A pelvic ultrasound uses soundwaves to create a picture of your uterus and ovaries. The soundwaves echo when they meet something dense, such as an organ or tumour and a computer creates a picture from the echoes.

A technician called a sonographer does the scan. A pelvic ultrasound appointment usually takes 15–30 minutes.

A pelvic ultrasound can be done in 2 ways:

• Abdominal ultrasound – To get clear pictures of the uterus and ovaries, the bladder needs to be full, so you will be asked to drink water before the appointment. You will lie on an examination table while the sonographer moves a small handheld device called a transducer over your abdomen.
• Transvaginal ultrasound – The sonographer inserts a small transducer wand into your vagina. The wand will be covered with a disposable plastic cover and gel to make it easier to insert. You may find a transvaginal ultrasound uncomfortable, but it should not be painful. If you feel embarrassed or concerned about having this procedure, you can ask for a female sonographer or to have someone in the room with you (e.g. your partner, a friend or a relative).

The transvaginal ultrasound is often the preferred method of ultrasound because it provides a clearer picture of both the ovaries and uterus.

A CT (computerised tomography) scan uses x-rays to create a detailed picture of the inside of the body. A CT scan can be used to check your abdomen, chest and pelvic area, look for signs the cancer has spread, and assist in guiding the needle if doing a biopsy.

The CT scanner is a large, doughnut-shaped machine. You will lie on a table that moves in and out of the scanner. CT scans are usually done at a hospital or radiology clinic. You will be asked to fast (not eat or drink) before the scan.

You may need to have an injection of a special dye, called contrast, which makes your organs appear white in the pictures so anything unusual can be seen more clearly. A CT scan is noisy but painless.

The contrast will be injected into a vein. It may make you feel hot all over, have a sudden urge to pass urine, and leave a bitter taste in your mouth. These sensations usually pass quickly, but tell the person carrying out the scan if they don’t.

The scan takes about 10–20 minutes, but it may take extra time to prepare. You usually go home as soon as the CT scan is over.

An MRI (magnetic resonance imaging) scan uses a powerful magnet and radio waves to build up detailed pictures of the inside of your body.

While not used often to diagnose ovarian cancer, an MRI may help if it is difficult to tell from the ultrasound whether an ovarian tumour is likely to be cancerous. A contrast may also be used with an MRI.

If you have a pacemaker, let the medical team know before having an MRI. The magnet can interfere with some pacemakers.

During the scan, you will lie on a bench inside a large metal tube that is open at both ends. The noisy, narrow machine makes some people feel anxious or claustrophobic. If you think you may become distressed, mention it beforehand to your medical team.

The MRI scan may take between 30 and 90 minutes.

A PET (positron emission tomography) scan combined with a CT scan is a specialised imaging test. It provides more information about the cancer than a CT scan on its own. Only some people will have a PET–CT scan.

Medicare covers the cost only for ovarian cancer that has returned, so these scans are not often used to look for ovarian cancer in the first instance. If you are having chemotherapy before surgery, you may have this scan beforehand.

To prepare for a PET–CT scan, you will be asked to fast (not eat or drink) for a period of time. Before the scan, you will be injected with a glucose solution containing a small amount of radioactive material.

Cancer cells show up brighter on the scan because they take up more glucose than normal cells do. You will be asked to sit for 30–90 minutes as the glucose spreads through your body, then you will have the scan.

The scan itself will take about 30 minutes. Any radiation will leave your body within a few hours.

If ovarian cancer is found, the biopsy sample or the tissue removed during surgery will usually have more tests.

Called molecular tests, these look for gene changes (mutations) and other features in the cancer cells that may help predict the cancer’s response to targeted therapy.

These gene changes are similar to those passed through families, however, for some people with ovarian cancer, the fault is only in the cancer cells. Molecular testing is recommended in most cases if you have high-grade ovarian cancer.

These tests may include HRD testing. HRD stands for homologous recombination deficiency, which is a characteristic of some cancer cells that makes it harder for them to fix or repair damaged DNA.

Testing your samples for HRD can help work out if targeted therapy can be part of your treatment. Medicare subsidies are available for some testing. Your doctor or family cancer clinic will be able to provide more information.

Your treatment team will use the results of molecular testing to help them work out what treatment may work best for you, and what treatment may not be as effective.