Transvaginal ultrasonographic characterization of ovarian masses with an improved, weighted scoring system

Lerner, Jodi P.; Timor‐Tritsch, Ilan E.; Federman, Alex D.; Абрамович, Г. В.

doi:10.1016/s0002-9378(13)70284-9

Cited by 116 publications

(142 citation statements)

References 10 publications

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“…9,10 However, little attention has been paid to discrimination between primary and metastatic malignant ovarian tumors. We know of only 1 published study that addressed this question.…”

Section: Discussionmentioning

confidence: 99%

Transvaginal Gray Scale and Color Doppler Sonography in Primary Ovarian Cancer and Metastatic Tumors to the Ovary

Alcázar

Galán

Ceamanos

et al. 2003

Journal of Ultrasound in Medicine

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Objective. To compare gray scale and color Doppler features of primary and metastatic ovarian carcinomas. Methods. Clinical, sonographic (gray scale and color Doppler), and histopathologic data of 143 patients with primary (n = 127 adnexal masses) and metastatic (n = 34 adnexal masses) ovarian cancer were reviewed. Morphologic gray scale parameters assessed were bilaterality, tumor volume, echogenicity, and presence of septa, papillary projections, or solid areas. Color Doppler parameters were presence of blood flow, tumor blood flow location (central versus peripheral), subjective impression of blood flow amount (scanty, moderate, or abundant), lowest resistive index, lowest pulsatility index, and maximal peak systolic velocity (centimeters per second). Results. No statistical differences were found in bilaterality, tumor volume, presence of septa, papillary projections or solid areas, presence of blood flow, tumor blood flow location, subjective impression of blood flow amount, lowest resistive index, lowest pulsatility index, and maximal peak systolic velocity. Metastatic carcinomas were more frequently purely solid tumors (47% versus 26%; P = .001; likelihood ratio, 2.4; 95% confidence interval, 1.2-4.7). Conclusions. The presence of a purely solid tumor indicates a higher probability of metastatic carcinoma than primary ovarian cancer. However, with the use of gray scale and color Doppler sonography, it is difficult to differentiate primary ovarian carcinomas from metastatic tumors to the ovary. Key words: color Doppler sonography; metastatic cancer; ovarian cancer; sonography.Received September 20, 2002, hen an ovarian tumor is identified as questionable at sonographic examination, primary ovarian cancer should be the main concern. However, about 5% to 30% of malignant ovarian tumors are metastatic tumors to the ovary. 1 The preoperative distinction between primary ovarian cancers and metastatic lesions might be of clinical relevance, because surgery is of the utmost importance in the treatment of primary ovarian cancer, given that optimal cytoreduction and accurate surgical staging are 2 of the most important prognostic factors in this disease. 2,3 However, this surgical effort in metastatic cancers to the ovary might not be worthwhile. 4

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“…9,10 However, little attention has been paid to discrimination between primary and metastatic malignant ovarian tumors. We know of only 1 published study that addressed this question.…”

Section: Discussionmentioning

confidence: 99%

Transvaginal Gray Scale and Color Doppler Sonography in Primary Ovarian Cancer and Metastatic Tumors to the Ovary

Alcázar

Galán

Ceamanos

et al. 2003

Journal of Ultrasound in Medicine

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“…Several scoring systems based on ultrasound morphology of adnexal cysts have been proposed to differentiate benign lesions from malignant adnexal masses [8][9][10][11][12][13][14] (B). These scoring systems are based on specific parameters such as surface, thickness of the wall, and cyst echogenicity; cyst volume; presence, thickness and number of septa; presence, size and number of vegetation, and presence and size of solid areas within the cyst.…”

Section: Laboratory and Image Aspectsmentioning

confidence: 99%

“…All proposed scoring systems appear to exhibit an acceptable level of sensitivity and specificity, ranging from 83.5 to 92% and from 63 to 97%, respectively 8,[11][12][13][14] (B). The choice of the scoring system may, therefore, be based on the preference of the observer 4 (A).…”

Section: Laboratory and Image Aspectsmentioning

confidence: 99%

Clinical management of incidental findings on pelvic adnexal masses

Dias

Bueloni-Dias

Delmanto

et al. 2015

Rev. Assoc. Med. Bras.

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Summary Due to widespread use of pelvic and transvaginal ultrasound in routine gynecological evaluation, the incidental finding of adnexal masses has led to discussions about management in asymptomatic patients regarding the risk of ovarian cancer. Transvaginal ultrasonography remains the modality of choice in the evaluation of suspicious characteristics. The combined analysis of ultrasound morphological parameters with Doppler study, serum carcinona antigen 125 and investigation of a symptom index may improve diagnosis. Surgical approach should be considered whenever there are suspicious images, rapid growth of cysts, changes in the appearance compared to the initial evaluation or when the patient has symptoms. Future studies on genetic and molecular mechanisms may help explain the pathophysiology of ovarian cancer, improving early diagnosis and treatment.

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“…In studies where pattern recognition was compared to other ultrasound methods (Lerner score [111], risk of malignancy index [112], the Tailor risk calculation model [113], the Timmerman risk calculation model [114] and the mathematical risk calculation models designed in the International Ovarian Tumor Analysis (IOTA) study [115]), pattern recognition was superior to the other methods for distinguishing benign from malignant adnexal masses (Table 7) [115][116][117].…”

Section: Palpable Pelvic Massmentioning

confidence: 99%

“…However, whether this is indeed the case has not been studied. Some of the risk calculation models (the Timmerman model [114], the Tailor model [113]) and scoring systems (the Sassone score [118], the Lerner score [111], the De Priest score [119]) did not perform very well when they were tested prospectively [116,117,120,121].…”

Section: Palpable Pelvic Massmentioning

confidence: 99%

Imaging in gynecology

Valentin

2006

Best Practice & Research Clinical Obstetrics & Gynaecol

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This chapter summarizes the diagnostic performance (sensitivity, specificity, positive and negative likelihood ratios) of ultrasound, computer tomography, and magnetic resonance imaging in the diagnosis of various gynecological diseases and tumors. Positron emission tomography is not discussed. Imaging in infertility, in the diagnosis of Mullerian duct anomalies and in gynecological oncology (staging of gynecological cancers, diagnosis of recurrence of gynecological cancer, diagnosis of trophoblastic tumors) is not dealt with.Ultrasound is the first line imaging method for discrimination between viable intrauterine pregnancy, miscarriage and tubal pregnancy in women with bleeding and/or pain in early pregnancy, for discrimination between benign and malignant adnexal masses and for making a specific diagnosis in adnexal tumors (e.g., dermoid cyst, endometrioma, hemaorrhagic corpus luteum, ectetera), for diagnosing intracavitary uterine pathology in women with bleeding problems, and for confirming or refuting pelvic pathology in women with pelvic pain. Magnetic resonance imaging may have a role as a secondary test in the diagnosis of adenomyosis, 'deep endometriosis' (e.g., endometriosis in the rectovaginal septum or in the utero-sacral ligaments), and in the diagnosis of extremely rare types of ectopic pregnancy (e.g., in the spleen, liver or retroperitoneum).

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Transvaginal ultrasonographic characterization of ovarian masses with an improved, weighted scoring system

Cited by 116 publications

References 10 publications

Transvaginal Gray Scale and Color Doppler Sonography in Primary Ovarian Cancer and Metastatic Tumors to the Ovary

Transvaginal Gray Scale and Color Doppler Sonography in Primary Ovarian Cancer and Metastatic Tumors to the Ovary

Clinical management of incidental findings on pelvic adnexal masses

Imaging in gynecology

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