Diagnostic Performance of Magnetic Resonance Imaging for Pediatric Ovarian Neoplasms: A Multi-Institutional Review.

Autor: Bergus KC; Center for Surgical Outcomes Research, Abigail Wexner Research Institute and Department of Surgery, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, Ohio., Knaus ME; Center for Surgical Outcomes Research, Abigail Wexner Research Institute and Department of Surgery, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, Ohio., Onwuka AJ; Center for Surgical Outcomes Research, Abigail Wexner Research Institute and Department of Surgery, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, Ohio., Afrazi A; American Family Children's Hospital, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin., Breech L; Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio., Corkum KS; Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois., Dillon PA; St. Louis Children's Hospital, Washington University School of Medicine in St. Louis, St. Louis, Missouri., Ehrlich PF; C.S. Mott Children's Hospital, University of Michigan Medical School, Ann Arbor, Michigan., Fallat ME; Norton Children's Hospital, University of Louisville School of Medicine, Louisville, Kentucky., Fraser JD; Children's Mercy Kansas City, University of Missouri Kansas City School of Medicine, Kansas City, Missouri., Gadepalli SK; C.S. Mott Children's Hospital, University of Michigan Medical School, Ann Arbor, Michigan., Grabowski JE; Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois., Hertweck SP; Norton Children's Hospital, University of Louisville School of Medicine, Louisville, Kentucky., Kabre R; Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois., Lal DR; Children's Hospital of Wisconsin, Medical College of Wisconsin, Milwaukee, Wisconsin., Landman MP; Riley Hospital for Children, Indiana University Health, Indianapolis, Indiana., Leys CM; American Family Children's Hospital, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin., Mak GZ; Comer Children's Hospital, The University of Chicago Medicine, Chicago, Illinois., Markel TA; Riley Hospital for Children, Indiana University Health, Indianapolis, Indiana., Merchant N; Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio., Overman RE; C.S. Mott Children's Hospital, University of Michigan Medical School, Ann Arbor, Michigan., Rademacher BL; American Family Children's Hospital, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin., Raiji MT; Comer Children's Hospital, The University of Chicago Medicine, Chicago, Illinois., Rymeski B; Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio., Sato TT; Children's Hospital of Wisconsin, Medical College of Wisconsin, Milwaukee, Wisconsin., Wright T; Norton Children's Hospital, University of Louisville School of Medicine, Louisville, Kentucky., Aldrink JH; Center for Surgical Outcomes Research, Abigail Wexner Research Institute and Department of Surgery, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, Ohio., Hewitt GD; Center for Surgical Outcomes Research, Abigail Wexner Research Institute and Department of Surgery, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, Ohio., Minneci PC; Center for Surgical Outcomes Research, Abigail Wexner Research Institute and Department of Surgery, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, Ohio; Department of Surgery, Nemours Children's Health, Delaware Valley, Wilmington, Delaware. Electronic address: peter.minneci@nemours.org., Deans KJ; Department of Surgery, Nemours Children's Health, Delaware Valley, Wilmington, Delaware.
Jazyk: angličtina
Zdroj: Journal of pediatric and adolescent gynecology [J Pediatr Adolesc Gynecol] 2024 Apr; Vol. 37 (2), pp. 192-197. Date of Electronic Publication: 2023 Nov 25.
DOI: 10.1016/j.jpag.2023.11.006
Abstrakt: Study Objective: To assess the diagnostic performance of MRI to predict ovarian malignancy alone and compared with other diagnostic studies.
Methods: A retrospective analysis was conducted of patients aged 2-21 years who underwent ovarian mass resection between 2009 and 2021 at 11 pediatric hospitals. Sociodemographic information, clinical and imaging findings, tumor markers, and operative and pathology details were collected. Diagnostic performance for detecting malignancy was assessed by calculating sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for MRI with other diagnostic modalities.
Results: One thousand and fifty-three patients, with a median age of 14.6 years, underwent resection of an ovarian mass; 10% (110/1053) had malignant disease on pathology, and 13% (136/1053) underwent preoperative MRI. MRI sensitivity, specificity, PPV, and NPV were 60%, 94%, 60%, and 94%. Ultrasound sensitivity, specificity, PPV, and NPV were 31%, 99%, 73%, and 95%. Tumor marker sensitivity, specificity, PPV, and NPV were 90%, 46%, 22%, and 96%. MRI and ultrasound concordance was 88%, with sensitivity, specificity, PPV, and NPV of 33%, 99%, 75%, and 94%. MRI sensitivity in ultrasound-discordant cases was 100%. MRI and tumor marker concordance was 88% with sensitivity, specificity, PPV, and NPV of 100%, 86%, 64%, and 100%. MRI specificity in tumor marker-discordant cases was 100%.
Conclusion: Diagnostic modalities used to assess ovarian neoplasms in pediatric patients typically agree. In cases of disagreement, MRI is more sensitive for malignancy than ultrasound and more specific than tumor markers. Selective use of MRI with preoperative ultrasound and tumor markers may be beneficial when the risk of malignancy is uncertain.
Concise Abstract: This retrospective review of 1053 patients aged 2-21 years who underwent ovarian mass resection between 2009 and 2021 at 11 pediatric hospitals found that ultrasound, tumor markers, and MRI tend to agree on benign vs malignant, but in cases of disagreement, MRI is more sensitive for malignancy than ultrasound.
(Copyright © 2023. Published by Elsevier Inc.)
Databáze: MEDLINE
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