scholarly journals Comparative Study of Ultrasound and Magnetic Resonance Imaging of Adnexal Masses

2020 ◽  
Vol 8 (2) ◽  
pp. 106-111
Author(s):  
Narikelapu Nitya ◽  
Rama Krishna Rao Baru
Keyword(s):  
Fallopian Tube ◽  
Adnexal Mass ◽  
Mucinous Cystadenocarcinoma ◽  
Ovarian Mass ◽  
Benign Lesions ◽  
Serous Cystadenocarcinoma ◽  
Tissue Content ◽  
Tissue Characteristics ◽  
Sensitivity Specificity ◽  
Mass Lesions

Background: Current study aimed to assess the role of ultrasound and MRI in the evaluation of adnexal mass lesions and comparison with clinical outcomes. Subjects & Methods: A total of 30 suspected adnexal mass detected on ultrasonography was performed MRI, and accuracy of both USG and MRI were compared with histopathology. Results: Abdominal pain was predominantly confined to the lower abdomen in13 of 30 cases (43.3%). On USG total number of benign lesions was 19, and the total number of malignancies was 11. However, on MRI, 21  cases were mild, and 9 cases were malignant. six cases were diagnosed as malignant in ultrasound. In these six cases, two cases were serous cystadenocarcinoma, two were mucinous cystadenocarcinoma, one was serious papillary cystadenocarcinoma of the fallopian tube, and one was a malignant tubo-ovarian mass. MRI accurately diagnosed 4 indeterminate cases that correlated with the histopathology report. 9 malignant lesions were diagnosed as malignant by MRI were 3 cases of serous cystadenocarcinoma, 2 cases of mucinous cystadenocarcinoma, 1 case of malignant tubo-ovarian mass, 1 case of endometrioid carcinoma, 1 case of serous papillary cystadenocarcinoma of the fallopian tube and 2 cases of malignant sex cord-stromal neoplasms. Both the cases of serous cystadenomas were correctly diagnosed as benign lesions on both ultrasound and MRI. There were 2 cases of mucinous cystadenocarcinoma, which were accurately diagnosed as malignant on both USG and MRI due to the presence of solid components, mural thickening. The sensitivity, specificity, and accuracy of USG were 36.6%, 94% and 55% respectively. The sensitivity, specificity, and accuracy of MRI were 81.80%, 94.7%, and 65.7%, respectively. Conclusion: The best agreement was observed between MR findings and diagnosis in origin, tissue content, and tissue characteristics. Sonography had a weak correlation in context to the definitive diagnosis for the origin and tissue content of a mass.

scholarly journals Role of multi-detector computed tomography in the detection and differentiation of adnexal mass lesions

2019 ◽  
Vol 8 (7) ◽  
pp. 2725
Author(s):  
Ezzat Khalda ◽  
Hafizur Rahman
Keyword(s):  
Computed Tomography ◽  
Predictive Value ◽  
Adnexal Mass ◽  
Histopathological Examination ◽  
Primary Diagnosis ◽  
Adnexal Masses ◽  
Sensitivity Specificity ◽  
Mass Lesions ◽  
Multi Detector Computed Tomography

