A new quantitative method to evaluate adnexal tumors

OBJECTIVE: The purpose of this study was to assess endometriomas and follicular cysts using a new quantitative method provided by the picture archiving and communication system. MATERIALS AND METHODS: We reviewed our computer ultrasound database of endometriomas and follicular cysts between November 2003 and July 2007. A total of 123 consecutive women diagnosed with an endometrioma or follicular cyst on two-dimensional sonography were re-evaluated using new parameters with the picture archiving and communication system. We chose quantitative tumor density and standard deviation on sonographic images as the new diagnostic parameters. Analysis of variance and Scheffé post hoc test were analyzed to compare the mean tumor density of the endometriomas and follicular cysts. The receiver operating characteristic curve was plotted to choose the cutoff value of the endometrioma tumor density with the best sensitivity and specificity. RESULTS: There was a significant difference when the tumor density of the follicular cyst and endometrioma groups was compared using the vaginal, abdominal or endovaginal approach (p < 0.001). Based on the results of the receiver operating characteristic curve, endovaginal ultrasonography is an excellent diagnostic tool with which to evaluate endometriomas. With endovaginal ultrasonography examination, the best cutoff value of tumor density is 28 and the sensitivity and specificity are 64% and 100%, respectively. CONCLUSION: The use of quantitative tumor density and standard deviation on sonographic images is a potential new diagnostic tool in the assessment of endometriomas and follicular cysts.