The Ontario eConsult Service is pleased to launch the Gynecology – Pelvic Mass Imaging provincial BASE™ managed specialty group

The Ontario eConsult Service is pleased to launch the Gynecology – Pelvic Mass Imaging provincial BASE™ managed specialty group. This specialty is available province-wide through the BASE™ managed specialty option and supports the management of pelvic masses found on imaging, especially pelvic ultrasounds. Pelvic masses include abnormalities found in the ovaries, fallopian tubes, adnexa and uterus.

Review of imaging patterns of practice reveal that far too many family physicians and gynecologists are repeating imaging or ordering unnecessary imaging such as MRI / CT scans which can delay timely surgical opinion and surgical management of pelvic masses including malignant disease. (Are too many imaging tests being performed in women with an adnexal mass? Kupets R, Fernandes K, Miroshnichenko G, Paszat L.J Obstet Gynaecol Can. 2013 Mar;35(3):246-251. doi: 10.1016/S1701-2163(15)30996-8.PMID: 23470112)

The primary objectives of this group are to :

Aid with the interpretation of the imaging findings focusing on a SINGLE imaging modality and determine next steps so that women with abnormal imaging findings are referred to the appropriate specialist or receive the next appropriate investigations. (eg: how to avoid ordering MRI’s and CT scans that are not required for referral to specialist)
To educate the family physician/ referring health care provider on evaluation of pelvic ultrasounds to determine if information provided is adequate and complete for interpretation. (eg: ORADS)
To educate the family physician/ referring health care provider on scenarios where tumor markers are appropriate and not appropriate. (e.g.: CA 125 are NOT recommended in premenopausal women and false positive can cause HARM)
To educate the family physician/ referring health care provider on how to interpret recommendations on imaging reports and to determine if these are most appropriate for the clinical scenario.