scholarly journals DIAGNOSTIC ROLE OF COMPRESSION SONOELASTOGRAPHY IN MULTIPARAMETRIC ULTRASOUND INVESTIGATION IN THE DETECTION OF BENIGN OVARIAN FORMATION

2021 ◽  
pp. 82-89
Author(s):  
I. D. Stasiv ◽  
V. M. Ryzyk
Keyword(s):  
Blood Flow ◽  
Ultrasound Examination ◽  
Mature Teratoma ◽  
Mucinous Cystadenoma ◽  
Ovarian Tumors ◽  
Qualitative Assessment ◽  
Ca 125 ◽  
Risk Of Malignancy ◽  
Benign Ovarian Tumors ◽  
Multiparametric Ultrasound

Properly diagnosed benign ovarian tumors are a condition for optimal treatment tactics. Qualitative assessment of signs detected by multiparametric ultrasound, including compression elastography, is highly effective in the differential diagnosis of benign ovarian tumors. Our study became especially relevant for women in the reproductive period, because the correct diagnosis influenced the choice of surgical treatment in order to preserve the ovarian reserve. A comprehensive radiological study of 51 women with benign ovarian tumors was performed. The age of patients averaged 37.3 ± 8.7 years. In the structure of benign ovarian tumors, the frequency of serous cystadenoma was 31.38%, serous superficial papillomas - 25.49%, mucinous cystadenoma - 17.65%, mature teratomas - 15.68%, fibroma - 9.8%. Ultrasound was performed on a HITACHI ALOCA ARIETTA 70 using a cavitary multifrequency sensor with a frequency of 7.5-10 mHz and a sector sensor with a frequency of 2-5 mHz. The article analyzes the detailed sonographic picture of these formations in B-mode, Doppler mode and compression sonoelastography mode. Color and energy Doppler mapping techniques, as well as pulsed Doppler mode, which gave a quantitative characterization of blood flow, were used to study blood vessels. Vessel localization was determined using color Doppler mapping, and detailed qualitative assessment of blood flow loci was determined using energy Doppler. For all types of benign ovarian formations, a qualitative feature was determined - elastotype on the Ueno scale and stiffness index - Strain Ratio (coefficient of deformation) - a quantitative indicator. It was found that serous and mucinous cystadenomas belong to 0 and I elastotype on the Ueno scale, the papillary component of serous superficial papillomas was mapped with I and II elastotype, fibroids mainly belonged to II and III elastotype, and mature teratomas - to IV end V elastotype. Quantitative deformation rate for all benign ovarian tumors ranged from 0,63 to 24,9. Thus, the cardiac index of stiffness in serous cystadenomas was 0.92 ± 0.46, and in mature teratomas - 16.7 ± 8.4. The increased density of the latter in comparison with other representatives of benign formations can be explained by the presence in their structure of such elements as fibroblasts, bundles of spindle-shaped cells and bundles of collagen fibers (fibroids), bone and cartilage (mature teratoma). In addition to all the above research methods, the mobile application IOTA ADNEX 2014 was used, which helped to calculate the risk of malignancy. This is a simple calculator, which loads the data of the ultrasound examination, the patient's age, the level of CA-125. Our results showed that ultrasound examination of ovarian tumors is an accurate and highly informative method for stratification of risks according to the O-RADS classification. For stratification and the ultrasound risk management system, the O-RADS system was guided by consensus guidance from the American College of Radiology, which reduces or eliminates ambiguity in the interpretation of data in ultrasound protocols and provides a more accurate definition of ovarian malignancy. The O-RADS working group includes 5 categories: O-RADS 0 - incomplete examination score, O-RADS 1 - normal unchanged premenopausal ovary, O-RADS 2 - almost always benign (risk of malignancy - <1%), O-RADS 3 - the presence of education with a low level of malignancy - from 1 to 10%, O-RADS 4 - medium risk of malignancy - from 10 to 50% and O-RADS 5 - education with a high level of malignancy -> 50%.

scholarly journals The Use of Compression Sonoelastography in Multiparametric Ultrasound Examination in Cases of Benign Ovarian Formations

