Figure 1: Monitoring and therapeutic decision of adnexal masses according
Ultrasound image |
Size (cm) |
Follow-up |
Surgery (cm) |
GI-RADS1 |
|
|
|
Normal |
- |
No |
No |
GI-RADS2 |
|
|
|
Functional |
> 5 |
6w/3m/6m/1y |
According to symptoms |
GI-RADS3 |
|
|
|
Premenopausal |
|
|
|
|
3-4 |
|
>4 |
|
3-5 |
6w/3m/6m/1y |
>5 |
|
>3 |
|
>10 |
Postmenopausal |
|
|
|
|
<3 |
|
>3 |
|
<3 |
6w/3m/6m/1y |
>3 |
|
>2.2 |
|
>10 |
GI-RADS4 |
|
|
|
1-2 findings suggestive of |
<3 |
6w/3m/6m/1y |
>3 |
GI-RADS5 |
|
|
|
>3 findings suggestive of |
|
|
All cyst |
Table 1: Management protocol for adnexal masses according to GI-RADS classification and hormonal status
Sonographic characteristics |
N (%) |
Size** |
4.6 (2.3) |
GI-RADS |
38 (24.7) |
Diferents GI-RADS 3
|
36 (45.6) |
Malignancy findings
|
19 (12.3) |
Sonographic changes
|
120 (81.9) 77 (67.8) |
Table 2: Sonographic characteristics
** Data expressed in cms as median values (interquartile range, RIQ)
Histologic results |
N (%) |
|
2 (3.9) |
Carcinomas:
|
8 (66.7) |
Diferentation grade:
|
2 (15.4) |
Table 3: Histologic results
Variable |
Surgery |
No surgery |
p |
Age* |
48.1 (17.1) |
41.6 (12.1) |
0.017 |
Menopausal |
21 (41.2) |
18 (17.5) |
0.001 |
Size(cm)** |
5.9 (3.9) |
4.2 (1.7) |
<0.0001 |
HE4 negative |
42 (82.4) |
99 (96.1) |
0.010 |
Ca125 |
32 (78) |
55 (88.7) |
0.144 |
GI-RADS |
5 (9.8) |
33 (32) |
<0.0001 |
Table 4: Comparison of study groups: surgical vs no surgical intervention
D* Data expressed as mean (SD) ** Data expressed as median (RIQ)
|
Sensitivity |
Specificity |
VPP |
VPN |
HE4 GLOBAL ROC 76.6% |
||||
- PC 70 |
70.6 (46-95.2) |
88.3 (82.6-94.1) |
42.9 (22.7-63) |
96 (92.2-99.8) |
- PC 82 |
70.6 (46-95.2) |
92 (87.1-96.9) |
52.2 (29.6-74.8) |
96.2 (92.5-99.8) |
- PC 100 |
58.8 (32.5-85.2) |
95.6 (91.8-99.4) |
62.5 (35.6-89.3) |
94,9 (90,9-98,9) |
- PC 130 |
47.1 (20.4-73.7) |
96.3 (92.8-99.9) |
61.5 (31.2-91.8) |
93.6 (89.2-98) |
HE4 PREMENOPAUSAL ROC 66.1% |
||||
- PC 70 |
60 (7,1-100) |
82.7 (87.4-98) |
27.3 (0-58.1) |
98.1 (95-100) |
- PC 82 |
60 (7.1-100) |
94.5 (89.8-99.2) |
33.3 (0-69.7) |
98.1 (95-100) |
- PC 100 |
40 (0-92,9) |
97.3 (93.8-100) |
40 (0-92.9) |
97.3 (93.8-100) |
- PC 130 |
40 (0-92,9) |
98.2 (95.2-100) |
50 (0-100) |
97.3 (93.8-100) |
HE4 POSMENOPAUSAL ROC 77.2% |
||||
- PC 70 |
75 (46.3-100) |
70.4 (51.3-89.5) |
52.9 (26.3-79.6) |
86.4 (69.7-100) |
75 (46.3- 100) |
81.5 (65-98) |
64.3 (35,6-93) |
88 (73.3-100) |
|
- PC 82 |
||||
- PC 100 |
66.7 (35.8-97.5) |
88.9 (75.2-100) |
72.7 (41.9-100) |
85.7 (71-100) |
- PC 130 |
50 (17.5-82.5) |
88.9 (75.2-100) |
66.7 (30.3-100) |
80 (64-96) |
Ca125 |
26.7 (0.9-52.4) |
84.1 (75.9-92.3) |
22.2 (0.2-44.2) |
87.1 (79.3-94.8) |
GIRADS |
88.2 (70-100) |
83.9 (22.4-90.4) |
40,5 (23.4-57.7) |
98.3 (95.5-100) |
- Premen |
100 (90-100) |
85.4 (78.4-92.5) |
23,8 (3.2-44.4) |
100 (99.5-100) |
- Posmen |
83.3 (58.1-100) |
77.8 (60.2-95.3) |
62.5 (35.6-89.3) |
91.3 (77.6-100) |
Table 5: Calculation of Sensitivity (S), Specificity (E), VPP and VPN of tumor and ultrasound markers
Tables at a glance
Figures at a glance