Background: The objective of this study was to evaluate the role of multi-detector computed tomography (MDCT) in the detection and differentiation of adnexal masses using post-operative histopathology findings as the gold standard.Methods: One hundred and forty five cases that were referred with a primary diagnosis of adnexal masses on clinical or USG examination were evaluated by MDCT in the Department of Radiodiagnosis from January 2013 to December 2013. One hundred twelve cases subsequently underwent surgical exploration and histopathological examination, which was used as a control for the evaluation of MDCT findings, were included in this study.Results: Majority (54.5%) of the patients were in the age group of 31-50 years. MDCT detected   adnexal masses as malignant in 56 cases, while in other 56 cases it read adnexal masses as benign. Final histopathology revealed adnexal masses in 57 (51%) cases as malignant while in 55 (49%) cases as benign. There were three cases which on MDCT appeared as malignant were subsequently found to be benign in histopathology. Similarly there were four cases which on MDCT appeared as benign were subsequently proved to malignant in histopathology. The sensitivity, specificity, Positive predictive value and negative predictive value of MDCT for diagnosing a malignant adnexal mass was 93.0%, 94.5%, 94.6% and 92.8% respectively. MDCT findings more predictive of malignancy were solid or cystic-solid mass, necrosis in a solid lesion, cystic lesion with thick, irregular walls or septa, and/or with papillary projections. The presence of ascites, peritoneal metastases, and lymphadenopathy were also helpful to confirm malignancy.Conclusions: MDCT is an excellent and accurate non-invasive modality in the detection and characterization of adnexal masses from benign and malignant

scholarly journals Hysteroscopy as a standard procedure for assessing endometrial lesions among postmenopausal women

2007 ◽  
Vol 125 (6) ◽  
pp. 338-342 ◽  
Author(s):  
Camila Toffoli Ribeiro ◽  
Júlio César Rosa-e-Silva ◽  
Marcos Felipe Silva-de-Sá ◽  
Ana Carolina Japur de Sá Rosa-e-Silva ◽  
Omero Benedicto Poli Neto ◽  
...  
Keyword(s):  
Endometrial Thickness ◽  
Standard Procedure ◽  
University Hospital ◽  
Histopathological Analysis ◽  
Benign Lesions ◽  
Predictive Values ◽  
Asymptomatic Patients ◽  
Cavity Design ◽  
Diagnostic Hysteroscopy ◽  
Sensitivity Specificity

CONTEXT AND OBJECTIVES: Endometrial cancer is the most prevalent type of malignant neoplasia of the genital tract. The objective of this study was to calculate the sensitivity, specificity, accuracy and positive and negative predictive values for diagnostic hysteroscopy, in comparison with histopathological tests, for all lesions of the endometrial cavity. DESIGN AND SETTING: Retrospective descriptive study at the public tertiary-level university hospital of Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo. METHODS: Diagnostic hysteroscopy was indicated in the following instances: endometrial thickness > 4 mm in asymptomatic patients; postmenopausal bleeding; and irregular endometrium or endometrium difficult to assess from ultrasound, with or without vaginal bleeding. Ultrasound evaluations were carried out no more than three months prior to hysteroscopy. RESULTS: There were 510 patients, with a mean age of 61.1 ± 2.0 years and mean time elapsed since the menopause of 12.7 ± 2.5 years. Endometrial biopsies were performed on 293 patients (57.5%). Histopathological analysis showed that 18 patients presented endometrial carcinoma or typical or atypical hyperplasia, and none of them presented endometrial thickness of less than 8 mm. No significant differences were found between the median thicknesses of the various benign lesions (p > 0.05). In our data, the sensitivity, specificity, accuracy and positive and negative predictive values for cancer or hyperplasia were 94.4%, 97.0%, 96.8%, 68% and 99.6%, respectively. CONCLUSIONS: Our results suggest that hysteroscopy is valuable as a diagnostic tool for malignant/hyperplastic and benign lesions, except for submucous myomas, for which the sensitivity was only 52.6%.

scholarly journals Comparison of RMI 3 and RMI 4 in pre-operative evaluation of ovarian masses

2019 ◽  
Vol 8 (9) ◽  
pp. 3602
Author(s):  
Badugu Rao Bahadur ◽  
Gangadhara Rao Koneru ◽  
Prabha Devi Kodey ◽  
Jyothi Melam
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Malignant Tumors ◽  
Clinical Approach ◽  
Ovarian Mass ◽  
Medical College ◽  
Operative Evaluation ◽  
Sensitivity Specificity ◽  
Final Confirmation

