Comparison of the diagnostic accuracy of International Ovarian Tumor Analysis simple rules and the risk of malignancy index to discriminate between benign and malignant adnexal masses

Auekitrungrueng, Rapeepat; Tinnangwattana, Dangcheewan; Tantipalakorn, Charuwan; Charoenratana, Cholaros; Lerthiranwong, Thitikarn; Wanapirak, Chanane; Tongsong, Theera

doi:10.1002/ijgo.12891

Cited by 36 publications

(41 citation statements)

References 13 publications

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“…It has been suggested that neoplasms are irregular solid tumor; multilocular and irregular masses of 10cm or more; presence of septa with a thickness of 2-3 mm; presence of at least 3 papillary projections; increased vascularization; evidence of ascites; or peritoneal masses. Even though there are no data showing the efficacy of this model in pregnancy, it is probable that its validity is applicable also in evaluating masses during pregnancy [ 8 , 9 ]. In case of non-conclusive ultrasound, or when a wider assessment of tissue planes and relation to other organs may be important in both obstetric and surgical planning, magnetic resonance imaging (MRI) can be a useful.…”

Section: Discussionmentioning

confidence: 99%

Management of adnexal masses' torsion during pregnancy

et al. 2020

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With the increased use and quality of ultrasound in pregnancy, adnexal masses are being encountered with greater frequency. Most of the time such masses are asymptomatic. It can be discovered in an emergency. Surgical intervention may cause risks to the mother and her fetus, while observation without intervention may also lead to unfavorable complications, such as ovarian torsion or the development of a tumor. Therefore, the management requires a balance between the maternal and fetal risks. We report two cases of torsion of adnexal masses during pregnancy, and we provide a brief literature review on the management and prognosis of this condition in pregnancy.

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Section: Discussionmentioning

confidence: 99%

Management of adnexal masses' torsion during pregnancy

et al. 2020

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“…The main disadvantage of the IOTA Simple Rules is the possibility of inconclusive results when they do not apply. According to previous reports, the proportion of inconclusive results could be as high as 20% [ 9 , 10 ]. A “two-step strategy” using the IOTA Simple Rules with the addition of subjective assessment for masses with inconclusive results was proposed and proved to have excellent test performance comparable to that of subjective assessment alone [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

“…For pre-surgical diagnosis of women with adnexal masses, the American College of Obstetrics and Gynecology recommends a multivariable approach by combining demographic, clinical, laboratory, and imaging parameters to achieve better diagnostic accuracy [ 3 , 14 ]. Even though the application of IOTA Simple Rules has recently been proven acceptably accurate in our setting [ 9 ], we hypothesized that its accuracy could be further improved by including other relevant parameters such as serum CA-125. The primary aim of this study was to evaluate the diagnostic added-value of serum CA-125 to the IOTA Simple Rules, without subjective assessment, to differentiate between malignant and benign ovarian tumors before surgery.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic Added-Value of Serum CA-125 on the IOTA Simple Rules and Derivation of Practical Combined Prediction Models (IOTA SR X CA-125)

et al. 2021

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Background: This study aimed to evaluate the diagnostic added-value of serum CA-125 to the International Ovarian Tumor Analysis (IOTA) Simple Rules in order to facilitate differentiation between malignant and benign ovarian tumors before surgery. Methods: A secondary analysis of a cross-sectional cohort of women scheduled for surgery in Maharaj Nakorn Chiang Mai Hospital between April 2010 and March 2018 was carried out. Demographic and clinical data were prospectively collected. Histopathologic diagnosis was used as the reference standard. Logistic regression was used for development of the model. Evaluation of the diagnostic added-value was based on the increment of the area under the receiver operating characteristic curve (AuROC). Results: One hundred and forty-five women (30.3%) out of a total of 479 with adnexal masses had malignant ovarian tumors. The model that included information from the IOTA Simple Rules and serum CA-125 was significantly more superior to the model that used only information from the IOTA Simple Rules (AuROC 0.95 vs. 0.89, p < 0.001 for pre-menopause and AuROC 0.98 vs 0.83, p < 0.001 for post-menopause). Conclusions: The IOTA SR X CA-125 model showed high discriminative ability and is potentially useful as a decision tool for guiding patient referrals to oncologic specialists.

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“…Even though there are no data showing the efficacy of this model in pregnancy, it is probable that its validity is applicable also in evaluating masses during pregnancy. 7,12 Ultrasound has some limitations. The augmented uterine volume after the 20th week of pregnancy makes it difficult to assess adnexal masses precisely.…”

Section: Introductionmentioning

confidence: 99%

Adnexal masses in pregnancy: an updated review on diagnosis and treatment

D’Ambrosio

Brunelli

Musacchio

et al. 2020

Tumori

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Adnexal masses are not common in pregnancy. They are often discovered incidentally during routine ultrasound examinations. In general, 24%–40% of the cases are benign tumors; up to 8% are malignant tumors. Adnexal masses are usually asymptomatic, but sometimes can be responsible for abdominal or pelvic pain. Transvaginal and transabdominal ultrasound is essential to define the morphology of pelvic masses and to distinguish between benign and malignant cases. Magnetic resonance imaging can be a complementary examination when ultrasound findings are equivocal and a useful additional examination to better define tissue planes and relations with other organs. Patient counseling can be challenging because there is no clear consensus on the management of adnexal masses during pregnancy. Treatment options consist of observational management (in case of asymptomatic women with reassuring instrumental findings) or surgery (via laparoscopy or laparotomy). Surgery can be offered as a primary tool when cancer is suspected or when acute complications such as ovarian torsion occur.

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Comparison of the diagnostic accuracy of International Ovarian Tumor Analysis simple rules and the risk of malignancy index to discriminate between benign and malignant adnexal masses

Cited by 36 publications

References 13 publications

Management of adnexal masses' torsion during pregnancy

Management of adnexal masses' torsion during pregnancy

Diagnostic Added-Value of Serum CA-125 on the IOTA Simple Rules and Derivation of Practical Combined Prediction Models (IOTA SR X CA-125)

Adnexal masses in pregnancy: an updated review on diagnosis and treatment

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