Preoperative risk assessment tests for suspicious ovarian mass

Abstract

Author(s): Russul Daad Abd Oun*, Hameed Jameel Hamzah, Akhlas Hashem Salman, Tahsin Hadi Husain, Nawfal Azzo, Atheer Adnan Fadhil and Ahmed Alshewered

Adnexal masses commonly are encountered and often present diagnostic and management dilemmas. The study aimed to compare the sensitivity, specificity, predictive value, and accuracy of the Risk Malignancy Index (RMI), simple rules, and Assessment of Different NEoplasias in the adneXa (ADNEX) model, in the diagnosis of an ovarian mass. A prospective observational cohort study was carried out in the Department of Obstetrics and Gynaecology / Baghdad Teaching Hospital. It was conducted over eighteen months starting from the first of January 2016 to the end of June 2017. A total number of 100 patients with the adnexal mass of different age groups were enrolled in this study. Those patients underwent surgery. They were sent for serum CA-125, and trans-vaginal and abdominal ultrasounds for masses were done preoperatively. Their scores for RMI, simple rules, and ADNEX were calculated preoperatively, and the results were compared with the result of histopathology. Histopathologic, all our patients were found to have an adnexal mass of ovarian origin. 71 (71%) of women were benign tumours and 29 (29%) women were malignant. The main benign type was serous cystadenoma (35.2%), while the main malignant type was serous cystadenocarcinoma (58.6%). Malignant tumours of different stages were found: (17.2%) of malignancies were border line, (34.4%) were in stage I, (6.8%) patients were in stage II, (31.0%) were in stage III, (6.8%) in stage IV, and (3.4%) metastasis. The validity results of risk of malignancy index (RMI) findings regarding histopathology were sensitivity (58.6%), specificity (91.5%), positive predictive value (73.9%), negative predictive value (84.40%) and accuracy (82.0%). The validity results of simple rules regarding histopathology were sensitivity (75.9%), specificity (85.9%), positive predictive value (100%), negative predictive value (96.8%), and accuracy (83.0%). The validity results of ADNEX findings regarding histopathology were sensitivity (86.2%), specificity (94.4%), positive predictive value (86.2%), negative predictive value (94.4%), and accuracy (92%). ADNEX model can be used as a first-line test for the diagnosis of adnexal mass preoperatively.

Share this article