Key Points

For women with known risk factors for ovarian cancer, transvaginal ultrasound continues to be the initial and the most promising imaging modality for ovarian cancer screening. Ultrasound (both gray-scale and Doppler) is considered the modality of choice for initial evaluation of an ovarian mass.

The features suggestive of ovarian malignancy on all cross-sectional imaging modalities (ultrasound, computed tomography, and MRI) include septations greater than 3 mm in thickness, mural nodu-larity, and the presence of papillary projections. Unilocular or multilocular ovarian cystic lesions without solid parts are more likely to be benign.

MR imaging is considered to be a problem-solving technique in the characterization of adnexal masses.

CT is the modality of choice in staging and preoperative planning for ovarian cancer.

The role of FDG-PET in combination with CT in the evaluation of ovarian cancer has been growing rapidly, with recognized advantages in the evaluation of tumor recurrence.

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