Review: Early Detection of Ovarian Cancer with Transvaginal Microbubble Sonography: Current and Potential Applications

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Abstract
Contrast Enhanced microbubble Transvaginal Sonography (CE-TVS) can distinguish benign and malignant ovarian tumors. Initial results from several medical centers around the world have indicated that there are unique enhancement patterns in ovarian neoplasms. Challenges to the implementation of CE-TVS remain since some
aggressive ovarian tumors (type 2) that arise in the tubal epithelium and metastasize without producing a clinically detectable mass may be difficult to detect. This is being addressed through the use of labelled microbubbles which
can detect rapidly growing tumor vessels. As shown in an avian model, labelled microbubbles can be used to detect neoplastic vessels associated with tumor neoangiogenesis. This has been achieved in vitro by fabrication of microbubbles that have antibody attached to the lipid coat. In this manner, microscopic tumors that arise in the tubal epithelium might be detected in patients. This short communication describes the potential for contrast enhanced sonography to provide a means for early detection of ovarian cancer.

Summary
Whether the addition of CE-TVS in screening/early detection
programs could further the long-term survival of screened women
awaits further investigation. With that said, CE-US is probably best
suited as a secondary test after a "liquid biopsy" and/or an initial
morphologic assessment of the lesion with standard morphologic TVS
identifies women at risk. The basis for optimism concerning the use of
CE-TVS for the early detection of ovarian cancer is substantiated and
this author encourages further multicenter investigation.