Diagnostic Efficacy of the Morphological Scoring System of Ultrasound, CA-125, Color Doppler Sonography(CDS), and Magnetic Resonance Imaging(MRI) in Detecting Ovarian Malignancy

Park, Yong Won; Kim, Jae Wook; Cho, Jae Sung; Han, Sung Sik; Kim, Young Tae; Suh, Seung Hyun

Abstract

OBJECTIVE
Ovarian cancer is a silent disease with few symptoms. Because early detection of ovarian cancer is difficult, most cases are diagnosed at an advanced stage. To determine whether an ovarian tumor is malignant or not, various diagnostic procedures have been used including physical examination, ultrasound and tumor markers such as CA-125. We recently compared color Doppler sonography(CDS) with the morphological scoring system and CA-125 levels in establishing an accurate preoperative diagnosis of adnexal mass. As a result, we tried to compare the morphological scoring system with CA-125 and CDS in the diagnosis of adnexal mass.
METHODS
The medical records of 47 patients referred with preexisting adnexal lesion were reviewed retrospectively by comparing ultrasonic data(morphological scoring system and color Doppler finding) with serum CA-125 and MRI findings.
RESULTS
Forty-nine masses were removed surgically and confirmed as 25 malignancies and 22 benign tumors. In cases using the morphological scoring system and CA-125, the accuracy showed 95% sensitivity. In cases using the morphological scoring system and CDS, the sensitivity was 88%. In cases using the morphological scoring system and CDS, the sensitivity was 48%.
CONCLUSIONS
The morphological scoring system and CA-125 are the basic methods for predicting ovarian malignancy. MRI and CDS may be also useful diagnosis methods in diagnosis of ovarian malignancy. But combination of these diagnositic modalities may not improve the accuracy of predicting ovarian malignancy, significantly.