Modified Computed Tomography Scoring System for Ovarian Tumors

Authors

  • Onnicha Areepongsa Department of Radiology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand.
  • Kamonwon Cattapan Department of Radiology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand.
  • Siriporn Leelakiatpaiboon Department of Radiology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand.
  • Teeravut Tubtawee Department of Radiology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand.
  • Ingporn Jiamset Department of Obstetrics and Gynecology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand.

DOI:

https://doi.org/10.31584/jhsmr.20241045

Keywords:

benign, computed tomography, malignant, ovarian tumor, scoring system

Abstract

Objective: Ovarian cancer is the sixth most common cancer in Thailand. Given the absence of a computed tomography (CT) score for differentiating between benign and malignant ovarian tumors, this study aimed to develop a CT scoring system for differentiating between benign and malignant ovarian tumors using pathologic findings as the reference standard.
Material and Methods: This retrospective study included all female patients having undergone abdominal/pelvic CT scans for evaluation of ovarian masses at our institute, from January 2011 to December 2021. Two radiologists independently reviewed CT features and obtained a CT score for each tumor. Comparison of the differentiation performance of the CT score, with reference to the pathologic findings, was performed using Fisher’s exact or chi-squared test. The diagnostic performance of the CT score was evaluated.
Results: A total of 144 patients with 191 ovarian masses were enrolled. Tumor component characteristics, septate thickness, ascites, and metastasis significantly differed between benign and malignant tumors (p-value<0.05). Multivariate logistic regression analysis showed that the presence of solid components and metastasis were significant independent differentiating factors (p-value<0.001). The CT score significantly differed between benign and malignant tumors (p-value<0.001), with 93.5% sensitivity and 81.6% specificity.
Conclusion: The CT scoring system can differentiate between benign and malignant ovarian tumors with high sensitivity and specificity. Furthermore, the presence of a solid component and metastasis are CT features that can be used to differentiate between benign and malignant tumors.

References

Wilailak S, Lertchaipattanakul N. The epidemiologic status of gynecologic cancer in Thailand. J Gynecol Oncol 2016;27:e65. doi: 10.3802/jgo.2016.27.e65.

Mukhtar S, Khan SA, Hussain M, Adil SO. Role of multidetector computed tomography in evaluation of ovarian lesions in women clinically suspected of malignancy. Asian Pac J Cancer Prev 2017;18:2059-62.

El-Badrawy A, Omran E, Khater A, Awad M, Helal A. 64 Multidetector CT with multiplanar reformation in evaluation of bilateral ovarian masses. Egypt J Radiol Nucl Med 2012;43:285-91.

Thomassin-Naggara I, Aubert E, Rockall A, Jalaguier-Coudray A, Rouzier R, Daraï E, et al. Adnexal masses: development and preliminary validation of an MR imaging scoring system. Radiology 2013;267:432-3.

Kang SK, Reinhold C, Atri M, Benson CB, Bhosale PR, Jhingran A, et al. ACR Appropriateness Criteria® staging and follow-up of ovarian cancer. J Am Coll Radiol 2018;15:S198-207.

Kawamoto S, Urban BA, Fishman EK. CT of epithelial ovarian tumors. Radio Graphics 1999;19:S85-102.

Golding SJ. Radiation exposure in CT: what is the professionally responsible approach? Radiology 2010;255:683-6.

DeSouza NM, O’Neill R, McIndoe GA, Dina R, Soutter WP. Borderline tumors of the ovary: CT and MRI features and tumor markers in differentiation from stage I disease. AJR Am J Roentgenol 2005;184:999-1003.

Frija G, Blažić I, Frush DP, Hierath M, Kawooya M, Donoso-Bach L, et al. How to improve access to medical imaging in low- and middle-income countries? Eclinicalmedicine 2021;38:101034.

Hilabi BS, Alghamdi SA, Almanaa M. Impact of magnetic resonance imaging on healthcare in low- and middle-income countries. Cureus 2023;15:e37698.

Sadowski EA, Thomassin-Naggara I, Rockall A, Maturen KE, Forstner R, Jha P, et al. O-RADS MRI risk stratification system: guide for assessing adnexal lesions from the ACR O-RADS committee. Radiology 2022;303:35-47.

Thomassin-Naggara I, Poncelet E, Jalaguier-Coudray A, Guerra A, Fournier LS, Stojanovic S, et al. Ovarian-adnexal reporting data system magnetic resonance imaging (O-RADS MRI) score for risk stratification of sonographically indeterminate adnexal masses. JAMA Netw Open 2020;3:e1919896.

Furlan A, Fakhran S, Federle MP. Spontaneous abdominal hemorrhage: causes, CT findings, and clinical implications. AJR Am J Roentgenol 2009;193:1077-87.

Reinhold C, Rockall A, Sadowski EA, Siegelman ES, Maturen KE, Vargas HA, et al. Ovarian-Adnexal Reporting Lexicon for MRI: A White Paper of the ACR Ovarian-Adnexal Reporting and Data Systems MRI Committee. J Am Coll Radiol 2021;18:713–29.

Berek JS, Renz M, Kehoe S, Kumar L, Friedlander M. Cancer of the ovary, fallopian tube, and peritoneum: 2021 update. Int J Gynecol Obstet 2021;155:61-85.

Armstrong DK, Alvarez RD, Bakkum-Gamez JN, Barroilhet L, Behbakht K, Berchuck A, et al. Ovarian cancer, version 2.2020, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw 2021;19:191-226.

Cui R, Wang Y, Li Y, Li Y. Clinical value of ROMA index in diagnosis of ovarian cancer: meta-analysis. Cancer Manag Res 2019;11:2545-51.

Taylor EC, Irshaid L, Mathur M. Multimodality imaging approach to ovarian neoplasms with pathologic correlation. Radiographics 2021;41:289-315.

Santoso JT, Robinson A, Suganda S, Praservit S, Wan JY, Ueland F. Computed tomography adnexal mass score to estimate risk for ovarian cancer. Arch Gynecol Obstet 2014;289:595-600.

Jung SE, Lee JM, Rha SE, Byun JY, Jung JI, Hahn ST. CT and MR imaging of ovarian tumors with emphasis on differential diagnosis. Radiographics 2002;22:1305-25.

Saga D, Bhadra R, Biswas N. Radiological evaluation of ovarian mass by contrast-enhanced computed tomography abdomen with clinicopathological correlation in Eastern Indian population. Asian J Med Sci 2022;13:243-7.

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Published

2024-06-21

How to Cite

1.
Areepongsa O, Cattapan K, Leelakiatpaiboon S, Tubtawee T, Jiamset I. Modified Computed Tomography Scoring System for Ovarian Tumors. J Health Sci Med Res [Internet]. 2024 Jun. 21 [cited 2024 Jun. 30];42(4):e20241045. Available from: https://he01.tci-thaijo.org/index.php/jhsmr/article/view/271993

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