Prospective external validation of IOTA three‐step strategy for characterizing and classifying adnexal masses and retrospective assessment of alternative two‐step strategy using simple‐rules risk

2019 ◽  
Vol 53 (5) ◽  
pp. 693-700
Author(s):  
J. J. Hidalgo ◽  
F. Ros ◽  
M. Aubá ◽  
T. Errasti ◽  
B. Olartecoechea ◽  
...  
Keyword(s):  
External Validation ◽  
Adnexal Masses ◽  
Retrospective Assessment ◽  
Simple Rules

scholarly journals External Validation of the IOTA Classification in Women with Ovarian Masses Suspected to Be Endometrioma

2021 ◽  
Vol 10 (13) ◽  
pp. 2971
Author(s):  
Lee Cohen Ben-Meir ◽  
Roy Mashiach ◽  
Vered H. Eisenberg
Keyword(s):  
Expert Opinion ◽  
Transvaginal Ultrasound ◽  
External Validation ◽  
Likelihood Ratios ◽  
Predictive Values ◽  
Adnexal Masses ◽  
Tertiary Referral Center ◽  
Surgery Group ◽  
Simple Rules ◽  
Potentially Malignant

The study aimed to perform external validation of the International Ovarian Tumor Analysis (IOTA) classification of adnexal masses as benign or malignant in women with suspected endometrioma. A retrospective study including women referred to an endometriosis tertiary referral center for dedicated transvaginal ultrasound (TVUS). Adnexal masses were evaluated using the IOTA classification simple descriptors, simple rules and expert opinion. The reference standard was definitive histology after mass removal at laparoscopy. In total, 621 women were evaluated and divided into four groups: endometrioma on TVUS and confirmed on surgery (Group 1 = 181), endometrioma on TVUS but other benign cysts on surgery (Group 2 = 9), other cysts on TVUS but endometrioma on surgery (Group 3 = 2), masses classified as other findings or suspicious for malignancy on TVUS and confirmed on surgery (Group 4 = 5 potentially malignant, 11 benign). This gave a sensitivity 98.9%, specificity 64%, positive 95.3% and negative 88.9% predictive values, positive 2.74 and negative 0.02 likelihood ratios and 94.7% overall accuracy. The surgical diagnosis for the five masses suspected to be malignant was: borderline serous tumor (2), borderline mucinous tumor (2), and endometrioid lesion with complex hyperplasia without atypia (1). The conclusions were that the IOTA classification simple descriptors, simple rules and expert opinion performs well for classifying adnexal masses suspected to be endometrioma. The most common potentially malignant masses in these women were borderline ovarian tumors.

External validation of IOTA simple descriptors and simple rules for classifying adnexal masses

2016 ◽  
Vol 48 (3) ◽  
pp. 397-402 ◽  
Author(s):  
J. L. Alcázar ◽  
M. A. Pascual ◽  
B. Graupera ◽  
M. Aubá ◽  
T. Errasti ◽  
...  
Keyword(s):  
External Validation ◽  
Adnexal Masses ◽  
Simple Rules

scholarly journals OC14.08: IOTA simple rules for discriminating between benign and malignant adnexal masses: a prospective external validation

2013 ◽  
Vol 42 (s1) ◽  
pp. 30-30 ◽  
Author(s):  
J. Alcazar ◽  
M. Pascual ◽  
B. Olartecoechea ◽  
M. Aubá ◽  
B. Graupera ◽  
...  
Keyword(s):  
External Validation ◽  
Adnexal Masses ◽  
Simple Rules

scholarly journals IOTA simple rules for discriminating between benign and malignant adnexal masses: prospective external validation

2013 ◽  
pp. n/a-n/a ◽  
Author(s):  
J. L. Alcázar ◽  
M. Á. Pascual ◽  
B. Olartecoechea ◽  
B. Graupera ◽  
M. Aubá ◽  
...  
Keyword(s):  
External Validation ◽  
Adnexal Masses ◽  
Simple Rules

scholarly journals EP34.10: A retrospective external validation of the IOTA simple rules to differentiate between benign and malignant adnexal masses

2019 ◽  
Vol 54 (S1) ◽  
pp. 443-443
Author(s):  
A. Esquivel Villabona ◽  
N. Rodriguez ◽  
C. Buritica ◽  
N. Rodríguez ◽  
N. Ayala ◽  
...  
Keyword(s):  
External Validation ◽  
Adnexal Masses ◽  
Simple Rules

