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Re: Adnexal Mass (Postreproductive group)From: Zach Newton (zbnewton@atl.mindspring.com)Fri Jul 18 15:49:54 1997
Terry- Thanks for getting back on this thread. Geff is developing a clinical protocol for adnexal masses with particular regard to indications for surgical intervention. Your comments on follicular evaluation are of interest and succinctly summarize up-to-date information. What Geff is looking for in this particular message is a guideline in respect to size alone as upper limits of normal for the 45 and older division. We agreed on 3 cm as an upper limit of normal. This is not to say that every woman 45 or older with an ovarian dimension greater than 3 cm should undergo surgical exploration. But, an upper limit must be declared to the range of normal, meaning no indication for further follow-up of current evaluation based on that parameter alone. Parenthetically, my comments alluded to the fact that it is common to find in office records the report of in-office pelvic sonograms that report 2 dimensions instead of 3 dimensions for the ovaries and uterus. Occasional studies do not allow for capturing 3 dimensions, but these are the exception with proper equipment and technique. On the other end of the spectrum are reports that give no dimensions at all. The point for Geff to consider with his protocol is the possible inclusion of basic standards on any report of sonographic study of the pelvis that is used to make a clinical decision. It would be helpful to know if AIUM has formally developed minimum reporting standards for TVUS or TAPUS that could be referenced in the protocol development. Thanks for responding and for any additional comments that you consider pertinent.
-- Zach Newton Z. B. Newton, III, M.D. Atlanta/Gyn
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