Story by Olivia Piché | Photograph by Jared Sych
A new pilot project highlights the benefits of contrast-enhanced ultrasound (CEUS) for ovarian lesions
Traditional grey-scale ultrasounds have limitations to how much detail they can provide; it’s why patients are often sent for further tests like MRI or CT scans. But contrast-enhanced ultrasound (CEUS), a relatively new imaging technique, uses minuscule bubbles and a contrast agent that is injected into a patient’s bloodstream to interact with the ultrasound waves to then produce more detailed images. The contrast agent improves the clarity, reliability, and functionality of traditional ultrasound scans. Using CEUS has led to improved diagnosis and has been widely approved for liver and kidney imaging but not yet for other organs, like ovaries.
Although it shows a lot of promise for earlier malignant detection, fewer follow-up appointments and overall better care for women with pelvic masses, CEUS for ovarian lesions has not yet been fully evaluated. Dr. Stephanie Wilson is on a mission to change this.
Calgary leading the way
As a CEUS pioneer, Wilson leads North America’s most advanced CEUS department at the Foothills Medical Centre. Her department performed 25,000 CEUS scans between 2010 and 2022, and in the last year, she’s been using CEUS for patients with ovarian pathology, many of whom had ovarian cancer, which can be difficult to detect with traditional imaging technology. Standard ultrasounds can’t always detect whether a mass is cancerous, but CEUS provides clearer imaging similar to MRI or CT scans, but without some of the cost, wait times, and discomfort. And with cancer, earlier detection is crucial to survival.
“I was involved in the very first [CEUS] patient study that was done in North America, around 20 years ago. I’m now the president of the International Contrast Ultrasound Society. This has kind of been my life,” says Wilson. “CEUS shows great potential as a primary diagnostic tool in an ovarian lesion investigation.”
One way to know whether a pelvic mass is benign is if it’s avascular, meaning there’s no blood flow. When a lesion is benign, the microbubbles used in CEUS cannot enter the mass, whereas if a lesion is potentially malignant, the microbubbles will appear in the CEUS imaging and light up the lesion.
“If we can confirm that something is benign, then we can reduce the amount of unnecessary follow-ups,” says Wilson. “Although we cannot always tell with absolute confidence [if a mass is malignant], CEUS improves detection and characterization of malignant features. And the goal, of course, is expedited care.”
Wilson is leading a pilot project to showcase the benefits of CEUS for ovarian lesions and is hopeful gynecologic oncologists will recognize the impact and use the technique more readily.
“We want to look at the new application of these proven benefits of CEUS and apply them to the ovary,” says Wilson.
An innovative study underway
The study, supported by Calgary Health Foundation, will examine 200 women with pelvic masses. It aims to measure whether quantification of blood flow is different between benign and malignant tumours and see if the addition of CEUS can improve how the current system looks at and classifies ovarian lesions.
Wilson felt a study would have the most impact when it came to introducing gynecology oncology professionals to the benefits of CEUS — the ultimate goal of the project and a big reason for why Calgary Health Foundation decided to back the project. “The real benefit is if people recognize what this is, what we get from it, and then become familiar with it,” says Wilson. “Hopefully, doing our study will give everyone an impetus to take one giant step forward.”
Donate toward the contrast-enhanced ultrasound pilot project and other initiatives leading the way to better cancer detection.
