Comparison of Sonography and CT-Scan in Differentiation of Benign and Malignance Ovarian Tumors

Document Type : Original Article

Authors

1 Associate Professor, Department of Obstetrics and Gynecology, School of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran.

2 Resident of Obstetrics and Gynecology, School of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran.

3 Assistant Professor, Department of Community Medicine, School of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran.

Abstract

Introduction: The early diagnosis of malignant ovarian cancer and well-timed intervention can lead to improve patient survival. A non-invasive test such as CT scan or sonography can help in distinguishing benign from malignant masses and consequently they can be used as a criterion for patient selection for surgery. This study was designed and implemented to assess the findings of CT scan and sonography in differentiating benign and malignant ovarian masses.
Methods: In this cross sectional study 87 patients with ovarian masses who had undergone surgery and pathologic tests were assessed during 2010 and 2011. The results of sonography and CT scan were reviewed. Odds ratio, sensitivity, specificity, positive predictive value and negative predictive value for the various indices of sonography and CT scan in differentiating malignant tumors from benign masses were calculated. Data were analyzed using SPSS software version 11.5.
Results: The Sensitivity, specificity, positive and negative predictive value, accuracy and odd ratio of sonography for the differentiation of malignant from benign masses were calculated 71.4%, 58.9%, 25%, 91.5%, 60.9% and 3.58 respectively (95% CI; 12.5-1.3). Concerning CT scan these indexes were calculated as 78.6%, 79.4%, 42.3%, 95.1%, 79.3% and 14.2, respectively (95% CI; 57.3-3.5). Tumor > 5 cm before menopause or tumor with any size after menopause had 92.8% sensitivity in sonography and 100% in CT scan. Tumor with multi-cavity presentation had 95.9% specificity in sonography and 100% in CT scan
Conclusion: CT scan is more effective than sonography in differentiating malignant from benign tumors. 

Keywords

References

  1. Jemal A, Siegel R, Ward E, Murray T, Xu J, Smigal C, et al. Cancer statistics. CA Cancer J Clin 2006 MarApr;56(2):106-30.
  2. Varras M. Benefits and limitations of ultrasonographic evaluation of uterine adnexal lesions in early detection of ovarian cancer. Clin Exp Obstet Gynecol 2004;31(2):85-98.
  3. Wingo SN, Knowles LM, Carrick KS, Miller DS, Schorge JO. Retrospective cohort study of surgical staging for ovarian low malignant potential tumors. Am J Obstet Gynecol 2006 May;194(5):e20-2.
  4. Marret H. [Doppler ultrasonography in the diagnosis of ovarian cysts: indications, pertinence and diagnostic criteria] [Article in French]. J Gynecol Obstet Biol Reprod (Paris) 2001 Nov;30(1 Suool):S20-33.
  5. Kurtz AB, Tsimikas JV, Tempany CM, Hamper UM, Arger PH, Bree RL, et al. Diagnosis and staging of ovarian cancer: comparative values of Doppler and conventional US ,CT, and MR imaging correlated with surgery and histopathologic analysis--report of the Radiology Diagnostic Oncology Group. Radiology 1999 Jul;212:19-27.
  6. Burges A, Schmalfeldt B. Ovarian cancer: diagnosis and treatment. Dtsch Arztebl Int 2011 Sep;108(38):635-41.
  7. Kurman RJ, Visvanathan K, Roden R, Wu TC, Shih Ie M. Early detection and treatment of ovarian cancer:

shifting from early stage to minimal volume of disease based on a new model of carcinogenesis. Am J Obstet Gynecol 2008 Apr;198(4):351-6.

