Impact of a multiparameter, ultrasound‐based triage on surgical management of adnexal masses

Berlanda, Nicola; Ferrari, María Rosa; Mezzopane, R.; Boero, Veronica; Grijuela, Barbara; Ferrazzi, E.; Pardi, Giorgio

doi:10.1046/j.1469-0705.2002.00776.x

Cited by 21 publications

(22 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Sonography is considered the firstline imaging technique for discriminating between malignant and benign lesions, and it has been shown to be useful for determining optimal treatment. [1][2][3] In most institutions, a different person from the one who treats the patient and makes clinical decisions performs the sonographic examination. Usually the clinical management decision is based on data provided in the sonographic report.…”

Section: Discussionmentioning

confidence: 99%

“…When used by experienced examiners, this technique achieves high sensitivity for identifying ovarian cancer, and it has been shown to be useful for selecting the best surgical approach. [1][2][3] However, despite the tremendous progress in the diagnostic capability of TVS, a large multicenter study reported that the false-positive rate could be as high as 24%. 4 One explanation for this high false-positive rate may be operator experience, as has been shown in a recent randomized trial.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Gynecologic Imaging Reporting and Data System

Amor¹,

Vaccaro²,

Alcázar

et al. 2009

Journal of Ultrasound in Medicine

View full text Add to dashboard Cite

Objective. The purpose of this study was to describe a new reporting system called the Gynecologic Imaging Reporting and Data System (GI-RADS) for reporting findings in adnexal masses based on transvaginal sonography. Methods. A total of 171 women (mean age, 39 years; range, 16-77 years) suspected of having an adnexal mass were evaluated by transvaginal sonography before treatment. Pattern recognition analysis and color Doppler blood flow location were used for determining the presumptive diagnosis. Then the GI-RADS was used, with the following classifications: GI-RADS 1, definitively benign; GI-RADS 2, very probably benign; GI-RADS 3, probably benign; GI-RADS 4, probably malignant; and GI-RADS 5, very probably malignant. Patients with GI-RADS 1 and 2 tumors were treated expectantly. All GI-RADS 3, 4, and 5 tumors were removed surgically, and a definitive histologic diagnosis was obtained. The GI-RADS classification was compared with final histologic diagnosis. Results. A total of 187 masses were evaluated. The prevalence rate for malignant tumors was 13.4%. Overall GI-RADS classification rates were as follows: GI-RADS 1, 4 cases (2.1%); GI-RADS 2, 52 cases (27.8%); GI-RADS 3, 90 cases (48.1%); GI-RADS 4, 13 cases (7%); and GI-RADS 5, 28 cases (15%). The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 92%, 97%, 85%, 99%, and 96%, respectively. Conclusions. Our proposed reporting system showed good diagnostic performance. It is simple and could facilitate communication between sonographers/ sonologists and clinicians. Key words: adnexal mass; reporting system; sonography. ransvaginal sonography (TVS) has become the first-step imaging technique for characterizing adnexal masses. When used by experienced examiners, this technique achieves high sensitivity for identifying ovarian cancer, and it has been shown to be useful for selecting the best surgical approach. [1][2][3] However, despite the tremendous progress in the diagnostic capability of TVS, a large multicenter study reported that the false-positive rate could be as high as 24%. 4 One explanation for this high false-positive rate may be operator experience, as has been shown in a recent randomized trial.5 Another reason could be a problem in the transmission of information about findings from the sonologist or sonographer to the clinician who makes final decision. As a matter of fact, reports describing sonographic findings are sometimes confusing.

show abstract

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Gynecologic Imaging Reporting and Data System

Amor¹,

Vaccaro²,

Alcázar

et al. 2009

Journal of Ultrasound in Medicine

View full text Add to dashboard Cite

show abstract

“…5 Most studies assessing the role of ultrasound for surgical or referral triaging of adnexal masses have been performed in series in which clinical complaints were not taking into account. [15][16][17][18][19] It could be speculated that the performance of this diagnostic technique could be different in women complaining symptoms suggestive of ovarian cancer.…”

