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OC148: The value of the “ovarian crescent sign” to exclude an invasive malignancy
Author(s) -
Van Holsbeke C.,
Czekierdowski A.,
Fischerova D.,
Jingzhang Z.,
de Jonge E.,
Jurkovic D.,
Paladini D.,
Testa A. C.,
Timmerman D.
Publication year - 2008
Publication title -
ultrasound in obstetrics and gynecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.202
H-Index - 141
eISSN - 1469-0705
pISSN - 0960-7692
DOI - 10.1002/uog.5556
Subject(s) - medicine , adnexal mass , malignancy , stage (stratigraphy) , ovary , ovarian cancer , ultrasound , metastasis , radiology , pathology , cancer , paleontology , biology
Aim\ud\udTo examine the value of the “ovarian crescent sign” - a rim of normal ovarian tissue adjacent to an ipsilateral adnexal mass - as a sonographic feature to exclude an invasive malignancy.\ud\ud\udMethods\ud\ud\udDuring the IOTA phase 2 study, patients with an adnexal mass were included in 19 different international centers. All patients were scanned following the same standardized ultrasound protocol. The primary outcome was the histological diagnosis.\ud\ud\udMore than 40 demographic and ultrasound variables were mandatory, but the evaluation of the “ovarian crescent sign” was optional.\ud\ud\udThe ovarian crescent sign is assumed to exclude an invasive malignancy, therefore benign and borderline tumors were analyzed as one group.\ud\ud\udResults\ud\ud\ud\ud1940 patients were included but the “ovarian crescent sign” was evaluated only in 1476 cases (76%) of which 1016 (69%) were benign and 460 (31%) malignant: 319 masses (21.6%) were primary invasive, 92 (6.2%) borderline and 49 (3.3%) metastatic.\ud\ud\udThe “ovarian crescent sign” was present in 464 masses (425 benign, 20 primary invasive, 17 borderline, 2 metastasis). 299 (94%) of the primary invasive masses had no ovarian crescent sign, but in 20 cases (6%) it was reported: 13 epithelial carcinomas (3 stage I, 1 stage II, 8 stage III, 1 stage IV), 3 rare malignancies (struma, teratoma, GCT) and 4 extra ovarian malignancies (2 tubal ca, 1 clear cell ca of the uterus and one peritoneal ca with normal ovaries).\ud\ud\udThe sensitivity and specificity for absence of the “ovarian crescent sign” to detect an invasive malignancy was 94.0% and 39.9%, LR + was 1.56 and LR − 0.15.\ud\udConclusion\ud\udThis study confirms previous reports that in the presence of the “ovarian crescent sign” the risk of an invasive malignancy is low. As a single ultrasound variable it can not reliably discriminate between benign and malignant adnexal masses but in combination with other ultrasound variables it might prove to be valuable. This far no scoring system or mathematical model has used it as a variable