Subjective ultrasound assessment, the ADNEX model and ultrasound-guided tru-cut biopsy to differentiate disseminated primary @entity43 from metastatic XXXX .

@entity43 @entity1 @entity5 @entity10224 @entity530 @entity281 @entity1410 @entity2670
OBJECTIVES: To compare subjective ultrasound assessment and the ADNEX model with ultrasound-guided tru-cut biopsy to differentiate disseminated primary @entity43 from metastatic @entity43 . METHODS: This was a prospective study including 143 consecutive @entity1 with @entity5 of unknown primary origin, with a @entity530 /carcinosis. @entity1 underwent either transvaginal or transrectal ultrasound as well as transabdominal ultrasound examination followed by tru-cut biopsy. The ultrasound examiner assessed @entity5 morphology, spread in the pelvis and abdomen, and predicted @entity5 origin as primary ovarian or metastatic using both subjective assessment and the ADNEX model. Histology from tru-cut biopsy served as the gold standard for assessment of diagnostic accuracy. Biopsy adequacy and the complication rate were assessed. RESULTS: Tru-cut biopsy was performed transvaginally in 131/143 (92%) @entity1 . Two @entity1 needed inpatient care (one had @entity1410 , and one @entity281 ). Biopsy resulted in a conclusive diagnosis in 126/143 (88%) @entity1 , amongst whom cytoreductive surgery was performed in 30/126 confirming the diagnosis in all cases. @entity43 was found in 37/126 (29%) @entity1 and primary @entity43 in 89/126 (71%) @entity1 . Subjective ultrasound evaluation had a sensitivity of 82% (73/89) and a specificity of 70% (26/37) in predicting primary @entity43 . The ADNEX model had an area under the receiver-operating characteristics curve of 0.891 (95% CI, 0.794-0.946) (in @entity1 with an @entity2670 , n   =   104). Tumor origin was associated with age, @entity10224 , previous @entity5 , presence of omental cake and @entity5 mobility. CONCLUSIONS: Subjective ultrasound assessment and the ADNEX model can both be used to predict whether a @entity530 is metastatic and of non-ovarian origin, indicating the need for tru-cut biopsy, which is associated with very few complications and will provide a conclusive diagnosis in nine out of 10 @entity1 . Copyright    2015 ISUOG.
