Ovarian cancer has a high mortality

and early diagnosis is the key to improve the survival rate. This article reviews and comments the ultrasound evaluation of malignant ovarian cancer and the research progress

including the International Ovarian Tumor Analysis (IOTA)

the value of contrast-enhanced ultrasound (CEUS) in differential diagnosis of ovarian tumors

the application of three-dimensional ultrasound

as well as the advance of targeted microbubbles (ultrasound contrast agents) in the diagnosis and treatment of ovarian cancer. IOTA is a research program with multiple centers and big samples. Both simple ultrasound-based rules (simple rules) and logistic regression model 2 (LR2) have shown excellent diagnostic accuracy

and are much better than the traditional modelrisk of malignancy index (RMI) when applied by examiners (non-experts) with limited clinical experiences. CEUS plays an important role in the differential diagnosis of annexal cystic-solid masses which are hard to be judged. The value of three-dimensional ultrasound in the diagnosis of ovarian cancer is limited. Microbubbles (ultrasound contrast agent) offers the possibility of early diagnosis of ovarian cancer by targeting the molecular ultrasound imaging; they can also carry therapeutic genes and drugs to the target site and release them

so as to improve the therapeutic effect. Targeted microbubbles maysignificantly improve the ability of ultrasound in early diagnosis of ovarian cancer in the future.