Background: To differentiate ovarian mass as benign or malignant could change clinical approach. Finding a screening and diagnostic method for ovarian cancer is challenging due to high mortality and insidious symptoms. Risk malignancy index (RMI) has the advantage of rapid and exact triage of patients with ovarian mass.Methods: Prospective study carried for 2 years at NRI Medical College and General Hospital, Chinakakani, Mangalagiri, Andhra Pradesh, India. 79 patients with ovarian mass were investigated and risk malignancy index (RMI-3 and RMI-4) calculated. Final confirmation was done based on histopathological report. Sensitivity, specificity, positive predictive value and negative predictive value were calculated for RMI 3 and RMI 4 taking histopathology as control and comparison was done.Results: (n=79); 50 (63.29%) cases were benign and 29 (36.70%) were malignant based on histopathology. RMI 4 is more sensitive (68.96%) than RMI 3 (62.06%), but RMI 3 is more specific (94%) than RMI 4 (92%).The positive predictive value of RMI-3 and RMI-4 were 85.71%  and 83.33% respectively. The negative predictive value for RMI-4 and RMI-3 were 83.63% and 81.03% respectively.Conclusions: With increasing age, chance of malignancy increases. RMI 4 was more sensitive than RMI-3, however less specific than RMI 3 in differentiating benign and malignant tumors. The positive predictive value is slightly more for RMI 3, than RMI 4. Negative predictive value is slightly more for RMI 4, than RMI 3. 

Detection of recurrent or persistent nasopharyngeal carcinomas after radiotherapy with 18-fluoro-2-deoxyglucose positron emission tomography and comparison with computed tomography.

1998 ◽  
Vol 16 (11) ◽  
pp. 3550-3555 ◽  
Author(s):  
C H Kao ◽  
S P ChangLai ◽  
P U Chieng ◽  
R F Yen ◽  
T C Yen
Keyword(s):  
Computed Tomography ◽  
Positron Emission Tomography ◽  
Fdg Pet ◽  
Emission Tomography ◽  
Visual Interpretation ◽  
Benign Lesions ◽  
Standardized Uptake Values ◽  
Positron Emission ◽  
Sensitivity Specificity ◽  
Suspected Recurrence

PURPOSE The effectiveness of positron emission tomography (PET) with 1 8-fluoro-2-deoxyglucose (FDG) for detecting suspected recurrence of nasopharyngeal carcinomas (NPC) was evaluated and compared with computed tomography (CT). PATIENTS AND METHODS FDG-PET studies were performed on 36 NPC patients 4 months after radiotherapy. The images were interpreted visually and quantitatively by calculating standardized uptake values (SUVs). RESULTS The sensitivity, specificity, and accuracy of visually interpreted FDG-PET images, for differentiation of recurrent or persistent NPC from benign lesions, were 100%, 96%, and 97%, respectively. Cases with recurrent or persistent NPC (1.6 to 5.8) had significantly higher SUVs than cases with benign lesions (0.8 to 1.5). The sensitivity, specificity, and accuracy of CT for detecting recurrent or persistent NPC were 72%, 88%, and 83%, respectively. CONCLUSION FDG-PET is a better tool than CT for the detection of recurrent or persistent NPC. Either visual interpretation or SUV can be used to differentiate benign lesions from recurrent or persistent NPC.

Accuracy of multiparametric MRI in distinguishing the breast malignant lesions from benign lesions: a meta-analysis

2020 ◽  
pp. 028418512096390
Author(s):  
Chun-Rong Zhu ◽  
Ke-Yu Chen ◽  
Pan Li ◽  
Zhi-Yang Xia ◽  
Bin Wang
Keyword(s):  
Likelihood Ratio ◽  
Odds Ratio ◽  
Area Under The Curve ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Diagnostic Odds Ratio ◽  
Multiparametric Mri ◽  
Benign Lesions ◽  
Malignant Lesions ◽  
Sensitivity Specificity

