Accuracy of CT Imaging in Diagnosing Adnexal Neoplasms

Background Most adnexal neoplasms are benign, and each of the most common benign lesions has a typical sonographic appearance. At times adnexal neoplasms may be considered as indeterminate through ultrasound examination, either the organ of origin cannot be ascertained or the mass cannot be classified as benign or malignant with conviction. The most insidious and intractable disease in the adnexa is ovarian cancer. Computed Tomography (CT) Providing a systematic and wide coverage of the abdomen in the same session makes CT well suited for imaging and staging of gynecologic diseases. Hence, CT is the current imaging modality of choice in the preoperative evaluation of ovarian cancer. This study review an approach to CT in the diagnosis of ovarian neoplasms. Methods This is an observational study, during January 2015 to October 2016, in the department of Radio diagnosis, Justice K. S. Hegde Hospital, Mangalore. The study were conducted in 46 cases who underwent contrast enhanced CT scan of abdomen and pelvis followed by histopathological examination of the specimen. Results In the study, histopathology revealed 23 benign (50 %) and 23 (50 %) malignant cases. CT scan showed sensitivity of 65.2 %, specificity of 82.6 %, PPV of 83.3 % and NPV of 90.5 % with an accuracy of 73.9 % in detecting ovarian neoplasms. Conclusion Knowledge of certain radiologic findings that predominate for each type of tumor may help to distinguish benign from malignant tumors. CT imaging using parameters such as ill-defined margin, mixed components, ascites, heterogeneous enhancement pattern and presence of peritoneal deposits can give a high confidence in deriving the diagnosis of malignancy in suspected cases of ovarian neoplasms.