Background and Objectives: Ovarian cancer is one of the leading cancers in women and patients present with varied symptomatology and at different stages of the disease. Prognosis of the disease depends on the stage and time of intervention. Preoperative investigation and assessment forms an important part of treatment and there are many investigating modalities used for it and patients are being subjected to multiple investigations. This study is assessing the efficiency of these modalities and exploring the option of minimal preoperative investigation without affecting the quality of treatment.
Methods: A prospective study with 69 women who were admitted in gynaecology ward, with adnexal mass and not associated with pregnancy in the time period from May 2019 to April 2022. Data like CA125, Menopausal status and radiology report of USG, MRI, CECT, CT were collected and Risk Malignancy Index calculated with both USG and other modalities and a scoring done. A value more than 200 suggested malignancy and less than 200 suggested benign nature of the mass. These were compared with the definitive histopathology report and an analysis was made to find better modality in evaluation of adnexal mass.
Results: The relationship of RMI [U (USG)] and HPE report is -The sensitivity and specificity of RMI [U] in estimating malignancy was 80% and 98.4% respectively. The positive predictive value was 80% and negative predictive value 98.4%. There was significant association between RMI [U] and the findings, = 42.45, p=0.001<0.05.
The relationship of RMI [C (CT, CECT, MRI)] and HPE report is -The sensitivity of RMI[C] in estimating malignancy was 60%, the specificity was 92.3%. The positive predictive value was 60% and negative predictive value was 92.3%. There was significant relationship of RMI [C]] with report, =8.48, p=0.004<0.05.
Conclusion: Both USG and other higher investigations like CT, CECT, MRI could be used in the preoperative assessment of adnexal lesions, but proceeding with only USG is found to be efficient enough in comparison with CT and MRI and further avoids patient’s going through unnecessary higher investigations, delay in definitive procedure, additional expenditure, radiation and contrast exposure.