Appearance of ovarian lesions on ultrasound may predict malignancy

The appearance of ovarian lesions on ultrasound may predict the risk for malignancy, according to a study published in the June issue of Radiology.

Akshya Gupta, M.D., from the University of Rochester Medical Center in New York, and colleagues conducted a retrospective cohort study that included isolated ovarian lesions identified at pelvic ultrasound to examine whether an ultrasound-based classification scheme of classic versus nonclassic appearance can be used to help appropriately triage women at average risk for ovarian cancer. Classic lesions included simple cysts, hemorrhagic cysts, endometriomas, and dermoids; other lesions were classified as nonclassic. Data were included for 970 isolated lesions in 878 women.

The researchers found that the malignancy rate for classic lesions was <1 percent. Overall, 6 percent of the 970 lesions were malignant. For nonclassic lesions, the malignancy rate was 32 and 8 percent, respectively, when blood flow was and was not present. For women older than 60 years, the malignancy rate was 50 and 13 percent, respectively, for lesions with and without blood flow. For the classic versus nonclassic schema, the sensitivity, specificity, positive predictive value, and negative predictive value were 93, 73, 17, and 99 percent, respectively, for detection of malignancy.

“If you have something that follows the classic imaging patterns described for these lesions, then the risk of cancer is really low,” Gupta said in a statement. “If you have something that’s not classic in appearance, then the presence of solid components and particularly the presence of Doppler blood flow is really what drives the risk of malignancy.”

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