Background The sensitivity of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) for detecting breast cancer was high and the specificity was relatively low. However, diffusion-weighted imaging (DWI) has a high specificity in the diagnosis of malignant lesions. Purpose To evaluate the accuracy of the multiparametric MRI (mp-MRI) in distinguishing the breast malignant lesions from the benign lesions. Material and Methods A comprehensive search of the PubMed, Embase, and Cochrane Library electronic databases was conducted up to March 2020. Data were analyzed for the following indexes: pooled sensitivity and specificity; positive likelihood ratio; negative likelihood ratio; diagnostic odds ratio; and the area under the curve. Results A total of 2356 patients with 1604 malignant and 967 benign breast lesions were included from 22 studies. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio, and area under the curve for mp-MRI were 0.93, 0.85, 6.3, 0.08, 81, and 0.96, respectively. The pooled sensitivity, specificity, and area under the curve for DCE-MRI alone were 0.95, 0.71, and 0.92, respectively. The pooled sensitivity, specificity, and area under the curve for DWI alone were 0.88, 0.84, and 0.93, respectively. Conclusion The mp-MRI did not improve the sensitivity but increased the specificity for the diagnosis of breast malignant lesions.

The Performance of Contrast-Enhanced FDG PET/CT for the Differential Diagnosis of Unexpected Ovarian Mass Lesions in Patients With Nongynecologic Cancer

2015 ◽  
Vol 40 (2) ◽  
pp. 97-102 ◽  
Author(s):  
Jeong Won Lee ◽  
Jae-Hoon Lee ◽  
Arthur Cho ◽  
Mijin Yun ◽  
Jong Doo Lee ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Fdg Pet ◽  
Ovarian Mass ◽  
Contrast Enhanced ◽  
Pet Ct ◽  
Fdg Pet Ct ◽  
Mass Lesions

CEA in Evaluation of Adnexal Mass: Retrospective Cohort Analysis and Review of the Literature

2015 ◽  
Vol 30 (4) ◽  
pp. 394-400 ◽  
Author(s):  
Lena Sagi-Dain ◽  
Ofer Lavie ◽  
Ron Auslander ◽  
Shlomi Sagi
Keyword(s):  
Predictive Value ◽  
Retrospective Cohort ◽  
Adnexal Mass ◽  
Medical Center ◽  
Cohort Analysis ◽  
Adnexal Masses ◽  
Retrospective Cohort Analysis ◽  
Serum Carcinoembryonic Antigen ◽  
Serum Ca125 ◽  
Sensitivity Specificity

Background The aim of this study was to estimate the diagnostic accuracy of serum carcinoembryonic antigen (CEA) levels in conjunction with Ca125 in the triage of adnexal masses. Methods This retrospective cohort study was carried out in 495 patients referred to the Gynecology Department at Carmel Medical Center due to adnexal mass, between 2005 and 2012. All patients underwent surgery with histopathologically confirmed diagnosis and preoperative measurements of serum Ca125 and CEA. For each marker, sensitivity, specificity, positive predictive value, negative predictive value and risk ratio were calculated. Results Combination of CEA with Ca125, compared with Ca125 levels alone, yielded a nonsignificant effect on sensitivity (87.4% vs. 88.9%, respectively, p = 0.64) and specificity (79.3% vs. 74.3%, p = 0.18) in differentiating malignant from benign adnexal masses. CEA levels were higher in mucinous histological types, but were not helpful in detection of borderline tumors. Significantly higher CEA (21.4 ± 53.6 vs. 3.2 ± 11.9 ng/mL, p = 0.0002) and lower Ca125 values (103.9 ± 84.9 vs. 796 ± 1,331.5 U/mL, p = 0.0338) were demonstrated in the 17 metastatic cases compared with 181 primary ovarian malignancies. Conclusions The combination of the tumor markers CEA and Ca125 did not contribute significantly to the detection of malignant adnexal masses compared with Ca125 alone. As our results suggest that higher CEA levels could be useful in differentiating metastatic tumors from primary ovarian malignancy and in diagnosis of mucinous histology, this issue should be investigated in large, well-designed, prospective cohort trials.

