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For: Shin KH, Kim HH, Yoon HJ, Kim ET, Suh DS, Kim KH. The Discrepancy between Preoperative Tumor Markers and Imaging Outcomes in Predicting Ovarian Malignancy. Cancers (Basel) 2022;14:cancers14235821. [PMID: 36497302 PMCID: PMC9737674 DOI: 10.3390/cancers14235821] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 11/18/2022] [Accepted: 11/22/2022] [Indexed: 11/29/2022] Open

For:	Shin KH, Kim HH, Yoon HJ, Kim ET, Suh DS, Kim KH. The Discrepancy between Preoperative Tumor Markers and Imaging Outcomes in Predicting Ovarian Malignancy. Cancers (Basel) 2022;14:cancers14235821. [PMID: 36497302 PMCID: PMC9737674 DOI: 10.3390/cancers14235821] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 11/18/2022] [Accepted: 11/22/2022] [Indexed: 11/29/2022] Open

Number

Cited by Other Article(s)

Shen L, Sadowski EA, Gupta A, Maturen KE, Patel-Lippmann KK, Zafar HM, Kamaya A, Antil N, Guo Y, Barroilhet LM, Jha P. The Ovarian-Adnexal Reporting and Data System (O-RADS) US Score Effect on Surgical Resection Rate. Radiology 2024;313:e240044. [PMID: 39377674 DOI: 10.1148/radiol.240044] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/09/2024]

Abstract

Background The Ovarian-Adnexal Imaging Reporting and Data System (O-RADS) US risk score can be used to accurately stratify ovarian lesions based on morphologic characteristics. However, there are no large multicenter studies assessing the potential impact of using O-RADS US version 2022 risk score in patients referred for surgery for an ovarian or adnexal lesion. Purpose To retrospectively determine the proportion of patients with ovarian or adnexal lesions without acute symptoms who may have been managed conservatively by using the O-RADS US version 2022 risk score. Materials and Methods This multicenter retrospective study included patients with ovarian cystic lesions and nonacute symptoms who underwent surgical resection after US before the introduction of O-RADS US between January 2011 and December 2014. Investigators blinded to the final diagnoses recorded lesion imaging features and O-RADS US risk scores. The frequency of malignancy and the diagnostic performance of the risk score were calculated. The Mann-Whitney test and Fisher exact test were performed, with P < .05 indicating a statistically significant difference. Results A total of 377 patients with surgically resected lesions were included. Among the resected lesions, 42% (157 of 377) were assigned an O-RADS US risk score of 2. Of the O-RADS US 2 lesions, 54% (86 of 157) were nonneoplastic, 45% (70 of 157) were dermoids or other benign tumors, and less than 1% (one of 157) were malignant. Using O-RADS US 4 as the optimal threshold for malignancy prediction yielded a 94% (68 of 72) sensitivity, 64% (195 of 305) specificity, 38% (68 of 178) positive predictive value, and 98% (195 of 199) negative predictive value. Conclusion In patients without acute symptoms who underwent surgery for ovarian and adnexal lesions before the O-RADS US risk score was published, nearly half (42%) of surgically resected lesions retrospectively met the O-RADS US 2 version 2022 criteria. In these patients, imaging follow-up or conservative management could have been offered. © RSNA, 2024 Supplemental material is available for this article. See also the editorial by Fournier in this issue.

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Affiliation(s)