  1. Teneriello MG, Park RC. Early detection of ovarian cancer. CA Cancer J Clin 1995 Mar-Apr;45(2):71-87.
  2. Stany MP, Maxwell GL, Rose GS. Clinical decision making using ovarian cancer risk assessment. AJR Am J Roentgenol 2010 Feb;194(2):337-42.
  3. Ghaemmaghami F, Fakour F, Karimi Zarchi M, Behtash N, Modares Gilani M, Mousavi A, et al. Clinical assessment, gross examination, frozen section of ovarian masses: do patients benefit? Arch Gynecol Obstet 2008 Sep;278(3):209-13.
  4. Givens V, Mitchell GE, Harraway-Smith C, Reddy A, Maness DL. Diagnosis and management of adnexal masses. Am Fam Physician 2009 Oct;80(8):815-20.
  5. Le T, Giede C, Salem S, Lefebvre G, Rosen B, Bentley J, et al. Initial evaluation and referral guidelines for management of pelvic/ovarian masses. J Obstet Gynaecol Can 2009 Jul;31(7):668-80.
  6. Wakahara F, Kikkawa F, Nawa A, Tamakoshi K, Ino K, Maeda O, et al. Diagnostic efficacy of tumor markers, sonography, and intraoperative frozen section for ovarian tumors. Gynecol Obstet Invest 2001;52(3):147-52.
  7. Salem S, White LM, Lai J. Doppler sonography of adnexal masses: the predictive value of the pulsatility index in benign and malignant disease. AJR Am J Roentgenol 1994 Nov;163(5):1147-50.
  8. Yazbek J, Aslam N, Tailor A, Hillaby K, Raju KS, Jurkovic D. A comparative study of the risk of malignancy index and the ovarian crescent sign for the diagnosis of invasive ovarian cancer. Ultrasound Obstet Gynecol 2006 Sep;28(3):320-4.
  9. Timmerman D, Testa AC, Bourne T, Ferrazzi E, Ameye L, Konstantinovic ML, et al. Logistic regression model to distinguish between the benign and malignant adnexal mass before surgery: a multicenter study by the International Ovarian Tumor Analysis Group. J Clin Oncol 2005 Dec 1;23(34):8794-801.
  10. Kashanian M, Kamalian N, Afsharpad K. [Frequency and age distribution of ovarian tumors in Shariati Hospital over a 20-year period] [Article in Persian]. Razi J Med Sci 2005 Mar;11(44):1021-8.
  11. Yousefi Z, Ayati S, Homaey F, Shakery MT. [Determining the prevalence, risk factors and management of borderline ovarian tumors] [Article in Persian]. Med J Reprod Infertil 2007;8(1):38-44.
  12. Cass I, Karlan B.Y. Ovarian and Tubal Cancer. In: Gibbs R.S, Karlan B.Y, Haney A.F, Nygaard I. Danforth's Obstetrics and Gynecology. 10th Philadelphia: Lippincott Williams & Wilkins (LWW); 2008: 1022-1060.
  13. Guerriero S, Alcazar JL, Coccia ME, Ajossa S, Scarselli G, Boi M, et al. Complex pelvic mass as a target of evaluation of vessel distribution by color Doppler sonography for the diagnosis of adnexal malignancies: results of a multicenter European study. J Ultrasound Med 2002 Oct;21(10):1105-11.
  14. Schorge JO, Schaffer JI, Halvorson LM, Hoffman BL ,Bradshow KD, Cunningham FG. Williams gynecology. New York: McGraw-Hill;2008.
  15. Marret H, Ecochard R, Giraudeau B, Golfier F, Raudrant D, Lansac J. Color Doppler energy prediction of malignancy in adnexal masses using logistic regression models. Ultrasound Obstet Gynecol 2002 Dec;20(6):597-604.
  16. Levine D, Feldstein VA, Babcook CJ, Filly RA. Sonography of ovarian masses: poor sensitivity of resistive index for identifying malignant lesions. AJR Am J Roentgenol 1994 Jun;162(6):1355-9.
  17. Moyle JW, Rochester D, Sider L, Shrock K, Krause P. Sonography of ovarian tumors: predictability of tumor type. AJR Am J Roentgenol 1983 Nov;141(5):985-91.

Files

Share

How to cite

Statistics