MDCT features of primary versus secondary ovarian malignancies
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Abstract
BACKGROUND: It is difficult to distinguish between primary and secondary ovarian malignancies by multidetector computed tomography (MDCT), but necessary for management.
OBJECTIVE: To determine MDCT appearances of primary that differs from secondary ovarian malignancies
RESULTS: Among 273 patients (395 ovarian malignancies) were 146 cases of primary ovarian malignancies (155 malignancies) and 127 cases of secondary ovarian malignancies (240 malignancies). For CT features, bilateral ovarian involvement was found in primary ovarian malignancies 9 cases (6.2%) and secondary ovarian malignancies 113 cases (89%) (p<0.001). The median of ovarian size of primary and secondary ovarian malignancies was 12.7 cm and 6.6 cm, respectively (p<0.001). Primary and secondary ovarian malignancies were mixed solid cystic or solid about 72 cases (46.4%) and 125 cases (52.1%), respectively (p=0.044). For enhancement, primary ovarian malignancies were equal enhancement for 37 malignancies (23.9%) and secondary ovarian malignancies were 124 malignancies (51.7%) (p<0.001). Multivariate regression showed only bilateral and smaller size than 8.8 cm having statistically significant differences to distinguish secondary from primary ovarian malignancies. The sensitivity, specificity, accuracy, PPV and NPV for diagnosis using bilateral and smaller size (< 8.8 cm) were 73.3%, 96.2%, 82.3%, 96.7% and 69.9% respectively.
CONCLUSION AND DISCUSSION: MDCT features of malignant ovarian tumor, bilateral and small size (less than 8.8 cm) favor of diagnosis secondary ovarian malignancy. This study, reviewed only the patient with known pathologic results from their ovaries, so the palliative care cases or severe diseases were not included but should further study.
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