The Diagnostic Yield of Multiphasic CT in Ovarian Cancer Staging among Women of Different Socioeconomic Strata

Abstract

Objective: To determine the diagnostic yield of multiphasic computed tomography (CT) in ovarian cancer staging among women of different socioeconomic strata.

Methods: This descriptive cross-sectional study was conducted at the Department of Obstetrics and Gynecology, Shaukat Omar Memorial Hospital, Fauji Foundation, from 1^st April 2026 to 30 June 2026.

A total of 153 women with suspected ovarian malignancy were enrolled through consecutive non-probability sampling. Demographic, clinical, and socioeconomic data were recorded using a structured proforma. Participants were categorized into low-, middle-, and high-income socioeconomic strata based on monthly household income. All patients underwent multiphasic contrast-enhanced CT of the abdomen and pelvis, and radiological staging was compared with the final surgical and histopathological findings, which served as the reference standard. Data were analyzed using SPSS version 28. Associations were assessed using the Chi-square test and one-way ANOVA, with p≤0.05 considered statistically significant.

Results: The mean age of participants was 52.8 ± 11.6 years. Serous epithelial carcinoma was the most common histopathological subtype (68.6%), while Stage III was the predominant FIGO stage (43.1%). Overall, 64.0% of women presented with advanced-stage disease (Stages III–IV). Multiphasic CT demonstrated a sensitivity of 93.6%, specificity of 50.0%, positive predictive value of 95.7%, negative predictive value of 40.0%, and an overall diagnostic accuracy of 90.2%. Diagnostic accuracy was significantly higher among women in the high socioeconomic stratum (97.1%) compared with the middle (91.8%) and low (84.5%) socioeconomic strata (p=0.033).

Conclusion: Multiphasic CT demonstrated high diagnostic accuracy for preoperative ovarian cancer staging. Socioeconomic status was significantly associated with diagnostic performance, highlighting the need for equitable access to timely diagnostic imaging to optimize staging and treatment planning.