Jingbo Zhang MD, Presenter: Nothing to Disclose

Svetlana Mironov MD, Abstract Co-Author: Nothing to Disclose

Hedvig Hricak MD, PhD, Abstract Co-Author: Nothing to Disclose

Chaya S. Moskowitz PhD, Abstract Co-Author: Nothing to Disclose

Nicole M. Ishill PhD, Abstract Co-Author: Nothing to Disclose

Robert Soslow, Abstract Co-Author: Nothing to Disclose

Dennis Chi, Abstract Co-Author: Nothing to Disclose

et al, Abstract Co-Author: Nothing to Disclose

et al, Abstract Co-Author: Nothing to Disclose

To determine the CT features predictive of adnexal malignancy and evaluate the accuracy of contrast-enhanced helical CT in the characterization of adnexal masses.

For 143 consecutive patients who underwent preoperative contrast-enhanced CT of the abdomen and pelvis and had adnexal masses found at surgical pathology, preoperative contrast-enhanced CT scans were retrospectively and independently reviewed by two radiologists. Receiver operating characteristic (ROC) analysis was used to assess the value of contrast-enhanced CT in detecting and characterizing adnexal masses. Feature analysis was performed to select the findings with the highest sensitivities and specificities for predicting malignant lesions. Interobserver variability was assessed using kappa statistics.

At surgical pathology 234 adnexal masses were found (165 malignant). Readers 1 and 2 detected 215 and 216 (92%) adnexal masses, respectively. For both readers, the features most predictive of malignancy were heterogeneity for a solid lesion; multilocularity (>3 locules), irregular and thickened cystic septations or walls, and the presence of internal vegetations for a cystic lesion. Irregular lesion contour and ancillary findings, including ascites, peritoneal implants, lymphadenopathy and pleural effusion, were predictive of malignancy in both solid and cystic lesions. In diagnosing malignancy in all patients and in the subgroup without ancillary findings, areas under the ROC curves were 0.88 (95% CI, (0.84, 0.93)) and 0.89 (95%CI (0.83, 0.96)) for reader 1, respectively and 0.90 (95% CI, (0.86, 0.94)) and 0.88 (95%CI (0.80, 0.97)) for reader 2, respectively. Interobserver agreement (ĸ 0.71) was good.

Contrast-enhanced helical CT is highly accurate in characterizing adnexal masses as malignant. Recognition of the CT features most often associated with adnexal malignancy will assist in more confident use of this modality and may potentially obviate the need for additional imaging studies before treatment selection.

Contrast-enhanced helical CT is highly accurate in characterizing adnexal masses as malignant even in the absence of ancillary findings.

Zhang, J, Mironov, S, Hricak, H, Moskowitz, C, Ishill, N, Soslow, R, Chi, D, et al, , et al, , Characterization of Adnexal Masses Using Feature Analysis at Contrast-enhanced Helical CT.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5016170.html