Abstract
BackgroundTo determine the best sonographic (US) and/or Doppler features that the radiologist can use as predictors or risk factors for ovarian malignancyResultsAmong the examined 156 ovarian lesions, there were 53 malignant and 103 benign lesions. Most of the malignant ovarian lesions were noted in older age than in benign lesions p < 0.001. Majority of the malignant lesions had non-hyperechoic solid component (92.5%); it had the highest sensitivity of 92.5%, specificity of 97%, accuracy of 94.8%, positive predictive value of 94%, negative predictive value of 96%, and AUC of 0.94 in discrimination between benign and malignant ovarian lesions. The presence of papillary projection, the absence of wall definitions and thick wall, and thick septation were noted in 83%, 81%, and 53.8% of the malignant ovarian lesions respectively. Color flow Doppler shows neovascularity in 88.7% of the malignant lesions, 73.6% of them has central blood flow. The multivariate regression analysis revealed that the presence of non-hyperechoic solid component, new vascularity with central location of the blood flow, papillary projection, thick septa, and old age were the most significant parameters in predicting ovarian cancer in decreasing order of frequency according to their odds ratio (19.45, 7.55, 4.56, 3.45, and 1.45, respectively).ConclusionsThe non-hyperechoic solid component, new vascularity with central location of the blood flow, papillary projection, and thick septa were the most significant and consistent US and Doppler predictors of ovarian malignancy in addition to one clinical feature which is the old age ≥ 52 years.
Highlights
To determine the best sonographic (US) and/or Doppler features that the radiologist can use as predictors or risk factors for ovarian malignancy
This study aims to determine the best sonographic and/or Doppler features that the radiologist can use as predictors or risk factors for ovarian malignancy, which in turn help the radiologist to select the high risk ovarian lesions that need further investigations in a specialized center
The majority of the malignant lesions had non-hyperechoic solid component (92.5%) (Fig. 2), and it had the highest sensitivity, specificity, accuracy, positive predictive value (PPV), negative predictive value (NPV), and Area under receiver operating curve (AUC) in discrimination between benign and malignant ovarian lesions as demonstrated at Table 1 with 19.45 odds ratio (p = 0.01) in predicting ovarian cancer, while the majority of benign lesions had no solid component (92.2%)
Summary
To determine the best sonographic (US) and/or Doppler features that the radiologist can use as predictors or risk factors for ovarian malignancy. Ovarian cancer is the fifth most common cancer death among women [1], and the second most common gynecologic malignancy [2]. Most women are diagnosed in late stages that have a poor survival rate [3], while only 20% are diagnosed at early stages, in which the 5-year survival rate exceeds 90% [4]. This study aims to determine the best sonographic and/or Doppler features that the radiologist can use as predictors or risk factors for ovarian malignancy, which in turn help the radiologist to select the high risk ovarian lesions that need further investigations in a specialized center
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