Table 2.
Diagnostic performances of different methods at various cut-off values in detecting ovarian malignancy
| Diagnostic method Cut-off value |
Sensitivity % |
95% CI | Specificity % |
95% CI | PPV % |
95% CI | NPV % |
95% CI | Accuracy % |
|---|---|---|---|---|---|---|---|---|---|
| Serum CA125 (kU/L) → Area under the ROC curve = 0.80 | |||||||||
| 24 | 71.9 | 53.3–86.3 | 78.8 | 67.0–87.9 | 62.2 | 44.8–77.5 | 85.3 | 73.8–93.0 | 76.5 |
| 35 | 59.4 | 40.6–76.3 | 84.9 | 73.9–92.5 | 65.5 | 45.7–82.1 | 81.2 | 69.9–89.6 | 76.5 |
| RMI → Area under the ROC curve = 0.81 | |||||||||
| 200 | 71.9 | 53.3–86.3 | 80.3 | 68.7–89.1 | 63.9 | 46.2–79.2 | 85.5 | 74.2–93.1 | 77.6 |
| 220 | 71.9 | 53.3–86.3 | 83.3 | 72.1–91.4 | 67.7 | 49.5–82.6 | 85.9 | 75.0–93.4 | 79.6 |
| Simple rules with expert opiniona | 90.6 | 75.0–98.0 | 84.6 | 73.9–92.5 | 74.4 | 57.9–87.0 | 94.9 | 85.9–98.9 | 86.7 |
| Expert opinion | 87.5 | 71.0–96.5 | 92.4 | 83.2–97.5 | 84.6 | 68.1–94.9 | 93.9 | 85.0–98.3 | 90.8 |
| Tumor vascularityb | 90.6 | 75.0–98.0 | 77.3 | 65.3–86.7 | 65.9 | 50.1–79.5 | 94.4 | 84.6–98.8 | 81.6 |
| LR2 (%) → Area under the ROC curve = 0.93 | |||||||||
| 10 | 100.0 | 89.1–100.0 | 36.4 | 24.9–49.1 | 43.2 | 31.8–55.3 | 100.0 | 85.8–100.0 | 57.1 |
| 25 | 90.6 | 75.0–98.0 | 77.3 | 65.3–86.7 | 65.9 | 50.1–79.5 | 94.4 | 84.6–98.8 | 81.6 |
| 43 | 81.3 | 63.6–92.8 | 90.9 | 81.3–96.6 | 81.3 | 63.6–92.8 | 90.9 | 81.3–96.6 | 87.8 |
IOTA International Ovarian Tumor Analysis; CI Confidential interval; PPV Positive predictive value; NPV Negative predictive value; ROC Receiver operating characteristics; RMI Risk of malignancy index; LR2 Logistic regression model 2
aTwo-step strategy: as a result of inconclusive findings by simple rules, the expert evaluates the tumor
bTwo-dimensional ultrasound vascular score 1-2 vs 3-4