CLINICAL ARTICLE Doppler ultrasound assessment and serum cancer antigen 125 in the diagnosis of ovarian tumors N. Erdog ˇan a, * , B. O ¨ zc ¸elik b ,I ˙ .S. Serin b ,M.Akgu¨n a , F. O ¨ ztu¨rk c a Erciyes University, Department of Radiology, Kayseri, Turkey b Erciyes University, Department of Obstetrics and Gynecology, Gynecologic Oncology Unit, Kayseri, Turkey c Erciyes University, Department of Pathology, Kayseri, Turkey Received 18 February 2005; received in revised form 2 April 2005; accepted 2 April 2005 Abstract Objective: To differentiate benign from malignant ovarian tumors based on sonographic detection of a solid component. Method: Sixty-three women with ovarian masses were evaluated preoperatively by grayscale and power/color Doppler ultrasonographic examination, with specific predefined criteria for the solid component. Sensitivity, specificity, and positive and negative predictive values were calculated and assessed against the histopathologic outcome. The contribution of cancer antigen (CA) 125 levels to the diagnostic accuracy was also assessed. Result: Sensitivity, specificity, and positive and negative predictive values were 100%, 95.2%, 91.3% and 100%, respectively, with two false-positive results. Had an elevated CA 125 level (N 35 U/mL) been included in the malignancy criteria, the false-positive results would have been eliminated, giving an accuracy of 100%. Conclusion: Sonographic evaluation with predefined specific criteria for the detection of a solid tumor component is an accurate method of preoperative discrimination between benign and malignant ovarian tumors. A serum CA 125 assay may assist in eliminating false-positive results. D 2005 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved. 1. Introduction Surgical removal is the standard treatment of an ovarian mass because of the difficulty in differen- tiating benign from malignant tumors prior to surgery [1]. At the same time, preoperative deter- 0020-7292/$ - see front matter D 2005 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.ijgo.2005.04.020 * Corresponding author. Erciyes Universitesi Tıp Fakultesi, Radyoloji AD, 38039-Kayseri, Turkey. Tel./fax: +90352 437 3719. E-mail address: nerdogan@erciyes.edu.tr (N. Erdog ˇan). KEYWORDS Ovarian neoplasms; Ultrasonography; Cancer antigen 125 International Journal of Gynecology and Obstetrics (2005) 91, 146 — 150 www.elsevier.com/locate/ijgo