2021 ◽  
Vol 11 (10) ◽  
pp. 229-241
Author(s):  
Iryna Stasiv
Keyword(s):  
Blood Flow ◽  
Ultrasound Examination ◽  
Mature Teratoma ◽  
Power Doppler ◽  
Qualitative Assessment ◽  
Flow Mapping ◽  
Color Flow ◽  
Color Flow Mapping ◽  
Pulsed Wave Doppler ◽  
Multiparametric Ultrasound

Properly diagnosed benign ovarian formations are a condition for appropriate treatment choice. Qualitative assessment of signs detected by multiparametric ultrasound, including compression elastography, is highly effective in the differential diagnosis of benign ovarian formations. Our study became especially relevant for women in the reproductive period since the correct diagnosis influenced the choice of surgical treatment in order to preserve the ovarian reserve. The detailed sonographic aspect of these formations in B-mode, Doppler mode and compression sonoelastography mode is analyzed in the article. Color Flow Mapping, power Doppler and pulsed wave Doppler were used to study blood vessels. Pulsed wave Doppler characterized blood flow quantitatively. Color Flow Mapping was used to determine vessels localization, and power Doppler was used to provide a detailed qualitative assessment of blood flow loci. Elastotype according to the Ueno scale as a qualitative feature and Strain Ratio (coefficient of deformation) as a quantitative indicator were determined for all types of benign ovarian formations. Serous and mucinous cystadenomas were found to belong to elastotypes 0 and I according to the Ueno scale, the papillary component of serous superficial papillomas was mapped as elastotype I and II, fibroids predominantly belonged to elastotype II and III, mature teratoma appertained to elastotypes IV and V. Quantitative coefficient of deformation for all benign ovarian formations ranged from 0.63 to 24.9. According to our results, ultrasound examination of ovarian formations is an accurate and highly informative method for stratification of risks in accordance with the O-RADS classification.

scholarly journals Diagnostic extended usefulness of RMI: comparison of four risk of malignancy index in preoperative differentiation of borderline ovarian tumors and benign ovarian tumors

2019 ◽  
Vol 12 (1) ◽  
Author(s):  
Shuang Zhang ◽  
Shan Yu ◽  
Wenying Hou ◽  
Xiaoying Li ◽  
Chunping Ning ◽  
...  
Keyword(s):  
Ovarian Tumor ◽  
Menopausal Status ◽  
Area Under The Curve ◽  
Ovarian Tumors ◽  
Borderline Ovarian Tumor ◽  
Cancer Antigen 125 ◽  
Borderline Ovarian Tumors ◽  
Risk Of Malignancy ◽  
Risk Of Malignancy Index ◽  
Benign Ovarian Tumors

Abstract Background This study aimed to examine the performance of the four risk of malignancy index (RMI) in discriminating borderline ovarian tumors (BOTs) and benign ovarian masses in daily clinical practice. Methods A total of 162 women with BOTs and 379 women with benign ovarian tumors diagnosed at the Second Affiliated Hospital of Harbin Medical University from January 2012 to December 2016 were enrolled in this retrospective study. Also, we classified these patients into serous borderline ovarian tumor (SBOT) and mucinous borderline ovarian tumor (MBOT) subgroup. Preoperative ultrasound findings, cancer antigen 125 (CA125) and menopausal status were reviewed. The area under the curve (AUC) of receiver operator characteristic curves (ROC) and performance indices of RMI I, RMI II, RMI III and RMI IV were calculated and compared for discrimination between benign ovarian tumors and BOTs. Results RMI I had the highest AUC (0.825, 95% CI: 0.790–0.856) among the four RMIs in BOTs group. Similar results were found in SBOT (0.839, 95% CI: 0.804–0.871) and MBOT (0.791, 95% CI: 0.749–0.829) subgroups. RMI I had the highest specificity among the BOTs group (87.6, 95% CI: 83.9–90.7%), SBOT (87.6, 95% CI: 83.9–90.7%) and MBOT group (87.6, 95% CI: 83.9–90.7%). RMI II scored the highest overall in terms of sensitivity among the BOTs group (69.75, 95% CI: 62.1–76.7%), SBOT (74.34, 95% CI: 65.3–82.1%) and MBOT (59.18, 95% CI: 44.2–73.0%) group. Conclusion Compared to other RMIs, RMI I was the best-performed method for differentiation of BOTs from benign ovarian tumors. At the same time, RMI I also performed best in the discrimination SBOT from benign ovarian tumors.

