title: Is three-dimensional ultrasonography of additional value in the assessment of adnexal masses?
abstract: OBJECTIVE
  Patient characteristics, CA125 level and two-dimensional (2D) ultrasonography can be used to predict the probability of malignancy of an ovarian mass. Three-dimensional (3D) ultrasonography might also contribute to the prediction of malignancy. We evaluated whether addition of 3D features to a diagnostic model could improve the discriminative capacity of the model.
  
  
  METHODS
  This multicenter prospective study was approved by the institutional review board. Women with an adnexal mass scheduled for surgery underwent 2D and 3D ultrasonographic examination in the week prior to surgery. Stepwise logistic regression was used to construct two models for the prediction of malignancy: a model based on patient characteristics, level of CA125 and 2D ultrasonography and a second model based on patient characteristics, level of CA125, 2D and 3D ultrasonography. Receiver operator characteristic (ROC) curve analysis was used to compare the capacity of the two models to discriminate between benign and malignant adnexal masses.
  
  
  RESULTS
  We included 181 women with an adnexal mass, of which144 were benign and 37 showed malignancy on histopathology. The 3D model discriminated better between benign and malignant adnexal masses than the 2D model (areas under the ROC curve of 0.92 and 0.82, respectively, p=0.02). The calibration of both models was good.
  
  
  CONCLUSIONS
  In the assessment of the ovarian mass, the use of 3D ultrasonography significantly improves the prediction of malignancy as compared to patient characteristics and 2D ultrasonography.
authors.affiliation: Department of Obstetrics and Gynecology, Máxima Medical Centre, Veldhoven, The Netherlands. peggy.geomini@hetnet.nl <peggy.geomini@hetnet.nl>
authors.forename: Peggy M A J
authors.initials: PM
authors.lastname: Geomini
authors.forename: Sjors F P J
authors.initials: SF
authors.lastname: Coppus
authors.forename: Kirsten B
authors.initials: KB
authors.lastname: Kluivers
authors.forename: Gérard L
authors.initials: GL
authors.lastname: Bremer
authors.forename: Roy F P M
authors.initials: RF
authors.lastname: Kruitwagen
authors.forename: Ben Willem J
authors.initials: BW
authors.lastname: Mol
mesh_terms: D000290:Adnexa Uteri / Q000000981:diagnostic imaging* / Q000601:surgery; D018394:CA-125 Antigen / Q000097:blood; D005260:Female; D006801:Humans; D016015:Logistic Models; D008954:Models, Biological; D015233:Models, Statistical; D010051:Ovarian Neoplasms / Q000097:blood / Q000000981:diagnostic imaging* / Q000601:surgery; D014463:Ultrasonography / Q000379:methods
chemical_list: D018394:CA-125 Antigen