{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T11:56:30Z","timestamp":1775735790832,"version":"3.50.1"},"reference-count":21,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2021,12,1]],"date-time":"2021-12-01T00:00:00Z","timestamp":1638316800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp;amp; Gyne"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Fusion imaging is an emerging technique that combines real\u2010time ultrasound examination with images acquired previously using other modalities, such as computed tomography (CT), magnetic resonance imaging and positron emission tomography. The primary aim of this study was to evaluate the feasibility of fusion imaging in patients with suspicion of ovarian or peritoneal cancer. Secondary aims were: to compare the agreement of findings on fusion imaging, CT alone and ultrasound imaging alone with laparoscopic findings, in the assessment of extent of intra\u2010abdominal disease; and to evaluate the time required for the fusion imaging technique.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients with clinical and\/or radiographic suspicion of advanced ovarian or peritoneal cancer who were candidates for surgery were enrolled prospectively between December 2019 and September 2020. All patients underwent a CT scan and ultrasound and fusion imaging to evaluate the presence or absence of the following abdominal\u2010cancer features according to the laparoscopy\u2010based scoring model (predictive index value (PIV)): supracolic omental disease, visceral carcinomatosis on the liver, lesser omental carcinomatosis and\/or visceral carcinomatosis on the lesser curvature of the stomach and\/or spleen, involvement of the paracolic gutter(s) and\/or anterior abdominal wall, involvement of the diaphragm and visceral carcinomatosis on the small and\/or large bowel (regardless of rectosigmoid involvement). The feasibility of the fusion examination in these patients was evaluated. Agreement of each imaging method (ultrasound, CT and fusion imaging) with laparoscopy (considered as reference standard) was calculated using Cohen's kappa coefficient.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fifty\u2010two patients were enrolled into the study. Fusion imaging was feasible in 51 (98%) of these patients (in one patient, it was not possible for technical reasons). Two patients were excluded because laparoscopy was not performed, leaving 49 women in the final analysis. Kappa values for CT, ultrasound and fusion imaging, using laparoscopy as the reference standard, in assessing the PIV parameters were, respectively: 0.781, 0.845 and 0.896 for the great omentum; 0.329, 0.608 and 0.847 for the liver surface; 0.472, 0.549 and 0.756 for the lesser omentum and\/or stomach and\/or spleen; 0.385, 0.588 and 0.795 for the paracolic gutter(s) and\/or anterior abdominal wall; 0.385, 0.497 and 0.657 for the diaphragm; and 0.336, 0.410 and 0.469 for the bowel. The median time needed to perform the fusion examination was 20 (range, 10\u201340)\u2009min.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Fusion of CT images and real\u2010time ultrasound imaging is feasible in patients with suspicion of ovarian or peritoneal cancer and improves the agreement with surgical findings when compared with ultrasound or CT scan alone. \u00a9 2021 International Society of Ultrasound in Obstetrics and Gynecology.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.23650","type":"journal-article","created":{"date-parts":[[2021,4,13]],"date-time":"2021-04-13T18:20:09Z","timestamp":1618338009000},"page":"916-925","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Fusion imaging in preoperative assessment of extent of disease in patients with advanced ovarian cancer: feasibility and agreement with laparoscopic findings"],"prefix":"10.1002","volume":"58","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5070-7245","authenticated-orcid":false,"given":"F.","family":"Moro","sequence":"first","affiliation":[{"name":"Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanit\u00e0 Pubblica  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"V.","family":"Bertoldo","sequence":"additional","affiliation":[{"name":"Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanit\u00e0 Pubblica  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G.","family":"Avesani","sequence":"additional","affiliation":[{"name":"Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3572-379X","authenticated-orcid":false,"given":"M. C.","family":"Moruzzi","sequence":"additional","affiliation":[{"name":"Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanit\u00e0 Pubblica  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0736-3114","authenticated-orcid":false,"given":"F.","family":"Mascilini","sequence":"additional","affiliation":[{"name":"Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanit\u00e0 Pubblica  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2404-6578","authenticated-orcid":false,"given":"G.","family":"Bolomini","sequence":"additional","affiliation":[{"name":"Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanit\u00e0 Pubblica  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G.","family":"Caliolo","sequence":"additional","affiliation":[{"name":"Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R.","family":"Esposito","sequence":"additional","affiliation":[{"name":"Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanit\u00e0 Pubblica  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R.","family":"Moroni","sequence":"additional","affiliation":[{"name":"Fondazione Policlinico Universitario Agostino Gemelli IRCCS Direzione Scientifica  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G. F.","family":"Zannoni","sequence":"additional","affiliation":[{"name":"Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanit\u00e0 Pubblica  Rome Italy"},{"name":"Istituto di Anatomia Patologica Universit\u00e0 Cattolica del Sacro Cuore  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Fagotti","sequence":"additional","affiliation":[{"name":"Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanit\u00e0 Pubblica  Rome Italy"},{"name":"Universit\u00e0 Cattolica del Sacro Cuore, Dipartimento Scienze della Vita e di Sanit\u00e0 Pubblica  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R.","family":"Manfredi","sequence":"additional","affiliation":[{"name":"Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia  Rome Italy"},{"name":"Istituto di Radiologia Universit\u00e0 Cattolica del Sacro Cuore  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G.","family":"Scambia","sequence":"additional","affiliation":[{"name":"Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanit\u00e0 Pubblica  Rome Italy"},{"name":"Universit\u00e0 Cattolica del Sacro Cuore, Dipartimento Scienze della Vita e di Sanit\u00e0 Pubblica  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A. 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