Geburtshilfe Frauenheilkd 2014; 74 - PO_Onko09_01
DOI: 10.1055/s-0034-1388479

Asymptomatic adnexal masses: accuracy of characterization with ultrasound scoring systems, 3D-ultrasound, 3D flow mapping with TUI (tomographic ultrasound imaging) and MR imaging

M Pinschke 1, G Schulte-Altedorneburg 2, M Kremer 3, D Grab 1
  • 1Städtisches Klinikum München Harlaching, Frauenklinik, München, Germany
  • 2Städtisches Klinikum München Harlaching, Institut für Diagnostische und Interventionelle Radiologie, München, Germany
  • 3Städtisches Klinikum München Harlaching, Institut für Pathologie, München, Germany

Objective: To determine the diagnostic accuracy of sonography, 3D-ultrasound, 3D flow mapping with TUI (tomographic ultrasound imaging) versus magnetic resonance (MR) imaging

Methods: 99 patients with asymptomatic potentially malignant adnexal masses underwent preoperative 3D-ultrasound and 3D flow mapping with TUI (evaluated by two different observers using the ultrasound scoring system from the International Ovarian Tumor Analysis (IOTA) group and the B- and M-rules for predicting a malignant tumor, both published by Timmerman et al.), as well as MR imaging. Histologic results and imagings were correlated in all cases. For each diagnostic modality alone and for the combination of ultrasound and MR imaging sensitivity, specificity, positive and negative predictive values as well as accuracy were calculated.

Results: Sonographic evaluation resulted in correct classification of 25 of 33 malignancies (sensitivity of 71%) and a specificity of 75% (50 of 66 benign masses). In comparison MR imaging alone had a sensitivity of 71% and specificity of 79%. By combining the results of TUI and MRI diagnostic accuracy increased significantly: sensitivity was 87%, specificity 97%, positive and negative predictive value as well as accuracy were 94% respectively.

Conclusion: Combination of ultrasound with MR imaging significantly improve the accuracy in differentiation of benign from malignant ovarian lesions compared with each diagnostic modality alone. Further improvement of accuracy can be obtained by 3D-ultrasound and 3D flow mapping with TUI (tomographic ultrasound imaging).