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Performance of Pre-Operative IOTA Three-Step Algorithm in Detecting Ovarian Carcinoma in a Referral Center in Indonesia Kurniadi, Andi; Permadi, Wiryawan; Kusuma, Aria Yusti; Kireina, Jessica; Andarini, Mia Yasmina; Winarno, Gatot Nyarumenteng Adhipurnawan; Harsono, Ali Budi
Indonesian Journal of Cancer Vol 18, No 1 (2024): March
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v18i1.1044

Abstract

Background: To assess the diagnostic performance of a three-step algorithm using the International Ovarian Tumor Analysis (IOTA) Group ‘simple rules’, ‘simple descriptors’, and Assessment of Different NEoplasias in the adneXa (ADNEX) model for discriminating benign and malignant adnexal masses. Methods:  This was a retrospective observational study, performed at a tertiary-care university hospital, on women diagnosed with adnexal mass on ultrasonography from January 2021 and February 2022. The examiner first classified the mass using ‘simple descriptors’ (first step) and, if not possible, using ‘simple rules’ (second step). For inconclusive masses, an assessment using the ADNEX model was done as the third step. All masses were managed surgically. Histopathology results were used as the reference standard.Results: One hundred and forty-one women were included (median age of 48 years). Histopathology results showed 104 (73.76%) mass to be malignant, and 37 (26.24%) mass to be benign. Twelve (8.51%) of 141 masses could be classified using simple descriptors, 89 (63.12%) masses were classified using simple rules, and 40 (28.37%) masses were classified using the ADNEX model. Overall accuracy, sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, and negative likelihood ratio of the three-step algorithm were 89.36%, 94.23%, 75.68%, 91.59%, 82.35%, 3.87, and 0.08 respectively.Conclusions: The IOTA three-step algorithm, based on the sequential use of simple descriptors, simple rules, and ADNEX model, performs well for classifying adnexal masses as benign or malignant
Peran Magnetic Resonance Imaging pada Diagnosis Kanker Serviks yang Menyerupai Kanker Endometrium – Laporan Kasus Erfiandi, Febia; Harsono, Ali Budi; Soekersi, Hari; Dewayani, Birgitta Maria; Kireina, Jessica
Indonesian Journal of Obstetrics & Gynecology Science Volume 7 Nomor 1 Maret 2024
Publisher : Dep/SMF Obstetri & Ginekologi Fakultas Kedokteran Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/obgynia.v7i1.444

Abstract

Pendahuluan: Magnetic resonance imaging (MRI) merupakan modalitas penting dalam diagnosis kanker ginekologi, terutama serviks dan endometrium. Laporan kasus ini bertujuan melihat peranan MRI dalam menentukan asal tumor, keterlibatan parametrium, dan metastasis kelenjar getah bening retroperitoneal.Presentasi Kasus: Pada laporan kasus ini pasien didiagnosis kanker serviks stadium IB3 dengan diagnosis banding kanker endometrium stadium II karena keluhan perdarahan pasca-menopause, massa di serviks bersifat endofitik, dan ukuran uterus membesar. Hasil histopatologi kuretase yaitu endometrioid endometrial carcinoma moderately differentiated Dd/adenocarcinoma cervix. Magnetic resonance imaging (MRI) dilakukan untuk melihat asal tumor dan menetukan stadium. Skor MRI menganalisis tujuh perbedaan fitur: lokasi dan perfusi tumor, penyengatan perifer, massa atau distensi rongga endometrium, invasi miometrium, dan infiltrasi jaringan sekitar; skor 10 didapatkan pada kasus dengan menggunakan sekuens T2WI sagital, DWI-ADC, dan DCE yang menyimpulkan bahwa tumor berasal dari serviks dan telah menginfiltrasi parametrium.Kesimpulan: Skor MRI bisa dijadikan pertimbangan untuk melihat asal tumor (serviks atau endometrium) selain melihat keterlibatan parametrium dan kelenjar getah bening pelvis sehingga diagnosis dan manajemen lebih baik.The Role of Magnetic Resonance Imaging in the Diagnosis of Cervical Cancer Resembling Endometrial Cancer – A Case ReportAbstractObjective: Magnetic resonance imaging (MRI) is an important modality in the diagnosis of gynecological cancer, especially cervical and endometrial cancer. This case report aims to examine the role of MRI in determining tumor origin, parametrial involvement, and retroperitoneal lymph node metastases.Case presentation: In this case report, the patient was diagnosed with stage IB3 cervical cancer Dd/ stage II endometrial cancer due to complaints of postmenopausal bleeding, endophytic cervical mass, and uterine enlargement. The histopathological results of curettage were moderately differentiated endometrioid endometrial carcinoma Dd/adenocarcinoma of the cervix. Magnetic resonance imaging (MRI) is performed to determine the origin of the tumor and its stage. MRI score was analyzed for seven distinct features: tumor location and perfusion, peripheral rim, endometrial cavity mass or distension, invasion of the myometrium, and surrounding organs infiltration; score of 10 was obtained in these cases using sagittal T2WI, DWI-ADC, and DCE sequence which concluded that the tumor was cervical origin and had infiltrated the parametrium.Conclusion: MRI score can be considered to see the origin of the tumor (cervical or endometrial) in addition look for involvement of the parametrium and pelvic lymph nodes so that diagnosis and management will be better.Key words: Magnetic Resonance Imaging, Cervical Cancer, Endometrial Cancer, Gynecological Cancer, Parametrial Infiltration