Objective: To assess the diagnostic performance of texture analysis indiscriminating between benign and malignant adnexal masses Design: prospective observational cross-sectional study Population: Women aged eighteen and above with known pelvic masses Methods: ultrasound images were collected from participants and transferred into PC for off-line analysis. MaZda software was used to perform the texture analysis. Two texture features applied: Grey-level co-occurrence matrix (GLCM) and wavelet. Risk of malignancy index,Pelvic mass index and ADNEX scoring systems were applied to the data, and then results were compared to GLCM and wavelet. Main outcome measures:The GLCM showed a higher sensitivity (72%) compared to two of the scoring systems applied (32% RMI and 62% ADNEX). When combining GLCM and wavelet features using logistic regression model resulted in high performance with AUC=0.8 and a good predictive capacity when tested using the Hosmer and Lemeshow test (p=.502).Results: 169 masses were collected, 116 benign, 29 malignant and 24 simple cyst. Data were divided into 95 premenopausal and 68 postmenopausal. There was a significance difference between benign and malignant p=.004, p=.027 for GLCM and wavelet respectively. GLCM had a higher sensitivity (72%) and NPV (90%) for the entire cohort in comparison to RMI (32%; 80%) and ADNEX (62%; 80%) respectively, Conclusions: Two features of texture analysis have a potential in differentiating benign from malignant pelvic masses which are (GLCM) and the wavelet.
BACKGROUND: The effect of maternal infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on the fetus is unclear, and there is no data from Saudi Arabia. OBJECTIVE: Assess the effect of maternal SARS-CoV-2 infection on fetal growth. DESIGN: Retrospective case-control SETTING: Tertiary care hospital, Riyadh, Saudi Arabia PATIENTS AND METHODS: We selected pregnant women who underwent an obstetric growth scan and umbilical artery Doppler ultra-sound examination between 28 and 41 weeks of pregnancy. Women with multiple pregnancy, fetal abnormalities, maternal body mass index >30, maternal hypertension, any other chronic diseases that might affect fetal growth or pregnant women suffering from cancer were excluded. Fetal growth parameters assessed included fetal biometry (biparietal diameter, head circumference, abdominal circumference and femur length). We also did an umbilical artery Doppler assessment, which includes the umbilical artery pulsatility index, resistive index and the systolic/diastolic ratio. MAIN OUTCOME MEASURE: Fetal biometry and biophysical profile SAMPLE SIZE: 48 SARS-CoV-2; 98 non-SARS-CoV-2 RESULTS: More women who had recovered from SARS-CoV-2 infection had small for gestational age fetuses compared with the control group ( P =.001). CONCLUSION: Maternal SARS-CoV-2 infection during pregnancy was associated with a higher prevalence of small for gestational age (SGA) fetuses. LIMITATIONS: Retrospective, middle cerebral artery and uterine artery Doppler data were not included nor were the effect of tobacco use and socioeconomic status, the relationship between the date of infection with the date of conceiving or the relationship between the severity of infection in the mother and fetal biometry and growth. CONFLICT OF INTEREST: None.
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