P27.13: Comparison of the diagnostic value of risk of malignancy index RMI‐I with CA125, HE4 and ROMA in the preoperative assessment of adnexal masses

Abstract

Electronic poster abstractssupplemented with MRI and CT scan. Surgery alone or in combination with chemotherapy is the proposed treatment of immature teratoma. P27.11Half a good diagnosis Guide the gynecologist on the type, origin and status of an adnexal mass is the fundamental role of transvaginal ultrasound. The Doppler mode in its various forms is an important auxiliary role in these cases. The following case shows a correct diagnosis in both the tumor type and its status, but also its mistake in the origin. The Images and videos we present are for a presumptive ultrasound diagnosis of uterine fibroid, subserosal pedunculated, with twisted pedicle (Whirlpool Sign with at least three turns on its axis), with preservation of flow. Although post-operative diagnosis corresponded to a fibroma with twisted pedicle, the true origin of the tumor corresponded to the ovary. Although the difference did not change diagnostic medical conduct, it was a partial misdiagnosis and a fail in our aim to achieve total accuracy in ultrasonographic diagnosis.Supporting information can be found in the online version of this abstract Department of Obstetrics, Gynecology and Oncology II Faculty of Medicine, Medical University of Warsaw, Warsaw, PolandObjectives: The aim of the study was to compare the diagnostic performance of the classic and modified RMI IV in the preoperative differentiation between malignant and non-malignant adnexal masses. Methods: 140 patients with adnexal masses were included in the study. An ultrasound examination was done for each patient. Formula of Yamamoto was used for calculation of risk of malignancy risk index RMI IV depending on the ultrasound score, menopause status and the serum concentration of CA125. The following ultrasound features were considered in the formula: the presence of multilocular cyst, presence of solid component, evidence of metastases in ultrasound scan, ascites, bilateral lesions and maximal diameter of the lesion. Serum concentration of CA125 was used directly in the classic formula. Menopause was defined as absence of menstruation for at least 12 months. Serum concentration of human epididymis protein HE4 was used directly in the modified formula instead of CA125. The definitive diagnosis of the adnexal pathology was confirmed by the pathological examination of the excised lesions. Results: Malignant disease was confirmed in 25 cases (17,86%) and non-malignant disease in 115 cases (82,14%). 59 patients (24,14%) were after menopause. The sensitivity of classic and modified RMI IV was 92% and 88% respectively. The specificity was 97,39% and 94,78% respectively. The positive predictive value was 88,46% and 78,57% respectively. The negative predictive value was 98,25% and 97,32% respectively. Conclusions:The classic RMI IV has higher sensitivity, specificity, positive and negative predictive values than the modified RMI IV. Replacing of CA125 by HE4 in the RMI IV formula does not improve the sensitivity, specificity, positive and predictive values of RMI IV. P27.13Comparison of the...