Taking ovarian cancer diagnosis to the next level: differential diagnosis of malignancy type, and added value of advanced data sources such as MRI, proteomics, circulating tumour DNA and circulating tumour cells

Excellent tools to predict whether a detected ovarian tumour is benign or malignant prior to surgery are pivotal for several reasons: (1) currently a minority of ovarian cancers is treated by experienced gynaecological oncologists, (2) the value of screening for ovarian cancer has not been established, and (3) ovarian cancer is largely asymptomatic in its early stages such that accurate diagnosis is paramount to optimize survival. The International Ovarian Tumour Analysis (IOTA) consortium has developed tools based on clinical and ultrasound information. However, it is time to take ovarian cancer diagnosis to the next level by fine-tuning existing tools on several grounds. Firstly, differential diagnosis of different classes of malignancy is clinically important for selecting the optimal treatment. Hence this project will focus on tools that predict whether a tumour is benign, borderline malignant, stage I cancer, advanced stage cancer, or secondary metastatic cancer. Secondly, this project will investigate the value of magnetic resonance imaging (MRI) as a second stage test, the added value of proteomics to differential diagnosis, and the role of circulating tumour DNA and circulating tumour cells for diagnosis. The ultimate potential of DNA and cell information may be to establish a procedure for a golden standard diagnosis for malignancy or malignancy type without the need for surgery.