Characterization of adnexal masses using feature analysis at contrast-enhanced helical computed tomography Journal Article
| Authors: | Zhang, J.; Mironov, S.; Hricak, H.; Ishill, N. M.; Moskowitz, C. S.; Soslow, R. A.; Chi, D. S. |
| Article Title: | Characterization of adnexal masses using feature analysis at contrast-enhanced helical computed tomography |
| Abstract: | OBJECTIVE: To determine the computed tomographic imaging features predictive of adnexal malignancy and evaluate the accuracy of contrast-enhanced helical computed tomography (CT) in the characterization of adnexal masses. MATERIALS AND METHODS: The institutional review board waived the informed consent requirement for this retrospective study, which was Health Insurance Portability and Accountability Act compliant. 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 computed tomographic scans were retrospectively and independently reviewed by 2 radiologists. Receiver operating characteristic 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 κ statistics. RESULTS: At surgical pathology, 234 adnexal masses were found (165 were 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 receiver operating characteristic curves were 0.88 (95% confidence interval [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 (κ = 0.71) was good. CONCLUSIONS: Contrast-enhanced helical CT is highly accurate in characterizing adnexal masses as malignant. Recognition of the computed tomographic 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. © 2008 by Lippincott Williams and Wilkins. |
| Keywords: | adolescent; adult; human tissue; aged; aged, 80 and over; middle aged; retrospective studies; clinical feature; ascites; solid tumor; treatment planning; methodology; cancer diagnosis; pelvis; diagnostic accuracy; preoperative evaluation; sensitivity and specificity; ovarian neoplasms; reproducibility; reproducibility of results; diagnosis, differential; observer variation; differential diagnosis; carcinoma, papillary; retrospective study; prediction; tomography, spiral computed; confidence interval; health insurance; abdomen; radiologist; evaluation; contrast enhancement; image quality; ovary tumor; prediction and forecasting; predictive value of tests; patient compliance; contrast medium; contrast media; radiography; pleura effusion; informed consent; papillary carcinoma; tumor; uterus cancer; lymphadenopathy; roc curve; receiver operating characteristic; ovary cyst; female genital system; ovarian; radiographic image enhancement; peritoneum; spiral computer assisted tomography; institutional review; kappa statistics; mass; adnexa disease; adnexa; adnexa uteri; adnexal diseases |
| Journal Title: | Journal of Computer Assisted Tomography |
| Volume: | 32 |
| Issue: | 4 |
| ISSN: | 0363-8715 |
| Publisher: | Lippincott Williams & Wilkins |
| Date Published: | 2008-07-01 |
| Start Page: | 533 |
| End Page: | 540 |
| Language: | English |
| DOI: | 10.1097/RCT.0b013e3181568890 |
| PUBMED: | 18664838 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 9" - "Export Date: 17 November 2011" - "CODEN: JCATD" - "Source: Scopus" |
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