scholarly journals Clinical-morphological features of malignant ovarian tumors in children in the Republic of Tajikistan

2021 ◽  
pp. 72-77
Author(s):  
M. N. Umarova ◽  
S. G. Umarzoda ◽  
Z. B. Akhmedova
Keyword(s):  
Comparative Analysis ◽  
Ultrasound Examination ◽  
Clinical Laboratory ◽  
Morphological Features ◽  
Ovarian Tumors ◽  
Ca 125 ◽  
Special Treatment ◽  
Scientific Center ◽  
Histological Variants ◽  
The Republic

Aim. The study of anamnestic and clinical-morphological features of the malignant ovarian tumors (MOT) course in children.Material and methods. Clinical and anamnestic features of 47 cases of MOT in children who received special treatment in the Department of pediatric oncology of the SI “Republican Oncological Scientific Center” for 2005- 2018 were compared. To identify clinical morphological features patients were divided into two groups according to histotypes “teratoblastoma” (17 patients) and “dysgerminoma” (25 patients). The study used anamnestic, physical, clinical-laboratory, sonography, morphological, statistical methods.Results and discussion. As a result of the study, it was found that the main complaints at admission were pain and palpable formation in the abdomen, which had dimensions of up to 10 cm in 19 (40.4%) cases, and in 28 (59.6%) cases - more than 10 cm. Ultrasound examination revealed a tumor-like formation of a heterogeneous/cystic structure, with dense walls, multiple chambers, with inclusions, tuberous, reaching significant sizes of 40-400 mm. The average values of the AFP onco-marker were 155 U/ml, Ca-125 - 87 U/ml, which exceeded the reference values. Dysgerminoma was found in more than half of cases - 25 (53.2%). There were no statistically significant differences in clinical and anamnestic measures between the different histological variants.Conclusion. Comparative analysis of peculiarities of the clinical-morphological course of MOT in children depending on histological type showed no statistically significant differences.

scholarly journals Risk of malignancy index in ovarian tumour for predicting ovarian malignancy by using Jacob’s score

2017 ◽  
Vol 6 (4) ◽  
pp. 1318
Author(s):  
Rao P. S. ◽  
Bala Reenu ◽  
S. Prajwal
Keyword(s):  
Predictive Value ◽  
Case Fatality ◽  
Ovarian Tumors ◽  
Ca 125 ◽  
Ovarian Malignancy ◽  
Gynecological Malignancy ◽  
Menopausal Women ◽  
Risk Of Malignancy ◽  
Risk Of Malignancy Index ◽  
Post Menopausal

Background: Ovarian malignancy is the most common gynecological malignancy after the cancer of the cervix. A woman's risk at birth of ovarian cancer at some time in her life is 1 % to 1.5% and that of dying from cancer is almost 0.5 %. The most commonly occurring ovarian tumors are of epithelial in origin. It has the highest case-fatality ratio of all gynecological malignancies. Hence the early diagnosis is the most important factor for better prognosis. A clinical evaluation of the patient, followed by ultrasonography and CA-125 is helpful. This study aims to determine the role of Risk of Malignancy Index (Jacob’s RMI) in ovarian tumors for prediction of ovarian malignancy.Methods: This is a prospective cohort study. The present study was carried out at department of OBG, in collaboration with the Departments of Radio diagnosis and Pathology, AHRR, New Delhi. 100 patients meeting the inclusion and exclusion criteria were considered. Detailed clinical history, examination and ultrasonography (Abdomen and pelvis) were done. Estimation of CA125 was done thereafter. Calculated JACOBS RMI score was compared with operative surgical staging and histopathological-cytological examination of the specimen. Data obtained thereafter was analysed using appropriate and relevant statistical software.Results: In present study sensitivity of RMI Score in the pre-menopausal women was 66.7% and in post-menopausal women was 83.3%. Specificity of RMI Score in the pre-menopausal women was 96.3% and in post-menopausal women was 81.8%. The positive predictive value in the pre-menopausal women was 40% and in post-menopausal women was 71.4%. The negative predictive value in the pre-menopausal women was 98.7% and in post-menopausal women was 90%. Diagnostic accuracy in a case of premenopausal women was is 95.2% and 82.4% for postmenopausal women.Conclusions: The present study shows that RMI Score helps in identifying effectively those patients who require Staging Laparotomy and hence referral to Gynecologist Oncologist. Patients with ovarian masses with low risk of malignancy index can be treated by minimal access procedures.

