A new scoring system to differentiate benign from malignant adnexal masses.
OBJECTIVE
The purpose of this study was to develop and cross-validate a new sonographic scoring system for differentiation between benign and malignant adnexal masses.


METHODS
This study was conducted in a tertiary care university hospital. In the first part of the study, we used a multivariate logistic regression analysis to develop a scoring system that was based on morphologic and Doppler sonographic data for 705 adnexal masses in 665 patients who were diagnosed and treated at our institution from January 1995 to June 2001. The scoring system was designed to use only those parameters that are found to be independent predictors of malignancy. In the second part of the study, we prospectively cross-validated this scoring system in a series of 90 adnexal masses in 86 patients between July 2001 and March 2002. With the use of the area under the curve of the respective ROC curves, we compared the new scoring system with other scoring systems.


RESULTS
Multivariate logistic regression analysis revealed that the only independent predictor parameters were thick papillary projections, solid areas, central flow, and velocimetric features of high velocity and low resistance. In the prospective cross-validation study, our scoring system had the best diagnostic performance (area under the curve, 0.98) compared with Sassone (area under the curve, 0.89; P =.017), De Priest (area under the curve, 0.92; P =.048), and Ferrazzi (area under the curve, 0.90; P =.013) scoring systems.


CONCLUSIONS
Our new sonographic scoring system had a better diagnostic performance than three previously published scoring systems.
Alcázar
Juan Luis
JL
Department of Obstetrics and Gynecology, Clínica Universitaria de Navarra, School of Medicine, University of Navarra, Pamplona, Spain. jlalcazar@unav.es
Mercé
Luis T
LT
Laparte
Carmen
C
Jurado
Matías
M
López-García
Guillermo
G
D000290:Adnexa Uteri / Q000000981:diagnostic imaging*; D000328:Adult; D003937:Diagnosis, Differential; D005260:Female; D005544:Forecasting; D005833:Genital Neoplasms, Female / Q000000981:diagnostic imaging*; D006801:Humans; D008875:Middle Aged; D015999:Multivariate Analysis; D011446:Prospective Studies; D012372:ROC Curve; D014463:Ultrasonography / Q000379:methods