Ultrasonography and Computed Tomography for Management of Adnexal Masses in Iranian Patients with Suspected Ovarian Cancer: Results of a Prospective Study

Background: To determine and compare the accuracy of sonographic and computerized tomography (CT)scan assessments in distinguishing between benign and malignant adnexal masses in an under-studied populationof Iranian patients.
Methods: Transabdominal sonography (TAS) and CT reports of 75 women with adnexalmasses (34 malignant, and 41 benign) who were consecutive operated patients at a tertiary gynecology cancercenter (Tehran, Iran) were examined. The sonography examinations were operated by a radiologist experiencedin the gynecologic oncology field. Biomarkers were determined in blood samples. For CT and TAS, to classifymasses as malignant or benign, receiver operating curves (ROC) were assessed and the areas under the curveswere compared.
Results: For TAS the sensitivity, specificity, positive predictive value and negative predictivevalue were 91%, 68%, 71% and 90%, respectively. For CT scans the results were 85%, 56 %, 62% and 83%,respectively. The AUC of sonography assessment to diagnose malignancy was significantly higher than that ofCT scan (0.8 vs.0.71; p<0.05).
Conclusion: TAS is a sensitive method for preoperative detection and staging ofsuspected ovarian cancer. Biomarkers and CT scan imaging add no additional findings for pre-operativecharacterization of ovarian masses.