Abdominopelvic computed tomography in the preoperative evaluation of suspected ovarian masses

To evaluate the efficacy of computed tomography (CT) in 175 patients scheduled to undergo surgery for a suspected ovarian mass, we compared preoperative CT findings with the findings at surgery and histology. At surgery, 115 patients were found to have epithelial ovarian malignancies (20 stage 1, 7 stage II, 50 stage III and 38 stage IV) while 60 had benign pelvic tumors. CT findings were suggestive of malignancy in 4 (7%) of 60 patients with benign tumors and suggestive of benign disease in 3 (3%) of 115 patients with malignant ovarian tumors; 30% of all scans were inconclusive. The sensitivity of CT for predicting pelvic or para-aortic lymph node involvement in 42 patients who underwent lymphadenectomy was 62 and 70%, respectively; the specificity was 100%. The results of this series suggest that the routine use of CT in the preoperative evaluation of patients does not seem justified.