The accuracy of radiological imaging in the diagnosis of orbital lesions in a regional hospital

Abstract

Aim: To compare the accuracy of radiological imaging with pathological findings in patients with orbital space- occupying lesions.

Patients and methods: This was a retrospective review of the records of consecutive patients who underwent orbitotomy for orbital masses in a regional hospital during 1998 to 2002. Only records with preoperative radiological reports and postoperative histopathological reports available were reviewed.

Results: Thirty two patients’ records were reviewed. The overall diagnostic accuracy of radiological imaging for specific groups of lesions was 78.1%. The accuracy of radiological imaging for the diagnosis of cystic lesions, vascular lesions, lacrimal lesions, neurogenic lesions, and lymphoid lesions was 100.0%, 83.3%, 60.0%, 50.0%, and 28.6%, respectively. In terms of accuracy of detecting malignancy, 17.6% of the lesions diagnosed as benign by imaging studies were malignant by histology. However, 50.0% of the lesions diagnosed as malignant by imaging studies were benign by histology.

Conclusions: Radiological investigations have a high specificity (0.92) and low sensitivity (0.28) for detecting malignancy. Radiology has a high negative-predictive value (0.82) and low positive-predictive value (0.50) for malignant lesions. Radiological reports from the studied regional hospital are accurate for ruling out malignant lesions and are relatively accurate for diagnosing cystic and vascular lesions.