EVALUATION OF TUMOR EXTENT AND LYMPH NODE INVOLVEMENT IN OVARIAN CANCER USING COMPUTED TOMOGRAPHY AND MAGNETIC RESONANCE IMAGING: A SYSTEMATIC REVIEW

Abstract

Introduction: Ovarian cancer has high mortality, mainly due to frequent diagnosis at advanced stages, when dissemination to the peritoneum, adjacent structures, and lymph nodes is common. Accurate assessment of tumor extent is essential for therapeutic and surgical planning. Objective: To evaluate the role of computed tomography (CT) and magnetic resonance imaging (MRI) in identifying ovarian cancer extension, adjacent structure involvement, and lymph node metastases. Methods: This systematic literature review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. Searches were performed in PubMed, Embase, Scopus, and the Virtual Health Library using descriptors related to ovarian cancer, CT, MRI, tumor extension, invasion, and lymph node metastases. Studies evaluating the performance of imaging methods in characterizing disease extent and surgical planning were included. Results: Fourteen studies were included. CT demonstrated usefulness in assessing advanced disease and peritoneal extension, although limitations were observed in detecting small implants and accurately determining resectability. MRI provided complementary information, particularly for peritoneal and lymph node assessment. Radiomics, nomograms, classification systems, and artificial intelligence showed potential to improve prediction of residual disease and lymph node metastases. Conclusion: CT and MRI are important tools for preoperative planning in ovarian cancer, particularly when combined with quantitative strategies and clinical information. However, imaging findings should be integrated with surgical assessment.