scholarly journals A comparative clinicopathological study between ultrasonography, mammography, FNAC and core needle biopsy of breast lump

2020 ◽  
Author(s):  
Arnab Mandal ◽  
Pradipta Jana ◽  
Sabyasachi Bakshi ◽  
Ram Krishna Mandal
Keyword(s):  
Core Needle Biopsy ◽  
Predictive Value ◽  
Needle Biopsy ◽  
Breast Disease ◽  
Ultra Sound ◽  
Benign Lesions ◽  
Breast Lump ◽  
Core Needle ◽  
Carcinoma Breast ◽  
Sensitivity Specificity

Abstract BACKGROUND:Early presentation and prompt diagnosis is the essential key in treatment of different variety of neoplastic as well as non-neoplastic breast disease. In this study usefulness of HRUSG, Mammography, FNAC and Core Needle Biopsy in correlation with histopathological pattern, was assessed.METHODS:After matching the criteria, 212 cases, were taken for this prospective, single center, observational study. RESULTS:Out of 212 cases, 163(76.88 %%) were benign lesions, 49(23.11%) were malignant and 1(0.47%) were of inflammatory pathology. Benign to malignant breast disease ratio was 3.3:1. Out of 49 malignant cases, 45 (91.83%) were ductal cell carcinoma and 4 (8.16%) was apocrine carcinoma. Maximum numbers of cancer patients were found in the 51- 60 year age groups.The sensitivity, specificity, Positive predictive value and Negative Predictive value of mammography in detecting carcinoma breast were 87.76%, 64.71%, 87.76% and 64.71% respectively. The sensitivity, specificity, PPV and NPV of HRUSG in detecting carcinoma breast were 85.71%, 90.18%, 72.41% and 95.45% respectively.Among benign lesions, 47 (28.83) % were diagnosed by mammography and 147(90.18) % were diagnosed by HRUSG. When these modalities were combined, >95% of the lesions was diagnosed accurately.CONCLUSIONS:Ultra sound used liberally as an adjunct to mammography, increase the cancer detection rate. Core needle biopsy is found more accurate but FNAC have limited value in evaluation of benign breast lump. This study also proves that preoperative categorization of breast lesions is utmost important for management of the patient and this will help to avoid unnecessary surgical treatment.

scholarly journals Primary Transitional Cell Carcinoma of Fallopian Tube: A Rare Entity with Review of Literature

2020 ◽  
pp. 13-16
Author(s):  
Arun Elangovan ◽  
Chinna Babu Dracham ◽  
Lokeswari Annam ◽  
Vani Bharani
Keyword(s):  
Transitional Cell Carcinoma ◽  
Cell Carcinoma ◽  
Fallopian Tube ◽  
Adnexal Mass ◽  
Transitional Cell ◽  
Female Genital Tract ◽  
Abdominal Distension ◽  
Figo Stage ◽  
Rare Entity ◽  
Primary Fallopian Tube Carcinoma

Objective: Primary fallopian tube carcinoma (PFTC) is a rare entity constituting only 0.2-1.5% of all primary female genital-tract malignancies. Transitional cell carcinoma of fallopian tube is very rare constituting only around 10% of the PFTC and very less literature have been reported worldwide. Case report: A 59-year-old postmenopausal women presented with discharge per vaginum and abdominal distension, and was found to have right adnexal mass on clinical examination. Imaging findings were suggestive of a heterogenous adnexal mass and she underwent staging laparotomy. Post-operative histopathology examination confirmed a primary transitional cell carcinoma of right fallopian tube. FIGO stage was IA, and she received six cycles of adjuvant chemotherapy. The patientis nowalive, after 10-years of initial treatment.

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