Luyao Shen From the Department of Radiology, Stanford University School of Medicine, 300 Pasteur Dr, H1307, Stanford, CA 94305 (L.S., A.K., N.A., P.J.); Departments of Radiology (E.A.S.) and Obstetrics and Gynecology (E.A.S., L.M.B.), University of Wisconsin School of Medicine and Public Health, Madison, Wis; Department of Imaging Sciences, University of Rochester, Rochester, NY (A.G.); Department of Radiology and Obstetrics and Gynecology, University of Michigan, Ann Arbor, Mich (K.E.M.); Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tenn (K.K.P.L.); Department of Radiology, Hospital of the University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pa (H.M.Z.); and Department of Radiology, Brigham and Women's Hospital, Boston, Mass (Y.G.)
Elizabeth A Sadowski From the Department of Radiology, Stanford University School of Medicine, 300 Pasteur Dr, H1307, Stanford, CA 94305 (L.S., A.K., N.A., P.J.); Departments of Radiology (E.A.S.) and Obstetrics and Gynecology (E.A.S., L.M.B.), University of Wisconsin School of Medicine and Public Health, Madison, Wis; Department of Imaging Sciences, University of Rochester, Rochester, NY (A.G.); Department of Radiology and Obstetrics and Gynecology, University of Michigan, Ann Arbor, Mich (K.E.M.); Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tenn (K.K.P.L.); Department of Radiology, Hospital of the University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pa (H.M.Z.); and Department of Radiology, Brigham and Women's Hospital, Boston, Mass (Y.G.)
Akshya Gupta From the Department of Radiology, Stanford University School of Medicine, 300 Pasteur Dr, H1307, Stanford, CA 94305 (L.S., A.K., N.A., P.J.); Departments of Radiology (E.A.S.) and Obstetrics and Gynecology (E.A.S., L.M.B.), University of Wisconsin School of Medicine and Public Health, Madison, Wis; Department of Imaging Sciences, University of Rochester, Rochester, NY (A.G.); Department of Radiology and Obstetrics and Gynecology, University of Michigan, Ann Arbor, Mich (K.E.M.); Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tenn (K.K.P.L.); Department of Radiology, Hospital of the University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pa (H.M.Z.); and Department of Radiology, Brigham and Women's Hospital, Boston, Mass (Y.G.)
Katherine E Maturen From the Department of Radiology, Stanford University School of Medicine, 300 Pasteur Dr, H1307, Stanford, CA 94305 (L.S., A.K., N.A., P.J.); Departments of Radiology (E.A.S.) and Obstetrics and Gynecology (E.A.S., L.M.B.), University of Wisconsin School of Medicine and Public Health, Madison, Wis; Department of Imaging Sciences, University of Rochester, Rochester, NY (A.G.); Department of Radiology and Obstetrics and Gynecology, University of Michigan, Ann Arbor, Mich (K.E.M.); Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tenn (K.K.P.L.); Department of Radiology, Hospital of the University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pa (H.M.Z.); and Department of Radiology, Brigham and Women's Hospital, Boston, Mass (Y.G.)
Krupa K Patel-Lippmann From the Department of Radiology, Stanford University School of Medicine, 300 Pasteur Dr, H1307, Stanford, CA 94305 (L.S., A.K., N.A., P.J.); Departments of Radiology (E.A.S.) and Obstetrics and Gynecology (E.A.S., L.M.B.), University of Wisconsin School of Medicine and Public Health, Madison, Wis; Department of Imaging Sciences, University of Rochester, Rochester, NY (A.G.); Department of Radiology and Obstetrics and Gynecology, University of Michigan, Ann Arbor, Mich (K.E.M.); Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tenn (K.K.P.L.); Department of Radiology, Hospital of the University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pa (H.M.Z.); and Department of Radiology, Brigham and Women's Hospital, Boston, Mass (Y.G.)
Hanna M Zafar From the Department of Radiology, Stanford University School of Medicine, 300 Pasteur Dr, H1307, Stanford, CA 94305 (L.S., A.K., N.A., P.J.); Departments of Radiology (E.A.S.) and Obstetrics and Gynecology (E.A.S., L.M.B.), University of Wisconsin School of Medicine and Public Health, Madison, Wis; Department of Imaging Sciences, University of Rochester, Rochester, NY (A.G.); Department of Radiology and Obstetrics and Gynecology, University of Michigan, Ann Arbor, Mich (K.E.M.); Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tenn (K.K.P.L.); Department of Radiology, Hospital of the University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pa (H.M.Z.); and Department of Radiology, Brigham and Women's Hospital, Boston, Mass (Y.G.)
Aya Kamaya From the Department of Radiology, Stanford University School of Medicine, 300 Pasteur Dr, H1307, Stanford, CA 94305 (L.S., A.K., N.A., P.J.); Departments of Radiology (E.A.S.) and Obstetrics and Gynecology (E.A.S., L.M.B.), University of Wisconsin School of Medicine and Public Health, Madison, Wis; Department of Imaging Sciences, University of Rochester, Rochester, NY (A.G.); Department of Radiology and Obstetrics and Gynecology, University of Michigan, Ann Arbor, Mich (K.E.M.); Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tenn (K.K.P.L.); Department of Radiology, Hospital of the University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pa (H.M.Z.); and Department of Radiology, Brigham and Women's Hospital, Boston, Mass (Y.G.)
Neha Antil From the Department of Radiology, Stanford University School of Medicine, 300 Pasteur Dr, H1307, Stanford, CA 94305 (L.S., A.K., N.A., P.J.); Departments of Radiology (E.A.S.) and Obstetrics and Gynecology (E.A.S., L.M.B.), University of Wisconsin School of Medicine and Public Health, Madison, Wis; Department of Imaging Sciences, University of Rochester, Rochester, NY (A.G.); Department of Radiology and Obstetrics and Gynecology, University of Michigan, Ann Arbor, Mich (K.E.M.); Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tenn (K.K.P.L.); Department of Radiology, Hospital of the University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pa (H.M.Z.); and Department of Radiology, Brigham and Women's Hospital, Boston, Mass (Y.G.)
Yang Guo From the Department of Radiology, Stanford University School of Medicine, 300 Pasteur Dr, H1307, Stanford, CA 94305 (L.S., A.K., N.A., P.J.); Departments of Radiology (E.A.S.) and Obstetrics and Gynecology (E.A.S., L.M.B.), University of Wisconsin School of Medicine and Public Health, Madison, Wis; Department of Imaging Sciences, University of Rochester, Rochester, NY (A.G.); Department of Radiology and Obstetrics and Gynecology, University of Michigan, Ann Arbor, Mich (K.E.M.); Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tenn (K.K.P.L.); Department of Radiology, Hospital of the University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pa (H.M.Z.); and Department of Radiology, Brigham and Women's Hospital, Boston, Mass (Y.G.)
Lisa M Barroilhet From the Department of Radiology, Stanford University School of Medicine, 300 Pasteur Dr, H1307, Stanford, CA 94305 (L.S., A.K., N.A., P.J.); Departments of Radiology (E.A.S.) and Obstetrics and Gynecology (E.A.S., L.M.B.), University of Wisconsin School of Medicine and Public Health, Madison, Wis; Department of Imaging Sciences, University of Rochester, Rochester, NY (A.G.); Department of Radiology and Obstetrics and Gynecology, University of Michigan, Ann Arbor, Mich (K.E.M.); Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tenn (K.K.P.L.); Department of Radiology, Hospital of the University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pa (H.M.Z.); and Department of Radiology, Brigham and Women's Hospital, Boston, Mass (Y.G.)
Priyanka Jha From the Department of Radiology, Stanford University School of Medicine, 300 Pasteur Dr, H1307, Stanford, CA 94305 (L.S., A.K., N.A., P.J.); Departments of Radiology (E.A.S.) and Obstetrics and Gynecology (E.A.S., L.M.B.), University of Wisconsin School of Medicine and Public Health, Madison, Wis; Department of Imaging Sciences, University of Rochester, Rochester, NY (A.G.); Department of Radiology and Obstetrics and Gynecology, University of Michigan, Ann Arbor, Mich (K.E.M.); Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tenn (K.K.P.L.); Department of Radiology, Hospital of the University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pa (H.M.Z.); and Department of Radiology, Brigham and Women's Hospital, Boston, Mass (Y.G.)

