title: Ovarian lesion volumes as a screening tool for malignancy in adolescent ovarian tumors.
abstract: BACKGROUND
  Preoperative evaluation of ovarian tumors for malignancy is essential to determine appropriate treatment. Our study assessed the utility of ovarian lesion volumes to screen for malignancy in adolescent ovarian lesions.
  
  
  METHODS
  A retrospective chart review of adolescent patients (8-18years) who underwent an ovarian operation from January 2008 to December 2012. Data included demographics, ultrasonographic volume measurements, and tumor markers. Volumes were calculated using the prolate ellipsoid formula. Data are presented as medians.
  
  
  RESULTS
  One hundred twenty-three females were included at a median age of 13.7years (IQR 12.5-16). Eight patients had malignancies. The median benign lesion volume was significantly smaller than malignant [152cm3 (IQR 57-592)vs. 1548cm(3) (IQR 627-2105), p=0.001]. A receiver operating characteristic (ROC) curve analysis (AUC 0.84, p=0.001) revealed a threshold ovarian lesion volume of <184cm(3) (100% sensitivity, 54% specificity, NPV 100%, PPV 13%) to accurately screen for malignancy. This held true when applied to our dataset as none of the 62 girls with volumes <184cm(3) had malignant pathology.
  
  
  CONCLUSIONS
  This is the first documented use of ovarian lesion volumes as a screening tool in adolescent ovarian lesions. This should be used in conjunction with tumor markers and other imaging features to better screen for malignancy.
authors.affiliation: Division of Pediatric Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA.
authors.forename: Paulette I
authors.initials: PI
authors.lastname: Abbas
authors.affiliation: Division of Pediatric Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA.
authors.forename: Simone C
authors.initials: SC
authors.lastname: Elder
authors.affiliation: E. B. Singleton Department of Pediatric Radiology, Texas Children's Hospital, Houston, TX, USA.
authors.forename: Amy R
authors.initials: AR
authors.lastname: Mehollin-Ray
authors.affiliation: E. B. Singleton Department of Pediatric Radiology, Texas Children's Hospital, Houston, TX, USA.
authors.forename: Richard M
authors.initials: RM
authors.lastname: Braverman
authors.affiliation: Division of Pediatric Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA.
authors.forename: Monica E
authors.initials: ME
authors.lastname: Lopez
authors.affiliation: Division of Pediatric and Adolescent Gynecology, Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, USA.
authors.forename: Jessica A
authors.initials: JA
authors.lastname: Francis
authors.affiliation: Division of Pediatric and Adolescent Gynecology, Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, USA. Electronic address: jedietri@texaschildrens.org.
authors.forename: Jennifer E
authors.initials: JE
authors.lastname: Dietrich
mesh_terms: D000293:Adolescent; D014408:Biomarkers, Tumor / Q000032:analysis; D002648:Child; D005260:Female; D006801:Humans; D010051:Ovarian Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D012372:ROC Curve; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D047368:Tumor Burden; D014463:Ultrasonography
chemical_list: D014408:Biomarkers, Tumor
keywords: Ovarian malignancy; Ovarian volumes; Pediatric gynecology; Pediatric ovarian lesions