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IOTA Simple Rules in Differentiating between Benign and Malignant Ovarian Tumors

  • Published : 2014.07.15

Abstract

Background: To evaluate the diagnostic performance of IOTA simple rules in differentiating between benign and malignant ovarian tumors. Materials and Methods: A study of diagnostic performance was conducted on women scheduled for elective surgery due to ovarian masses between March 2007 and March 2012. All patients underwent ultrasound examination for IOTA simple rules within 24 hours of surgery. All examinations were performed by the authors, who had no any clinical information of the patients, to differentiate between benign and malignant adnexal masses using IOTA simple rules. Gold standard diagnosis was based on pathological or operative findings. Results: A total of 398 adnexal masses, in 376 women, were available for analysis. Of them, the IOTA simple rules could be applied in 319 (80.1%) including 212 (66.5%) benign tumors and 107 (33.6%) malignant tumors. The simple rules yielded inconclusive results in 79 (19.9%) masses. In the 319 masses for which the IOTA simple rules could be applied, sensitivity was 82.9% and specificity 95.3%. Conclusions: The IOTA simple rules have high diagnostic performance in differentiating between benign and malignant adnexal masses. Nevertheless, inconclusive results are relatively common.

Keywords

References

  1. Alcazar JL, Guerriero S, Laparte C, Ajossa S, Jurado M (2011). Contribution of power Doppler blood flow mapping to gray-scale ultrasound for predicting malignancy of adnexal masses in symptomatic and asymptomatic women. Eur J Obstet Gynecol Reprod Biol, 155, 99-105. https://doi.org/10.1016/j.ejogrb.2010.11.010
  2. Alcazar JL, Pascual MA, Olartecoechea B, et al (2013). IOTA simple rules for discriminating between benign and malignant adnexal masses: prospective external validation. Ultrasound Obstet Gynecol, 42, 467-71.
  3. Arab M, Yaseri M, Ashrafganjoi T, et al (2012). Comparison of two ovarian malignancy prediction models based on age sonographic findings and serum CA125 measurement. Asian Pac J Cancer Prev, 13, 4199-202. https://doi.org/10.7314/APJCP.2012.13.8.4199
  4. Erdogan N, Ozcelik B, Serin IS, Akgun M, Ozturk F (2005). Doppler ultrasound assessment and serum cancer antigen 125 in the diagnosis of ovarian tumors. Int J Gynaecol Obstet, 91, 146-50. https://doi.org/10.1016/j.ijgo.2005.04.020
  5. Fathallah K, Huchon C, Bats AS, et al (2011). External validation of simple ultrasound rules of Timmerman on 122 ovarian tumors. Gynecol Obstet Fertil, 39, 477-81. https://doi.org/10.1016/j.gyobfe.2011.05.007
  6. Guerriero S, Alcazar JL, Pascual MA, et al (2011). The diagnosis of ovarian cancer: is color Doppler imaging reproducible and accurate in examiners with different degrees of experience? J Womens Health, 20, 273-7. https://doi.org/10.1089/jwh.2010.2277
  7. Hafeez S, Sufian S, Beg M, et al (2013). Role of ultrasound in characterization of ovarian masses. Asian Pac J Cancer Prev, 14, 603-6. https://doi.org/10.7314/APJCP.2013.14.1.603
  8. Hartman CA, Juliato CR, Sarian LO, et al (2012). Ultrasound criteria and CA 125 as predictive variables of ovarian cancer in women with adnexal tumors. Ultrasound Obstet Gynecol, 40, 360-6. https://doi.org/10.1002/uog.11201
  9. Kaijser J, Van GT, Van HK, et al (2013). A comparison between an ultrasound based prediction model (LR2) and the risk of ovarian malignancy algorithm (ROMA) to assess the risk of malignancy in women with an adnexal mass. Gynecol Oncol, 129, 377-83. https://doi.org/10.1016/j.ygyno.2013.01.018
  10. Kurjak A, Predanic M, Kupesic-Urek S, Jukic S (1993) Transvaginal color and pulsed Doppler assessment of adnexal tumor vascularity. Gynecol Oncol, 50, 3-9. https://doi.org/10.1006/gyno.1993.1154
  11. Lerner JP, Timor-Tritsch IE, Federman A, Abramovich G (1994) Transvaginal ultrasonographic characterization of ovarian masses with an improved, weighted scoring system. Am J Obstet Gynecol, 170, 81-5. https://doi.org/10.1016/S0002-9378(94)70388-4
  12. Mousavi AS, Borna S, Moeinoddini S (2006). Estimation of probability of malignancy using a logistic model combining color Doppler ultrasonography, serum CA125 level in women with a pelvic mass. Int J Gynecol Cancer, 16, 92-8. https://doi.org/10.1111/j.1525-1438.2006.00469.x
  13. Sassone AM, Timor-Tritsch IE, Artner A, Westhoff C, Warren WB (1991). Transvaginal sonographic characterization of ovarian disease: evaluation of a new scoring system to predict ovarian malignancy. Obstet Gynecol, 78, 70-6.
  14. Timmerman D, Ameye L, Fischerova D, et al (2010a). Simple ultrasound rules to distinguish between benign and malignant adnexal masses before surgery: prospective validation by IOTA group. BMJ, 341, 6839. https://doi.org/10.1136/bmj.c6839
  15. Timmerman D, Schwarzler P, Collins WP, et al (1999). Subjective assessment of adnexal masses with the use of ultrasonography: an analysis of interobserver variability and experience. Ultrasound Obstet Gynecol, 13, 11-6. https://doi.org/10.1046/j.1469-0705.1999.13010011.x
  16. Timmerman D, Testa AC, Bourne T, et al (2008). Simple ultrasound-based rules for the diagnosis of ovarian cancer. Ultrasound Obstet Gynecol, 31, 681-90. https://doi.org/10.1002/uog.5365
  17. Timmerman D, Van CB, Testa AC, et al (2010b). Ovarian cancer prediction in adnexal masses using ultrasound-based logistic regression models: a temporal and external validation study by the IOTA group. Ultrasound Obstet Gynecol, 36, 226-34.
  18. Tongsong T, Wanapirak C, Neeyalavira V, Khunamornpong S, Sukpan K (2009). E-flow D oppler indices for prediction of benign and malignant ovarian tumors. Asian Pac J Cancer Prev, 10, 139-42.
  19. Tongsong T, Wanapirak C, Sukpan K, Khunamornpong S, Pathumbal A (2007). Subjective sonographic assessment for differentiation between malignant and benign adnexal masses. Asian Pac J Cancer Prev, 8, 124-6.
  20. Yavuzcan A, Caglar M, Ozgu E, et al (2013). Should cut-off values of the risk of malignancy index be changed for evaluation of adnexal masses in Asian and Pacific populations? Asian Pac J Cancer Prev, 14, 5455-9. https://doi.org/10.7314/APJCP.2013.14.9.5455

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