The Discrepancy between Preoperative Tumor Markers and Imaging Outcomes in Predicting Ovarian Malignancy

Abstract

Preoperative tumor markers and imaging often differ in predicting whether an ovarian tumor is malignant. Therefore, we evaluated the correlation between the predictive values of imaging and tumor markers for diagnosing ovarian tumors, especially when there were discrepancies between the two. We enrolled 1047 patients with ovarian tumors. The predictive values and concordance rates between the preoperative risk of ovarian malignancy algorithm (ROMA) and imaging, including CT and MRI, were evaluated. Diagnoses of 561 CT (77.9%) and 322 MRI group (69.2%) participants were consistent with the ROMA. Among them, 96.4% of the CT (541/561) and 92.5% of the MRI (298/322) group predicted an accurate diagnosis. In contrast, 67.3% (101/150) of CT and 75.2% (100/133) of MRI cases accurately predicted the diagnosis in cases with discrepancies between ROMA and CT or MRI; a total of 32% (48/150) of the CT and 25.5% (34/133) of the MRI group showed an accurate ROMA diagnosis in cases with discrepancies between ROMA and imaging. In the event of a discrepancy between ROMA and imaging when ovarian tumor malignancy prediction, the question is which method should take precedence. This study demonstrates that MRI has the greatest diagnostic accuracy, followed by CT and ROMA. It is also important to understand underlying diseases and benign conditions and rare histopathologies of malignant tumors.

An algorithm for the pre-operative differentiation of benign ovarian tumours based on magnetic resonance imaging interpretation in a regional core hospital: A retrospective study

“…When the possibility of a Bo/Ma-OT is detected, laparoscopic salpingo-oophorectomy may be selected to prevent the spread of tumour cells. Similar to previous studies [6] , [7] , [8] , [9] , this differentiation between Be-OTs and Bo/Ma-OTs is performed based on MRI interpretation at the study hospital. Over 8 years, data from > 1000 OT cases were accumulated and analysed to evaluate the algorithm for selecting the type of surgery.…”

“…Therefore, gynaecologists must perform a differential diagnosis between Bo/Ma-OTs and Be-OTs as accurately as possible before surgery. To ensure accurate classification of many types of ovarian tumours (OTs) at the same time, magnetic resonance imaging (MRI), considered one of the most reliable tools [6] , [7] , [8] , [9] , is usually performed after the OT is detected by transvaginal ultrasound (TVUS) in an outpatient examination. At the study hospital, which is a moderate-scale regional institution, differential diagnosis is performed on the basis of MRI results.…”