BACKGROUND: In addition to the diagnostic accuracy of imaging methods, patient-reported satisfaction with imaging methods is important. OBJECTIVE: To report a secondary outcome of the prospective international multicenter Imaging Study in Advanced ovArian Cancer (ISAAC Study), detailing patients' experience with abdomino-pelvic ultrasound, whole-body contrast-enhanced computed tomography (CT), and whole-body diffusion-weighted magnetic resonance imaging (WB-DWI/MRI) for pre-operative ovarian cancer work-up. METHODS: In total, 144 patients with suspected ovarian cancer at four institutions in two countries (Italy, Czech Republic) underwent ultrasound, CT, and WB-DWI/MRI for pre-operative work-up between January 2020 and November 2022. After having undergone all three examinations, the patients filled in a questionnaire evaluating their overall experience and experience in five domains: preparation before the examination, duration of examination, noise during the procedure, radiation load of CT, and surrounding space. Pain perception, examination-related patient-perceived unexpected, unpleasant, or dangerous events ('adverse events'), and preferred method were also noted. RESULTS: Ultrasound was the preferred method by 49% (70/144) of responders, followed by CT (38%, 55/144), and WB-DWI/MRI (13%, 19/144) (p<0.001). The poorest experience in all domains was reported for WB-DWI/MRI, which was also associated with the largest number of patients who reported adverse events (eg, dyspnea). Patients reported higher levels of pain during the ultrasound examination than during CT and WB-DWI/MRI (p<0.001): 78% (112/144) reported no pain or mild pain, 19% (27/144) moderate pain, and 3% (5/144) reported severe pain (pain score >7 of 10) during the ultrasound examination. We did not identify any factors related to patients' preferred method. CONCLUSION: Ultrasound was the imaging method preferred by most patients despite being associated with more pain during the examination in comparison with CT and WB-DWI/MRI. TRIAL REGISTRATION NUMBER: NCT03808792.

1st Faculty of Medicine Charles University Prague Czech Republic

Department of Clinical Sciences Malmö Lund University Lund Sweden

Department of Gynecologic Oncology Foundation IRCCS National Cancer Institute Milan Italy

Department of Gynecology Portuguese Institute of Oncology of Lisbon Francisco Gentil Lisboa Portugal

Department of Obstetrics and Gynaecology Skane University Hospital Malmo Sweden

Department of Radiology 1st Faculty of Medicine Charles University and General University Hospital Prague Czech Republic

Department of Radiology Fondazione IRCCS Istituto Nazionale dei Tumori Milan Italy

Dipartimento di Diagnostica per Immagini Radioterapia Oncologica ed Ematologia Fondazione Policlinico Universitario Agostino Gemelli IRCCS Rome Lazio Italy

Dipartimento Scienze della Salute della Donna del Bambino e di Sanità Pubblica Fondazione Policlinico Universitario Agostino Gemelli IRCCS Rome Lazio Italy

Dipartimento Scienze della Vita e Sanità Pubblica Università Cattolica del Sacro Cuore Rome Italy

Division of Radiology Istituto Europeo di Oncologia Milan Italy

Gynecologic Oncology Centre Department of Gynecology Obstetrics and Neonatology 1st Faculty of Medicine Charles University and General University Hospital Prague Prague Czech Republic

Masaryk University Institute of Biostatistics and Analyses Brno Czech Republic

Preventive Gynecology Unit Division of Gynaecology European Institute of Oncology Milan Italy

Preventive Gynecology Unit Division of Gynecology European Institute of Oncology Milan Italy

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NCT03808792