Diagnostic value of the gynecology imaging reporting and data system (GI-RADS) with the ovarian malignancy marker CA-125 in preoperative adnexal tumor assessment

Abstract

Abstract Objectives The purpose of this study is to assess the preoperative evaluation of an adnexal mass using the GI-RADS classification and to verify whether CA-125 measurement can offer any additional benefits to the GI-RADS-based prediction of ovarian tumor malignancy. Material and methods In this study, we assessed a total of 215 women with an adnexal tumor using the GI-RADS classification combined with CA-125 measurement. All adnexal masses underwent histological verification. Results Of a total of 215 lesions, we classified 2 lesions as GI-RADS 2 (0.9%), 118 lesions as GI-RADS 3 (54.9%), 86 lesions as GI-RADS 4 (40.0%) and 9 lesions as GI-RADS 5 (4.2%). For GI-RADS 4–5 lesions, the sensitivity, specificity, PPV, NPV, ACC and OR were as follows: 94.3, 72.2, 52.6, 97.5, 77.7%, and 43.3 (CI 12.0–146), respectively. The corresponding parameters resulting from combining the GI-RADS classification with the CA-125 marker were as follows: 66.0, 93.8, 77.8, 89.4, 87.0%, and 29.6 (CI 12.6–69.6), respectively, with p 30 IU/mL alone, the results were as follows: 70.0, 80.3, 53.8, 89.1, 77.7%, and 9.5 (4.6–19.6), respectively, with p 30 IU/mL and GIRADS 5). Conclusions GI-RADS classification had good performance in discriminating ovarian tumors. The additional measurement of CA-125 improves the system specificity, PPV and ACC for preoperative adnexal tumor assessment.

Keywords

• Gynecology imaging reporting and data system
• Ca-125
• Ultrasound
• Ovarian tumor