Section: Discussionmentioning

confidence: 99%

Assessment of an Ultrasound-based Scoring System for Triaging Ovarian Tumors in Symptomatic Women

Galván¹,

Alcázar

Royo³

et al. 2009

Donald School Journal of Ultrasound in Obstetrics and Gynecology

View full text Add to dashboard Cite

Objective: To evaluate prospectively an ultrasound-based scoring system as a method for triaging symptomatic women presenting with an adnexal mass for surgical treatment.Methods: 151 symptomatic women scheduled for surgical treatment at our institution were included in this prospective study. Patients were evaluated by transvaginal power Doppler ultrasound prior to surgery. Patients were classified as low-risk or high-risk for malignancy according an ultrasound-based scoring system. Patients with low risk for malignancy were scheduled for laparoscopy and patients for high risk for malignancy were scheduled for laparotomy. Some patients with high-risk were scheduled for advanced oncologic laparoscopic surgery. Patients with low risk but tumor size > 10 cm were scheduled for laparotomy.Results: 82 women presented with pelvic pain, 8 had uterine bleeding and 61 referred symptoms suggestive for ovarian malignancy, such as abdominal swelling, bloating and abdominal discomfort. 75 (49.7%) masses were considered as "low-risk" and treated by laparoscopy in 58 cases and by laparotomy in 7 cases, because emergency or associated pathology (All tumors were benign). 76 (50.3%) masses were considered as "high-risk" and all treated by laparotomy (56 malignant and 4 benign tumors) or by advanced laparoscopy (16 malignant tumors). Ten (6.7%) tumors were considered as "low-risk" but scheduled for primary laparotomy because of size > 10 cm (9 benign and 1 malignant). Sensitivity, specificity, PPV and NPV for this scoring system were 98.6%, 94.9%, 94.7% and 98.7%, respectively. The scoring system were more sensitive than patient's complaints (98.6% vs 79.5%, p < 0.0001) and more specific than physical examination (94.9% vs 85.9%, p < 0.0001) Conclusions: Ultrasound based triage of symptomatic women diagnosed, as having an adnexal mass is effective for selecting surgical approach.

show abstract

“…6 For these reasons, we think that a "simplified" validated approach based on echo features highly presumptive of a given disease [2][3][4] is not the "simplistic" description of a complex mass advocated by Timor-Tritsch and Goldstein. …”

Section: J Ultrasound Med 2006; 25:558-562mentioning

confidence: 99%

“…Their study does not answer the question of whether a score is more reproducible than the subjective impression because the aim of the study was not to compare the score with other approaches. [2][3][4] Ferrazzi et al 1 stated that their study was designed to assess the intercenter reproducibility of transvaginal gray scale sonographic examination. In our opinion, their study was not designed to assess the reproducibility of the approach because in "Materials and Methods," they did not report any of the several methods to evaluate agreement between observers (eg, the κ index).…”

Section: J Ultrasound Med 2006; 25:558-562mentioning

confidence: 99%

Pattern Recognition and Descriptive Sonographic Scoring in the Diagnosis of Ovarian Cancer

2006

Journal of Ultrasound in Medicine

View full text Add to dashboard Cite

Impact of a multiparameter, ultrasound‐based triage on surgical management of adnexal masses

Abstract: The accuracy of this new algorithm was higher than that of the sonographic morphological scoring system alone. In the present series, it allowed the treatment by laparoscopy of 96% of benign adnexal masses without mismanagement of any cases of ovarian cancer.

Cited by 21 publications

References 14 publications

Gynecologic Imaging Reporting and Data System

Gynecologic Imaging Reporting and Data System

Assessment of an Ultrasound-based Scoring System for Triaging Ovarian Tumors in Symptomatic Women

Pattern Recognition and Descriptive Sonographic Scoring in the Diagnosis of Ovarian Cancer

Contact Info

Product

Resources

About