Ultrasound criteria and CA 125 as predictive variables of ovarian cancer in women with adnexal tumors

Hartman, Caio Augusto; Juliato, Cássia Raquel Teatin; Sarian, Luís Otávio; Toledo, Maria Carolina Szymanski de; Jales, Rodrigo Menezes; Morais, Solita Soares de; Pitta, Denise da Rocha; Marussi, Emílio Francisco; Derchain, Sophie

doi:10.1002/uog.11201

Cited by 61 publications

(54 citation statements)

References 22 publications

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“…Up to now, plenty of studies [17, 18] have proved that the simple rules were suitable for about 76–89.3% adnexal tumors. In our study, the conclusive ratio of the simple diagnosis was 79.4%.…”

Section: Discussionmentioning

confidence: 99%

Association between the sonographer’s experience and diagnostic performance of IOTA simple rules

Ning

Wang

et al. 2018

World J Surg Onc

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BackgroundTo validate the clinical value of simple rules in distinguishing malignant adnexal masses from benign ones and to explore the effect of simple rules for experienced and less-experienced sonographers.MethodsPatients with persistent adnexal masses were enrolled between November 2013 and December 2015. All masses were proven through histological examinations. Five sets of diagnoses were made and compared with one another. Diagnosis 1 was made, according to the simple rules, by a trainee with little clinical diagnostic experience. Diagnoses 2 and 3 were made by experienced and less-experienced sonographers, respectively, according to their clinical experiences. With diagnosis 1 as a reference, the two sonographers were asked to provide a second diagnosis, which were diagnoses 4 and 5. The efficiency of the five sets of diagnoses was compared using ROC curves.ResultsIn total, 75 malignant (37.7%) and 124 benign lesions (62.3%) were enrolled in this study. The mean diameter of the benign masses was obviously smaller than that of the malignant ones (6.8 ± 3.4 cm vs. 9.3 ± 4.9 cm, p < 0.01). The malignant ratio in postmenopausal women was much higher (66.1%) than that in the premenopausal population (25.7%) (p < 0.0001). Totally, 156 of the 199 cases (79.4%) resulted in conclusive diagnoses. Sensitivity and specificity were 98.4% and 73.9%, respectively, among the conclusive cases. The area under the ROC curve (Az) for the simple rule diagnosis was significantly lower than that for the experienced sonographer diagnosis (0.85 vs. 0.96, p < 0.0001); compared with the less-experienced sonographer, this difference was not significant (0.85 vs. 0.86, p = 0.9776). No significant difference was found in the comparison between the diagnoses made by the experienced sonographer before and after referencing the simple rule diagnosis (Az, 0.96 vs. 0.97, p = 0.2055). Using diagnosis 1 as a reference, the diagnostic performance of the less-experienced sonographer increased (from 0.86 to 0.92, p = 0.012); however, it was still lower than that of the experienced sonographer (Az, 96% vs. 92%, p = 0.0241).ConclusionsThe simple rules was an appealing method for discriminating malignant masses from benign ones, particularly for a less-experienced sonographer.

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Section: Discussionmentioning

confidence: 99%

Association between the sonographer’s experience and diagnostic performance of IOTA simple rules

Ning

Wang

et al. 2018

World J Surg Onc

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“…Forest plots for LR2, SRs and RMI were used to present centre-specific and combined results. Subgroup analyses for RMI and the most extensively validated IOTA methods (i.e., LR2 and SRs) (Timmerman et al , 2010a; Hartman et al , 2012; Nunes et al , 2012, 2013; Alcázar et al , 2013; Sayasneh et al , 2013a, 2013b) were performed for pre- and postmenopausal women.…”

Section: Methodsmentioning

confidence: 99%

Strategies to diagnose ovarian cancer: new evidence from phase 3 of the multicentre international IOTA study

et al. 2014

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Background:To compare different ultrasound-based international ovarian tumour analysis (IOTA) strategies and risk of malignancy index (RMI) for ovarian cancer diagnosis using a meta-analysis approach of centre-specific data from IOTA3.Methods:This prospective multicentre diagnostic accuracy study included 2403 patients with 1423 benign and 980 malignant adnexal masses from 2009 until 2012. All patients underwent standardised transvaginal ultrasonography. Test performance of RMI, subjective assessment (SA) of ultrasound findings, two IOTA risk models (LR1 and LR2), and strategies involving combinations of IOTA simple rules (SRs), simple descriptors (SDs) and LR2 with and without SA was estimated using a meta-analysis approach. Reference standard was histology after surgery.Results:The areas under the receiver operator characteristic curves of LR1, LR2, SA and RMI were 0.930 (0.917–0.942), 0.918 (0.905–0.930), 0.914 (0.886–0.936) and 0.875 (0.853–0.894). Diagnostic one-step and two-step strategies using LR1, LR2, SR and SD achieved summary estimates for sensitivity 90–96%, specificity 74–79% and diagnostic odds ratio (DOR) 32.8–50.5. Adding SA when IOTA methods yielded equivocal results improved performance (DOR 57.6–75.7). Risk of Malignancy Index had sensitivity 67%, specificity 91% and DOR 17.5.Conclusions:This study shows all IOTA strategies had excellent diagnostic performance in comparison with RMI. The IOTA strategy chosen may be determined by clinical preference.

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“…To date several studies [7][8][9][10][11] have been reported demonstrating that these Simple Rules can be applied in about 76-89% of adnexal masses and that their diagnostic performance is good in both experienced and non-experienced hands.…”

Section: Commentsmentioning

confidence: 99%

“…Several papers have been reported so far validating these SR, used by expert and non-expert examiners [8][9][10][11]. Nunes et al have recently reported a meta-analysis about the use of IOTA simple rules, which conclude that the simple rules can be used in routine clinical practice being an accurate test [12].…”

Section: Introductionmentioning

confidence: 99%

Diagnostic performance of IOTA simple rules for adnexal masses classification: a comparison between two centers with different ovarian cancer prevalence

Gauna

Rodríguez

Olartecoechea

et al. 2015

European Journal of Obstetrics & Gynecology and Reproductiv

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Ultrasound criteria and CA 125 as predictive variables of ovarian cancer in women with adnexal tumors

Abstract: Objectives

Cited by 61 publications

References 22 publications

Association between the sonographer’s experience and diagnostic performance of IOTA simple rules

Association between the sonographer’s experience and diagnostic performance of IOTA simple rules

Strategies to diagnose ovarian cancer: new evidence from phase 3 of the multicentre international IOTA study

Diagnostic performance of IOTA simple rules for adnexal masses classification: a comparison between two centers with different ovarian cancer prevalence

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