Immature teratomas remain difficult to diagnose: A cross-sectional study

Area of Science:

• Gynecologic Oncology
• Diagnostic Imaging
• Pathology

Background:

• Ovarian mature teratomas have well-defined ultrasound features.
• Ultrasound characteristics of ovarian immature teratomas are less documented and can be mistaken for mature teratomas.

Purpose of the Study:

• To evaluate the subjective assessment accuracy of ultrasound examiners in differentiating between ovarian mature and immature teratomas using static B-mode images.

Main Methods:

• A retrospective analysis of 23 anonymized ultrasound images (9 immature, 9 mature teratomas) was conducted.
• Ultrasound examiners (Levels 1-3) completed an electronic questionnaire assessing image diagnosis.
• Histological confirmation of surgically removed masses served as the reference standard.

Main Results:

• Sensitivity and specificity for subjective assessment ranged widely (16.3%-97.7% and 81.6%-96.1%).
• Accurate diagnosis rates for mature teratomas were 41.3% sensitivity and 82.2% specificity.
• Accurate diagnosis rates for immature teratomas were 41.2% sensitivity and 81.6% specificity.
• No statistically significant difference was found in diagnostic performance between mature and immature teratomas (p=0.975).

Conclusions:

• Static 2D ultrasound imaging demonstrates low diagnostic performance for differentiating ovarian mature and immature teratomas.
• Immature teratomas continue to present a diagnostic challenge in ultrasound imaging.