eik-Nes S (2001) Comparison of ’pattern recognition’ and logistic regression models for discrimination between benign and malignant pelvic masses: a prospective cross validation. Ultrasound Obstet Gynecol. Oct;18(4):357–65CrossRef Valentin L, Hagen B, Tingulstad S, Eik-Nes S (2001) Comparison of ’pattern recognition’ and logistic regression models for discrimination between benign and malignant pelvic masses: a prospective cross validation. Ultrasound Obstet Gynecol. Oct;18(4):357–65CrossRef
Zurück zum Zitat Van Holsbeke C, Daemen A, Yazbek J, Holland TK, Bourne T, Mesens T, Lannoo L, De Moor B, De Jonge E, Testa AC, Valentin L, Jurkovic D, Timmerman D (2009) Ultrasound methods to distinguish between malignant and benign adnexal masses in the hands of examiners with different levels of experience. Ultrasound Obstet Gynecol. Oct;34(4):454–61CrossRef Van Holsbeke C, Daemen A, Yazbek J, Holland TK, Bourne T, Mesens T, Lannoo L, De Moor B, De Jonge E, Testa AC, Valentin L, Jurkovic D, Timmerman D (2009) Ultrasound methods to distinguish between malignant and benign adnexal masses in the hands of examiners with different levels of experience. Ultrasound Obstet Gynecol. Oct;34(4):454–61CrossRef
Zurück zum Zitat Vijayaraghavan SB (2004) Sonographic whirlpool sign in ovarian torsion. J Ultrasound Med. 2004 Dec;23(12):1643–9;CrossRef Vijayaraghavan SB (2004) Sonographic whirlpool sign in ovarian torsion. J Ultrasound Med. 2004 Dec;23(12):1643–9;CrossRef
Zurück zum Zitat Yazbek J, Raju SK, Ben-Nagi J, Holland TK, Hillaby K, Jurkovic D (2008) Effect of quality of gynaecological ultrasonography on management of patients with suspected ovarian cancer: a randomised controlled trial. Lancet Oncol. 9(2):124–31CrossRef Yazbek J, Raju SK, Ben-Nagi J, Holland TK, Hillaby K, Jurkovic D (2008) Effect of quality of gynaecological ultrasonography on management of patients with suspected ovarian cancer: a randomised controlled trial. Lancet Oncol. 9(2):124–31CrossRef
Metadaten
Titel
Diagnostischer Einsatz bei Adnextumoren
verfasst von
G. Bogner
Copyright-Jahr
2018
Verlag
Springer Berlin Heidelberg
DOI
https://doi.org/10.1007/978-3-662-54966-7_26

Antikörper-Wirkstoff-Konjugat hält solide Tumoren in Schach

16.05.2024 Zielgerichtete Therapie Nachrichten

Trastuzumab deruxtecan scheint auch jenseits von Lungenkrebs gut gegen solide Tumoren mit HER2-Mutationen zu wirken. Dafür sprechen die Daten einer offenen Pan-Tumor-Studie.

Mammakarzinom: Senken Statine das krebsbedingte Sterberisiko?

15.05.2024 Mammakarzinom Nachrichten

Frauen mit lokalem oder metastasiertem Brustkrebs, die Statine einnehmen, haben eine niedrigere krebsspezifische Mortalität als Patientinnen, die dies nicht tun, legen neue Daten aus den USA nahe.

S3-Leitlinie zur unkomplizierten Zystitis: Auf Antibiotika verzichten?

15.05.2024 Harnwegsinfektionen Nachrichten

Welche Antibiotika darf man bei unkomplizierter Zystitis verwenden und wovon sollte man die Finger lassen? Welche pflanzlichen Präparate können helfen? Was taugt der zugelassene Impfstoff? Antworten vom Koordinator der frisch überarbeiteten S3-Leitlinie, Prof. Florian Wagenlehner.

Gestationsdiabetes: In der zweiten Schwangerschaft folgenreicher als in der ersten

13.05.2024 Gestationsdiabetes Nachrichten

Das Risiko, nach einem Gestationsdiabetes einen Typ-2-Diabetes zu entwickeln, hängt nicht nur von der Zahl, sondern auch von der Reihenfolge der betroffenen Schwangerschaften ab.

Update Gynäkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert – ganz bequem per eMail.