الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Ovarian cancer is a leading cause of cancer deaths and it’s frequency of diagnosis increases as age increases with most cases diagnosed at advanced stages. Upfront cytoreductive surgery followed by adjuvant chemotherapy is the treatment modality for advanced stage ovarian cancer (III, IV) with complete resection of all macroscopic tumour with no residual disease after surgery. Residual disease after surgery is an important prognostic factor which influences progression free and overall survivals. Both advanced ultrasound by expert gynecologist and computed tomography by expert radiologist have the ability to assess residual tumour in the pelvis and upper abdomen (suboptimal cytoreduction), to detect lesions equal to and more than 1cm but advanced ultrasound can detect small lesions (less than 1cm), computed tomography can’t differentiate between malignant residual and early post-operative oedema of tissues (benign condition) but advanced ultrasound has the ability to differentiate between benign and malignant lesions because it has features that are unique to it which are the direct visualization of vascularization of the tumour and the dynamic aspects of the examination. Comparison between surgery, computed tomography and advanced ultrasound regarding presence and absence of residual disease, it’s site and size. The surgeon reported at the end of the cytoreductive surgery that 26 cases(86.7%) reached R0 with no macroscopic residual tumour but couldn’t reach complete cytoreduction in only 4 cases(13.3%), regarding site of residual disease left; there was one case (25%) in the splenic hilum, one case(25%) in the right copula of diaphragm and two cases(50%) in the rectosigmoid colon, regarding size of residual disease; there were two cases(50%) with residual disease equal to 1cm and two cases(50%) with residual disease more than 1cm. The expert radiologist reported that after cytoreductive surgery by one month; 24 cases(80%) were free of lesion and lesion was present in only 6 cases(20%), regarding site of lesion; one case(16.7%) in the splenic hilum, one case(16.7%) in the left copula of diaphragm, two cases(33.3%) in the right copula of diaphragm and two cases(33.3%) in the rectosigmoid colon, regarding size of lesion; there were two cases(33.3%) with lesion equal to 1cm and four cases(66.7%) with lesion more than 1cm. The ultrasound expert reported that after cytoreductive surgery by one month; 22 cases(73.3%) were free of lesion and lesion was present in 8 cases(26.7%), regarding site of lesion; one case(12.5%) in the upper ileum, one case (12.5%) in the lower ileum, one case (12.5%) in the splenic hilum, one case (12.5%) in the left copula of diaphragm, two cases (25%) in the right copula of diaphragm and two cases (25%) in the rectosigmoid colon, regarding size of lesion; there were two cases (25%) with lesion less than 1cm, two cases (25%) with lesion equal to 1cm and four cases (50%) with lesion more than 1cm but by assessment of vascularity and echogenicity there were 2 cases (25%) from these 8 cases with vascularity score 1 and hyperechogenicity indicating that the two lesions detected by computed tomography as malignant residual were benign lesions most probably early postoperative tissue oedema. Previously published studies, from different parts of the world agree with our findings. This strongly indicates that ultrasound has a dynamic and functional features. So it’s recommended to use advanced ultrasound as it’s an easy, non invasive, inexpensive with no risk of radiation.