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[Diagnostic importance of the sonographic scoring system in differentiating between malignant and benign ovarian
1Klinika za ginekologiju i akuserstvo, Klinicki centar, Medicinski fakultet, Novi Sad. Winter@PTT.YU
Introduction:
There have been several different sonographic scoring systems developed for evaluation of particular characteristics of ovarian tumors in order to classify malignant diseases in the most objective way. The aim of this study was to evaluate diagnostic significance of our own scoring system and possibilities of its application in differentiation of malignant and benign ovarian tumors.
Material And Methods:
A prospective study comprised 177 women with different ovarian tumors. All patients underwent ultrasound examination using a unit with a 5 MHz probe. Certain tumor characteristics (size, morphology, septa, type of capsule and ascites) were estimated by scores from 0 to 2 whereas the sum of all scores presented the total score. A final diagnosis was made after histopathologic examination: group A--malignant ovarian tumors (n = 71) and group B--benign ovarian tumors (n = 106).
Results:
The highest value of reliability in differentiation of malignant and benign ovarian tumors was score 6 and more than six (sensitivity 87.3%, specificity 91.5%, positive predictive value 87.3%, negative predictive value 91.5% and test accuracy 90.9%).
Discussion:
A separate diagnostic problem during application of mentioned sonographic scoring system were solid malignant tumors with a low total score (4 and 5 scores) and benign tumors of complex consistence of high total score (7 and 8 scores). The total score 1-3 eliminates malignant tumors and the score from 9-10 eliminates benign type of tumors.
Conclusion:
High sensitivity (95.7%) is present at the total score of 5 and more than five, but low specificity (81.1%) and test accuracy (87%) gives advantage to the score 6 and more, where differences between separate statistical parameters are least present.