Sonographic patterns of ovarian tumors: prediction of malignancy.

Four hundred four women with suspected pelvic masses or histories suggesting ovarian cancer (eg, low abdominal pain) entered a prospective study designed to assess the accuracy of sonography in confirming or excluding the presence of ovarian cancer. Three hundred twelve of these patients were operated on and evaluated within three weeks after sonography. The predictive value of the sonographic evidence of malignancy was 73% (38 of 52 patients), whereas benign tumors were predicted correctly in 95.6% (177 of 185). Sonographic reassessment of masses with patterns suggesting benign disease may be an alternative to immediate surgical exploration in a selected population (ie, those with poor surgical risk). The sonographic detection of ovarian malignancy requires further improvement; as a diagnostic tool it continues to present a challenge.