Publication:

Efficacy of morphological indexing of ovarian tumor: preoperative determination of risk of malignancy

Background Ovarian cancers ranks fifth in cancer death worldwide and in India it ranks third among the female genital tract malignancies. Objective of present study was to assess prospectively the efficacy of morphological indexing (MI) as a method to predict malignancy in sonographically confirmed ovarian tumors.

Methods A prospective study conducted in a tertiary care hospital in Tamil Nadu from September 2011 to August 2012.  The risk of malignancy is preoperatively assessed in 136 patients with ovarian tumour using a morphological index based on tumour volume and wall structure. Each tumour was assigned a score of 0 to 10 based on increasing volume and morphologic complexity. The efficacy of the index was assessed by histopathological examination of the tumour.

Results The benign tumours had a mean MI score of 4.3 and malignant tumours had a mean of 8.3 which was statistically significant. Of the 54 tumours with MI 5, 54 (51.2%) were malignant. With MI >5 as a predictor of malignancy the present study had a Sensitivity-95.5%, Specificity-56.5%, Positive predictive value-51.2%, Negative predictive value-94%, and Accuracy-68%.

Conclusions Morphological index is a simple, valuable and inexpensive diagnostic tool to rule out malignancy in pre operative evaluations of ovarian tumors.