Peritoneal Fluid Cytokines and the Differential Diagnosis of Benign and Malignant Ovarian Tumors and Residual/Recurrent Disease Examination

2007 ◽  
Vol 22 (3) ◽  
pp. 172-180 ◽  
Author(s):  
M. Chechlinska ◽  
J. Kaminska ◽  
J. Markowska ◽  
A. Kramar ◽  
J. Steffen
Keyword(s):  
Ovarian Cancer ◽  
Differential Diagnosis ◽  
Cancer Patients ◽  
Peritoneal Fluid ◽  
Recurrent Disease ◽  
Ovarian Tumors ◽  
Therapy Outcome ◽  
Ca 125 ◽  
Benign Ovarian Tumors ◽  
Local Cytokine

This study aimed to assess the potential value of peritoneal fluid cytokine examination for the differential diagnosis of ovarian tumors and for evaluating residual or recurrent disease after treatment. The cytokines that are commonly elevated in ovarian cancer, VEGF, IL-6, bFGF, IL-8 and M-CSF, and a reference ovarian tumor marker, CA 125, were measured in peritoneal fluids of 53 previously untreated patients with epithelial ovarian cancer, 18 ovarian cancer patients after surgical treatment and chemotherapy, and 17 patients with benign epithelial ovarian tumors. Non-parametric statistical analysis of data was performed. Ovarian cancer peritoneal fluids, as compared to peritoneal fluids of patients with benign ovarian tumors, contained significantly higher concentrations of IL-6, VEGF and CA 125, and significantly lower concentrations of bFGF and M-CSF, but only the levels of IL-6 and VEGF were significantly higher in peritoneal fluids of stage I and II ovarian cancer patients than of patients with benign ovarian conditions. IL-6 at the cutoff level of 400 pg/mL discriminated benign and malignant ovarian tumors with 92% sensitivity and 60% specificity, while VEGF at the cutoff of 400 pg/mL had 90% sensitivity and 80% specificity. At the cutoff level of 1200 pg/mL, IL-6 had 84% sensitivity and 87% specificity. A radical decrease in local cytokine and CA 125 levels in patients after treatment was independent of therapy outcome. IL-6 and VEGF measurements in peritoneal fluids might be useful for the differential diagnosis of malignant and benign ovarian conditions, but not for residual or recurrent disease examination.

scholarly journals Diagnostic Accuracy and Appropriate Cut Off Value of Risk of Malignancy Index in Preoperative Discrimination Between Malignant and Benign Ovarian Tumors: Prospective Cross-sectional Study

2021 ◽  
Author(s):  
bezza Kedida Dabi ◽  
Fanta Asefa Disasa ◽  
Ayantu Kebede Olika
Keyword(s):  
Diagnostic Accuracy ◽  
Menopausal Status ◽  
Cross Sectional Study ◽  
Ovarian Tumors ◽  
Ca 125 ◽  
Benign Tumors ◽  
Cross Sectional ◽  
Malignant Ovarian Tumor ◽  
Ultrasound Score ◽  
Benign Ovarian Tumors

