External validation of simple ultrasound rules of Timmerman on 122 ovarian tumors

Objective. - To study the correlation between the nature of the ovarian tumors presumed according to the ultrasound criteria of Timmerman and the final histological diagnosis. Patients and methods. - We made a prospective study during a period of 4 years, concerning consecutive patients having an ovarian tumor, investigated by pelvic ultrasonography using Timmerman's rules estimating their benign or malignant characteristics in order to determine the efficiency of this score. The diagnostic reference was histology. Sensitivity and specificity of these criteria were calculated with their 95% confidence intervals. Results. - One hundred and twenty-two patients having adnexal masse were included between January 2002 and December 2005. Among these tumors, 88.5% (108/122) were benign, and 11.5% (14/122) were malignant or borderline. The ultrasound-based rules of classification were applicable for 89.3% (109/122) of them. The sensitivity of these rules was 73% (95% Cl [45-100]) and the specificity was 97% (IC 95% Cl [94-100]). Discussion and conclusion. - Most adnexal masses can be classified according to the ultrasound simple rules of the score of Timmerman with a good specificity to eliminate their malignant or borderline characteristics. Tumors which cannot be classified according to these rules must be referred to an expert ultrasonographist. (C) 2011 Elsevier Masson SAS. All rights reserved.