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Ultrasound differentiation between benign versus malignant adnexal masses in pregnant patients
, 123, 12, 4, 12
Affiliations- Gynaecology and Oncology Clinical Department, University Hospital, Cracow, Poland
- Chair of Gynecology and Obstetrics, Jagiellonian University Medical College, Cracow, Poland
- Centre of Postgraduate Medical Education, Warsaw, Poland
- District Sanitary Epidemiologic Station, Wieliczka, Poland
open access
Abstract
Objectives: The aim of this study was to assess the performance of the International Ovarian Tumor Analysis (IOTA) group ultrasound Simple Rules method in differentiating between benign and malignant ovarian tumors in pregnant patients.
Material and methods: A prospective observational study that involved pregnant patients referred to our center due to suspicions of ovarian masses between January 2015 and December 2017 was performed. The Simple Rules performance was evaluated against the histopathological results. Each of the 10 sonographic Simple Rules were computed by logistic regression to demonstrate their odds ratios in predicting malignancy.
Results: Ultrasound were conducted in 153 subjects, and 61 of those patients underwent surgery. By assigning masses presenting inconclusive picture as probably malignant, the Simple Rules method showed sensitivity of 91.67% and specificity of 69.39%. After exclusion of masses with inconclusive findings, the method showed sensitivity of 87.5% and specificity of 94.44%. The Simple Rules risk estimation method for the 1% risk cutoff showed sensitivity of 100% and specificity of 51.02%. For the 3% cutoff, sensitivity was 91.67% and specificity was 53.06%. And for 30 % cutoff, sensitivity was 91.67% and specificity 73.47 %. The logistic regression model showed that the M-rules increased the risk of malignancy while the B-rules decreased the risk.
Conclusions: Most ovarian masses in pregnant patients may be correctly categorized as benign or malignant using Simple Rules. This protocol may facilitate the management of pregnant patients presenting with adnexal masses.
Abstract
Objectives: The aim of this study was to assess the performance of the International Ovarian Tumor Analysis (IOTA) group ultrasound Simple Rules method in differentiating between benign and malignant ovarian tumors in pregnant patients.
Material and methods: A prospective observational study that involved pregnant patients referred to our center due to suspicions of ovarian masses between January 2015 and December 2017 was performed. The Simple Rules performance was evaluated against the histopathological results. Each of the 10 sonographic Simple Rules were computed by logistic regression to demonstrate their odds ratios in predicting malignancy.
Results: Ultrasound were conducted in 153 subjects, and 61 of those patients underwent surgery. By assigning masses presenting inconclusive picture as probably malignant, the Simple Rules method showed sensitivity of 91.67% and specificity of 69.39%. After exclusion of masses with inconclusive findings, the method showed sensitivity of 87.5% and specificity of 94.44%. The Simple Rules risk estimation method for the 1% risk cutoff showed sensitivity of 100% and specificity of 51.02%. For the 3% cutoff, sensitivity was 91.67% and specificity was 53.06%. And for 30 % cutoff, sensitivity was 91.67% and specificity 73.47 %. The logistic regression model showed that the M-rules increased the risk of malignancy while the B-rules decreased the risk.
Conclusions: Most ovarian masses in pregnant patients may be correctly categorized as benign or malignant using Simple Rules. This protocol may facilitate the management of pregnant patients presenting with adnexal masses.
Keywords
pregnancy; adnexal diseases; ovarian neoplasms; ultrasonography
About this articleTitle
Ultrasound differentiation between benign versus malignant adnexal masses in pregnant patients
Journal
Issue
Article type
Research paper
Pages
643-649
Published online
2021-10-13
Page views
4338
Article views/downloads
830
DOI
Pubmed
Bibliographic record
Ginekol Pol 2022;93(8):643-649.
Keywords
pregnancy
adnexal diseases
ovarian neoplasms
ultrasonography
Authors
Ewa Rabiej-Wronska
Marcin Wiechec
Kazimierz Pitynski
Ewa Wiercinska
Agnieszka Kotlarz
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