Abstract
Purpose
Because of the need for rapid, accurate clinical differentiation between malignant and benign ovarian masses, we investigated the diagnostic efficacy of the echo pattern classification used together with transvaginal ultrasound.
Methods
We classified, on the basis of six echo pattern types, transvaginal ultrasound images of 405 ovarian masses treated surgically between January 2011 and December 2012. We compared the resulting classifications to the postoperative histopathologic diagnoses and computed the diagnostic sensitivity and specificity of the echo pattern-based classification for malignancy.
Results
Our review yielded the following echo patterns: type I, n = 61; type II; n = 154; type III, n = 82; type IV, n = 61; type V, n = 34; and type VI, n = 13. Histopathologically, there were 75 borderline malignant/malignant tumors and 330 benign tumors. Diagnostic sensitivity was 80.0 % and specificity was 85.5 % when echo types I–III were categorized as benign and types IV–VI were categorized as malignant. Further, with respect to benign tumors: sensitivity and specificity for chocolate cysts were 85.5 and 88.4 %, respectively, and for dermoid cysts were 67.2 and 97.9 %, respectively.
Conclusions
With the echo pattern classification, ovarian masses can be diagnosed easily and accurately upon transvaginal ultrasound.
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References
Japan Society of Obstetrics and Gynecology. Guideline for Gynecological Practice in Japan 2014. Tokyo: Japan Society of Obstetrics and Gynecology; 2014 (in Japanese).
Jacobs I, Oram D, Fairbanks J, et al. A risk of malignancy index incorporating CA125, ultrasound and menopausal status for the accurate preoperative diagnosis of ovarian cancer. Br J Obstet Gynecol. 1990;97:922–9.
Timmerman D, Testa AC, Bourne T, et al. Simple ultrasound-based rules for the diagnosis of ovarian cancer. Ultrasound Obstet Gynecol. 2008;31:681–90.
Okai T. Terminology and Diagnostic Criteria Committee, Japan Society of Ultrasonics in Medicine. Echo pattern classification of ovarian tumors. J Med Ultrasonics. 2000;27:912–4.
Di Legge A, Testa AC, Ameye L, et al. Lesion size affects diagnostic performance of IOTA logistic regression models, IOTA simple rules and risk of malignancy index in discriminating between benign and malignant adnexal masses. Ultrasound Obstet Gynecol. 2012;40:345–54.
Kobayashi H, Yamada Y, Sado T, et al. A randomized study of screening for ovarian cancer: a multicenter study in Japan. Int J Gynecol Cancer. 2008;18:414–20.
Testa A, Kaijser J, Wynants L. Strategies to diagnose ovarian cancer: new evidence from phase 3 of the multicentere international IOTA study. Br J Cancer. 2014;111:680–8.
Timmerman D, Testa AC, Bourne T, 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;23:8794–801.
Ameye L, Timmerman D, Valentin L, et al. Clinically oriented three-step strategy for assessment of adnexal pathology. Ultrasound Obstet Gynecol. 2012;40:582–91.
Ferrazzi E, Lissoni A, Dordoni D, et al. Differentiation of small adnexal masses based on morphologic characteristics of transvaginal sonographic imaging. J Ultrasound Med. 2005;24:1467–73.
Reuss M, Kolton S, Tharakan T. Transvaginal ultrasonography in gynecologic office practice: assessment in 663 premenopausal women. Am J Obstet Gynecol. 1996;175:1189–94.
Timmerman D, Valentin L, Bourne TH, et al. Terms, definitions and measurements to describe the sonographic features of adnexal tumors: a consensus opinion from the International Ovarian Tumor Analysis (IOTA) Group. Ultrasound Obstet Gynecol. 2000;16:500–5.
Bayoğlu Tekin Y, Dede FS. What is the success of ultrasonography of benign adnexal mass? J Obstet Gynecol Res. 2014;40:473–8.
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Atsushi Tajima, Chikako Suzuki, Iwaho Kikuchi, Hanako Kasahara, Akari Koizumi, Michio Nojima, and Koyo Yoshida declare that they have no conflict of interest in association with this study.
Ethical considerations
Transvaginal ultrasound is currently widely used during gynecologic examinations in Japan. Our institution’s ethics committee granted approval for the study described herein and waived the requirement for written informed consent.
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Tajima, A., Suzuki, C., Kikuchi, I. et al. Efficacy of the echo pattern classification of ovarian tumors 2000 in conjunction with transvaginal ultrasonography for diagnosis of ovarian masses. J Med Ultrasonics 43, 249–255 (2016). https://doi.org/10.1007/s10396-015-0689-2
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DOI: https://doi.org/10.1007/s10396-015-0689-2