OP24.10: GI-RADS: a new proposal for classifying adnexal masses based on sonographic findings

Abstract

Oral poster abstracts S-BOT (p = 0.05). M-BOT had echogenic fluid more than S-BOT, but this difference did not reach statistical significance. Only in 5/11 tumors (45%) a significant blood flow was documented. 11/23 (47%) tumors were correctly triaged for oncology-related surgery procedure based on clinical and sonographic evaluation. Conclusions: Echogenic fluid, multilocularity and a larger diameter is more typical to M-BOT. Papillary projections are more often associated with S-BOT. Correct triage for an oncology-related surgery, based on these factors, seem less successful than expected. Objective: The purpose of this study was to evaluate the intraobserver and interobserver agreement for identifying adnexal malignancy using color flow location in indeterminate masses after a gray-scale transvaginal sonography. Methods: Digitally stored color Doppler sonographic images, from a consecutive series of 130 women with an adnexal mass submitted to surgery after transvaginal sonography were evaluated by 6 different examiners with different degree of experience. Only consecutive cystic mass in which the gray-scale echo architecture was not suggestive of benign histology was included in the study. Solid excrescences or solid portions of the tumor were evaluated for vascular flow with color Doppler sonography. A mass was graded malignant if flow was shown within the excrescences or solid areas (central flow) and benign if there was no flow or only peripheral. Intraobserver and interobserver agreement according with the level of experience were assessed by calculating the kappa index. Results: Of the 130 consecutive cases with indeterminate findings at gray-scale evaluation, definitive histologic diagnoses were as follows: 80 (61.5%) benign and 50 (38.5%) malignant masses. Intraobserver agreement was good or very good for all examiners with different degree of experience (kappa ranging from 0.721 to 0.888). Interobserver agreement was good to moderate for all operators (kappa ranging from 0.478 to 0.714), irrespective of degree of experience. A correct classification was obtained by all assessors in 52% of malignant masses. Only ten masses (7.7%) were incorrectly classified by all the assessors. Conclusions: The use of color Doppler in the evaluation of flow location for the detection of adnexal malignancy seems to be reproducible method even in moderate experienced examiners. OP24.08 OP24.09Transrectal ultrasound in the evaluation of locally advanced cervical cancer after neoadjuvant chemotherapy Objective: We compared accuracy of transrectal ultrasound (TRUS) and magnetic resonance (MRI) in evaluation of locally advanced cervical cancer after neoadjuvant chemotherapy (NACT) in this study. Total 36 women with histologically verified cervical cancer stage IB2, incipient IIB and deep stromal invasion with response to NACT were included in this study. All patients were treated with ifosfamide/cisplatin chemotherapy followed by radical hysterectomy at our department in years [2004][2005][2006][2007][2008]. The histologica...

Clinical, ultrasound parameters and tumor marker-based mathematical models and scoring systems in pre-surgical diagnosis of adnexal tumors

“…Grade 3 adnexal masses need surgical intervention by gynecologists, while grade 4-5 patients should be referred to gynecological oncologist for further management [11]. The sensitivity and specificity of GI-RADS in the study of Amor et al, were 92% and 97%, respectively [10].…”

“…Adnexal masses, most probably malignant, which have at least three malignant features represent grade 5. The risk of malignancy in this grade exceeds 20% [10,11]. This system may help physicians to choose the most appropriate, grade-dependent method of management.…”

“…In 2009, Amor F et al, presented an ultrasound-based Gynecologic Imaging -Report and Data System (GI-RADS), which has five grades of ultrasonographic assessment of the adnexa and their pathologies [10]. The system is based on the concept of Breast Imaging Report and Data System (BI-RADS).…”

Clinical management of incidental findings on pelvic adnexal masses

“…All proposed scoring systems appear to exhibit an acceptable level of sensitivity and specificity, ranging from 83.5 to 92% and from 63 to 97%, respectively 8,[11][12][13][14] (B). The choice of the scoring system may, therefore, be based on the preference of the observer 4 (A).…”

“…Several scoring systems based on ultrasound morphology of adnexal cysts have been proposed to differentiate benign lesions from malignant adnexal masses [8][9][10][11][12][13][14] (B). These scoring systems are based on specific parameters such as surface, thickness of the wall, and cyst echogenicity; cyst volume; presence, thickness and number of septa; presence, size and number of vegetation, and presence and size of solid areas within the cyst.…”