Abstract BackgroundRisk of malignancy index (RMI) is scoring system which was introduced to differentiate between benign and malignant ovarian tumor. It incorporates CA-125, ultrasound score and menopausal status for prediction of ovarian malignancies in preoperative period. There is no universal screening method to discriminate between benign and malignant adnexal masses yet. So, this study was conducted to determine the diagnostic accuracy of RMI and determine best cut off value for RMI.MethodsProspective cross-sectional study was carried out among women with ovarian mass admitted to Gynecology ward and operated from September 1, 2019 to June 30, 2020.Data analysis was carried out using SPSS version 26. CA-125 level, menopausal status and ultrasound score were used to calculate RMI. Finally, RMI score was compared to histopathology result used as gold standard.ResultsNinity nine patients were enrolled in this study. Prevalence of benign ovarian tumors were 61.6% (61/99) and that of malignant ovarian tumors were 38.4% (38/99). The mean age for benign tumors was 30±9yrs and the mean age for malignant tumors was 50.6±10.8yrs. Among benign tumors, serous cystadenoma was the most common (36%), followed by dermoid cyst (32.9%), mucinous cyst adenoma (14.8%). The most common malignant ovarian tumor was serous cyst adenocarcinoma (63.2%), followed by mucinous cystadenocarcinoma (23.8%) and dysgerminoma (5.3%). Overall, using RMI score cut off value 220 has good sensitivity (84.2%), specificity (77%), PPV (69.5%), NPV (88.7%) and diagnostic accuracy (79.8%) for discriminating between benign and malignant ovarian tumors.ConclusionFrom this study there were high proportion of women with RMI>=220 in malignant ovarian tumors group. The study shows that there is significant role of RMI in prediction of ovarian malignancy thus helping in deciding which patients need referral to a center where gynecologic oncologists are available. It is good practice to use it in developing countries including our country because of its simplicity, safety and applicability in initial evaluations of patients with adnexal mass.

scholarly journals Risk of Malignancy Index Has a Poor Sensitivity in Detecting Borderline Epithelal Tumors and Non-Epithelial Ovarian Tumors

2019 ◽  
pp. 1
Author(s):  
Yasin Durmus ◽  
Mehmet Mutlu Meydanli
Keyword(s):  
Predictive Value ◽  
Ovarian Tumors ◽  
Ca 125 ◽  
Histopathological Diagnosis ◽  
Adnexal Masses ◽  
Epithelial Tumors ◽  
Ovarian Cancers ◽  
Risk Of Malignancy ◽  
Risk Of Malignancy Index ◽  
The Difference

<p><strong>Objectives:</strong> To evaluate diagnostic accuracy of "Risk Of Malignancy İndex-1" (RMI-1) for postmenopausal adnexal masses.</p><p><strong>Study Design:</strong> Fifty postmenopausal women who had undergone surgery because of adnexal masses were included in this prospective study. RMI-1 scores were calculated through the formula: [RMI= Ultrasound Score x Menopause Score x Serum Ca-125 Level] and noted preoperatively by the same sonographer for each case. "Final histopathological diagnosis" was accepted as gold standard for benign-malignant categorical distribution. Borderline tumors were categorized in malignant tumor group.<br /><strong></strong></p><p><strong>Results:</strong> According to final histopathological results; 20 of the 50 patients had malignant adnexal masses. Twelve of them had invasive epithelial tumors. The remaining 8 patients had borderline epithelial tumors or non-epithelial ovarian cancers. When the RMI score ≥200 was accepted as a positive test result compatible with the literature; we calculated the sensitivity: 75%, specificity: 93%, positive predictive value: 88%, negative predictive value: 85% predicting malignant adnexal masses. All of the 12 patients with invasive epithelial tumors had RMI-1 scores higher than 200. Nevertheless, only 3 of the 8 patients with borderline epithelial tumors or non-epithelial ovarian cancers had RMI-1 scores higher than 200. We have found out that invasive epithelial tumors had higher USG Scores, Ca-125 Levels and RMI Scores when compared to borderline epithelial tumors and non-epithelial ovarian cancers and the difference was statistically significant.<br /><strong></strong></p><p><strong>Conclusions:</strong> RMI-1 is a valuable and applicable method in the initial evaluation of postmenopausal patients with adnexal masses. İt has a high diagnostic performance in detecting invasive epithelial ovarian cancers, but it has a poor sensitivity in detecting borderline ovarian tumors and non-epithelial ovarian cancers.</p>

Sign in / Sign up

Export Citation Format

Share Document