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Isono W, Tsuchiya H, Matsuyama R, Fujimoto A, Nishii O. 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. Eur J Obstet Gynecol Reprod Biol X 2023;20:100260. [PMID: 38058586 PMCID: PMC10696378 DOI: 10.1016/j.eurox.2023.100260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Revised: 10/14/2023] [Accepted: 11/13/2023] [Indexed: 12/08/2023] Open

Abstract

Objective

For selecting minimally invasive surgery (i.e. laparoscopic ovarian cystectomy) for treating ovarian tumours (OTs) in premenopausal patients, the pre-operative differentiation of benign ovarian tumours (Be-OTs) based on magnetic resonance imaging (MRI) interpretation is important. This paper describes the authors' 8-year experience of approximately 1000 OT cases, and provides information about a diagnostic algorithm to help other hospitals.

Study design

The medical records of 901 patients aged < 50 years with OTs from 1 January 2015-31 March 31 2023 were reviewed. First, the accuracy of pre-operative differentiation between Be-OTs and borderline/malignant ovarian tumours (Bo/Ma-OTs) was compared in each type of OT. Second, to identify the factors influencing differentiation between Be-OTs and Bo/Ma-OTs in 164 serous/mucinous ovarian tumours (SM-OTs), a multi-variate logistic regression analysis was performed to assess the effect of 13 factors, including MRI findings, OT size and tumour markers.

Results

In the comparison of diagnostic accuracy of pre-operative MRI for each OT type, accuracy was found to be notably high for ovarian endometrial cyst (OEC) (n = 409), ovarian mature cystic teratoma (OMCT) (n = 308), ovarian endometrioid adenocarcinoma (OEA) (n = 6) and ovarian clear cell adenocarcinoma (OCCA) (n = 14). On the other hand, discrepancies between MRI and pathological findings often occurred in SM-OTs, including ovarian serous cystadenoma (n = 86), ovarian mucinous adenocarcinoma (n = 61), ovarian serous adenocarcinoma (n = 12) and ovarian mucinous adenocarcinoma (n = 5). In the multi-variate logistic regression analysis of the latter 164 patients, in addition to MRI findings, OT size and carbohydrate antigen 125 also had an effect to some extent. The combination of MRI interpretation and OT size may enhance differentiation of Be-OTs and Bo/Ma-OTs.

Conclusions

Among four types of OTs (OEC, OMCT, OEA and OCCA), MRI interpretation was able to differentiate between Be-OTs and Bo/Ma-OTs almost perfectly. Additionally, to mitigate the difficulty in differentiating SM-OTs, OT size may be useful in combination with MRI findings, although further accumulation and analysis of OT cases is needed.

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