Ultrasonographic prediction of benign versus malignant adnexal masses

January 01, 0001

Ultrasonographic prediction of benign versus malignant adnexal masses

These Eurpean researchers sought to determine the diagnostic performance of ultrasound to predict whether an adnexal mass is benign or malignant. They performed a prospective validation study. The rules utilized ultrasonic features (shape, size, solidity, and results of color Doppler examination) to determine if the mass was malignant or benign.

The researchers found: "Of the 1938 patients with an adnexal mass, 1396 (72%) had benign tumours, 373 (19.2%) had primary invasive tumours, 111 (5.7%) had borderline malignant tumours, and 58 (3%) had metastatic tumours in the ovary. The simple rules yielded a conclusive result in 1501 (77%) masses, for which they resulted in a sensitivity of 92% and a specificity of 96%. The corresponding sensitivity and specificity of subjective assessment were 91% and 96%. In the 357 masses for which the simple rules yielded an inconclusive result and with available results of CA-125 measurements, the sensitivities were 89% for subjective assessment, 50% for the risk of malignancy index, 89% for logistic regression model 1, and 82% for logistic regression model 2. The corresponding specificities were 78%, 84%, 44%, and 48%. Use of the simple rules as a triage test and subjective assessment for those masses for which the simple rules yielded an inconclusive result gave a sensitivity of 91% and a specificity of 93%, compared with a sensitivity of 90% and a specificity of 93% when subjective assessment was used in all masses."

The researchers concluded: "The use of the simple rules has the potential to improve the management of women with adnexal masses. In adnexal masses for which the rules yielded an inconclusive result, subjective assessment of ultrasonic findings by an experienced ultrasound examiner was the most accurate diagnostic test. The risk of malignancy index and the two regression models were not useful."

This study characterizes the predictive value of using ultrasound to determine if an adnexal mass is benign or malignant.

For the full abstract, click here.

BMJ 341:c6839, 14 December 2010 © 2010 BMJ Publishing Group Ltd.
Simple ultrasound rules to distinguish between benign and malignant adnexal masses before surgery: prospective validation by IOTA group. Dirk Timmerman, Lieveke Ameye, Daniela Fischerova, et al. Correspondence to D Timmerman: [email protected]

Category: X. Female Genital System, Breast. Keywords: adnexal mass, ultrasound, benign, malignant, prediction, prospective validation trial, journal watch.
Synopsis edited by Dr Paul Schaefer, Toledo, Ohio. Posted on Global Family Doctor 21 January 2011

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.

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