Objectives: To evaluate grayscale US combined with contrast-enhanced ultrasound (CEUS) in the preoperative differentiation between benign and malignant ovarian masses in a pediatric population.
Materials And Methods: This retrospective study enrolled patients who underwent grayscale US and CEUS before surgery because of ovarian masses between July 2018 and September 2023, with available histopathologic or follow-up results. Two senior radiologists summarized the grayscale US and CEUS characteristics of all ovarian masses, including percentage of solidity, ascites, vascularity, and enhanced vessel morphology. These characteristics were then independently reviewed by radiologists with different experience to assess interobserver agreement. Diagnostic performance was evaluated using the area under the receiver operating characteristic curve (AUC), while interobserver agreement was evaluated by intraclass correlation coefficient (ICC).
Results: A total of 26 children (median age: 10.1 [7.5, 11.7] years; age range: 0-14 years; benign: 15 patients) were included. The main characteristics of malignant ovarian tumors were abundant blood flow and twisted blood vessels within the mass, enhanced portion of the mass over 50 percent (all p < 0.001). The grayscale US combined with CEUS showed better diagnostic performance than the grayscale US alone (AUC = 0.99 [95% CI: 0.95, 1.00] vs AUC = 0.70 [95% CI: 0.50, 0.90] p < 0.001). A statistically significant AUC before and after CEUS was also shown between two junior radiologists (0.75 vs 0.92 and 0.69 vs 0.86, respectively, both p < 0.05). ICC of CEUS was better than that of grayscale US among radiologists.
Conclusion: The combination of grayscale US and CEUS might improve the diagnostic accuracy in differentiating benign and malignant pediatric ovarian masses.
Clinical Relevance Statement: Grayscale ultrasound combined with contrast-enhanced ultrasound can improve the diagnostic performance in the preoperative differentiation of benign and malignant ovarian lesions in a pediatric population.
Key Points: Correctly distinguishing benign from malignant ovarian masses in pediatric patients is critical for determining treatments. Grayscale combined with contrast-enhanced ultrasound (CEUS) differentiated benign and malignant pediatric ovarian masses better than grayscale US alone. Junior radiologists' diagnostic performances could be and were significantly improved with the application of CEUS.
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http://dx.doi.org/10.1007/s00330-024-11011-z | DOI Listing |
J Ovarian Res
December 2024
Department of Gynecology and Obstetrics, The Affiliated Hospital of Nankai University, Tianjin No. 4 Hospital, Tianjin, 300222, China.
Immune checkpoint-based immunotherapy has shown limited efficacy in the treatment of ovarian cancer. In recent years, the emergence of immune checkpoint co-targeting therapies, led by the combination targeting of TIGIT and FAK, has shown promise in ovarian cancer treatment. Our preliminary research indicates that TIGIT is predominantly expressed in regulatory T cells during ovarian cancer.
View Article and Find Full Text PDFJ Indian Assoc Pediatr Surg
November 2024
Department of Pediatric Surgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
Aims: This study aims to review our experience of treating ovarian masses in children with an emphasis on clinical presentation, diagnosis, treatment, and outcome.
Methods: We retrospectively reviewed the electronic medical records of all patients below 18 years of age who underwent surgical treatment for ovarian masses at our institute between 2009 and 2023. Study variables included demography, clinical presentation, physical findings, tumor markers, radiologic features, operative details, histopathology, follow-up status, and overall survival.
Ovarian yolk sac tumors (OYSTs), also known as endodermal sinus tumors, are rare and highly malignant germ cell tumors, accounting for approximately 1% of all ovarian cancers. They predominantly affect children and young adults, with a rapid growth rate and early metastasis, making early diagnosis and treatment crucial. This report presents the case of a 6-year-old female from a low-resource setting who initially presented with symptoms suggestive of acute appendicitis, including abdominal pain, fever, and vomiting.
View Article and Find Full Text PDFVet Radiol Ultrasound
January 2025
Department of Veterinary Medicine, Università degli Studi di Milano, Lodi, Italy.
The aim of this retrospective multicentric case series is to describe the CT findings of ovarian neoplasia in dogs. Twenty dogs with pre- and postcontrast CT exams and cytological/histological diagnosis of ovarian neoplasia were included. Five dogs presented with bilateral tumors, for a total of 25 neoplasms: 15 carcinomas (4 bilateral), 4 granulosa cell tumors, 2 poorly differentiated malignant neoplasia (bilateral), 2 luteomas, 1 teratoma, 1 dysgerminoma.
View Article and Find Full Text PDFAm J Case Rep
December 2024
Department of Obstetrics and Gynaecology, Raigmore Hospital, NHS Highland, Inverness, United Kingdom.
BACKGROUND Acute epiploic appendagitis is an uncommon cause of acute abdominal pain characterized by pain in the left or right lower quadrants of the abdomen. It is caused by torsion or spontaneous venous thrombosis of one of the epiploic appendages, which are found along the colon, most commonly in the sigmoid colon. The literature consistently compares the presenting symptoms and clinical picture of acute epiploic appendagitis to acute diverticulitis and acute appendicitis.
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