Journal of Ultrasound in Medicine, Vol 18, Issue 12 837-842, Copyright © 1999 by American Institute of Ultrasound in Medicine
Prospective evaluation of a logistic model based on sonographic morphologic and color Doppler findings developed to predict adnexal malignancy
J. L. Alcazar and M. Jurado
Department of Obstetrics and Gynecology, Clinica Universitaria de Navarra, School of Medicine, University of Navarra, Pamplona, Spain.
To assess prospectively a logistic model based on sonographic morphologic
and color Doppler findings, which had been developed to predict adnexal
malignancy, 167 consecutive and unselected patients (mean age, 45.7 yr;
range, 17 to 81 yr; 113 [67.7%] premenopausal and 54 [32.3%]
postmenopausal) diagnosed as having an adnexal mass and scheduled for
surgery were prospectively included in this study. All patients were
evaluated by transvaginal color Doppler ultrasonography. The probability of
adnexal malignancy was estimated prior to surgery, applying a logistic
model developed previously. A probability of malignancy greater than 75%
was considered to assess model performance. Sensitivity, specificity,
positive predictive value, negative predictive value, and accuracy were
calculated for the model. In all cases definitive histopathologic diagnosis
was obtained. One hundred and twenty-five (74.9%) benign and 42 (25.1%)
malignant tumors were found. The sensitivity, specificity, positive
predictive value, and negative predictive value of the model were 85.7%
(95% confidence intervals, 71.4% to 94.6%), 100% (95% confidence intervals,
97.1% to 100%), 100% (95% confidence intervals, 90.3% to 100%), and 95.4%
(95% confidence intervals, 90.3% to 98.3%), respectively. Overall accuracy
was 96.4% (95% confidence intervals, 91.3% to 98.7%). Our results confirm
the validity of the proposed logistic model in predicting adnexal
malignancy.
