OP24.01: 3D procedure: immediate response for benignity or malignancy of ovarian lesions

Characterize preoperatively an ovarian mass as benign or malignant during ultrasound examination. Women with at least one persistent adnexal mass were recruited. All patients (n = 361) underwent preoperatively ultrasound examination based on IOTA terms and definitions. 3D volumes were analyzed immediately into three steps. 1st: achievement of main image. 2nd: inversion of it. Using the ImageJ system, we expressed numerically the images appearance. ImageJ system represents an image processing program developed at the National Institutes of Health, which is any form of signal processing for which the input is an image, such as a photograph (Wikipedia). 3rd: by 3D software of Voluson, we calculated the inversion volume of the lesion. The women were allocated in 7 groups based on the histological diagnosis (M/malignant lesion: 63, T/teratoma: 49, S/serous cysts: 32, C/cystadenoma: 76, E/endometrioma: 71, B/benign simple cysts: 46 and INF/inflammation including hydrosalpinx and abscess cases: 32). Concerning the main image, significant difference was observed between the M group and all benign groups except the INF group (main image/ M: 31.6 ± 1.8, I: 33.08 ± 3.4 P > 0.05). Regarding the inverted image, absence of significant difference was observed only between M and E groups (14.6 ± 1.1 vs. 11.7 ± 1 respectively, P > 0.05). On the contrary, inversion volume was significantly higher in malignant masses as compared to all benign groups (M: 58.2 ± 11, T: 11 ± 2.5, S: 12 ± 5, C: 22.8 ± 4.3, E: 4.4 ± 0.6, B: 21.6 ± 4.9, I: 10.7 ± 4.9; P < 0.01). Although we present preliminary data, we strongly suggest that inversion volume of the ovarian lesion during preoperative ultrasound examination represents a promising marker of benignity or malignancy.