OC01.02: External validation of IOTA simple descriptors and simple rules for differential diagnosis of adnexal masses

2015 ◽  
Vol 46 ◽  
pp. 1-1
Author(s):  
M. Pascual ◽  
J. Alcazar ◽  
S. Guerriero ◽  
B. Graupera ◽  
L. Hereter ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
External Validation ◽  
Adnexal Masses ◽  
Simple Rules

scholarly journals Sonographic Assessment of Complex Ultrasound Morphology in Pregnant Women with the Use of IOTA Simple Rules Risk and ADNEX Scoring Systems

Diagnostics ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 414
Author(s):  
Artur Czekierdowski ◽  
Norbert Stachowicz ◽  
Agata Smoleń ◽  
Tomasz Kluz ◽  
Tomasz Łoziński ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Risk Model ◽  
Malignant Tumors ◽  
Scoring Systems ◽  
Subjective Assessment ◽  
Risk Level ◽  
Likelihood Ratios ◽  
Predictive Values ◽  
Adnexal Masses ◽  
Simple Rules

Background: To evaluate the accuracy of subjective assessment (SA), the International Ovarian Tumor Analysis (IOTA) group Simple Rules Risk (SRR) and the Assessment of Different NEoplasias in the adneXa (ADNEX) model for the preoperative differentiation of adnexal masses in pregnant women. Methods: The study population comprised 36 pregnant women (median age: 28.5 years old, range: 20–42 years old) with a mean gestation age of 13.5 (range: 8–31) weeks at diagnosis. Tumors were prospectively classified by local sonographers as probably benign or probably malignant using SA. Final tumor histological diagnosis was used as the reference standard in all cases. Logistic regression SRR and ADNEX models were used to obtain a risk score for every case. Serum CA125 and human epidydimis protein 4 (HE4) concentrations were also retrieved and the Risk of Ovarian Malignancy Algorithm (ROMA) value was calculated. The calculated predictive values included positive and negative likelihood ratios of ultrasound and biochemical tests. Results: Final histology confirmed 27 benign and 9 malignant (including 2 borderline) masses. The highest sensitivity (89%) and specificity (70%) were found for the subjective tumor assessment. Although no malignancy was classified as benign using the SRR criteria (sensitivity = 100%), the specificity of this scoring system was only 37%. At the cut-off risk level of >20%, the ADNEX model had a sensitivity of 78% and a specificity of 70%. Serum levels of CA125, HE4 and the ROMA risk model correctly identified adnexal malignant tumors with a sensitivity of 67%, 25% and 25%, respectively. Corresponding specificities were 72%, 100% and 100%, respectively. The highest positive and negative likelihood ratios were found for SA (LR+ = 3.0 and LR− = 0.16, respectively). Overall diagnostic accuracy of all predictive methods used in this study were similar (range: 70–75%) except for SRR (53%). Conclusion: Subjective assessment remains the best predictive method in complex adnexal masses found at prenatal ultrasound in pregnant women. For less experienced sonographers, both the SRR and ADNEX scoring systems may be also used for the characterization of such tumors, while serum tumor markers CA125 and HE4, along with the ROMA algorithm appear to be less accurate.

scholarly journals External validation of the adapted Risk of Malignancy Index incorporating tumor size in the preoperative evaluation of adnexal masses

2011 ◽  
Vol 159 (2) ◽  
pp. 422-425 ◽  
Author(s):  
Petronella A.J. van den Akker ◽  
Petra L.M. Zusterzeel ◽  
Anette L. Aalders ◽  
Marc P.L.M. Snijders ◽  
Rahul A.K. Samlal ◽  
...  
Keyword(s):  
Tumor Size ◽  
Preoperative Evaluation ◽  
External Validation ◽  
Adnexal Masses ◽  
Risk Of Malignancy ◽  
Risk Of Malignancy Index

Comparison of the diagnostic performances of the Assessment of Different NEoplasias in the adneXa model, Simple Rules model, and Risk of Malignancy Index for adnexal masses in a gynecological oncology centre  in China

2020 ◽  
Author(s):  
Le Qian ◽  
Qinwen Du ◽  
Meijiao Jiang ◽  
Fei Yuan ◽  
Hui Chen ◽  
...  
Keyword(s):  
Prediction Models ◽  
Roc Curves ◽  
Chinese Patients ◽  
Malignant Tumours ◽  
Likelihood Ratios ◽  
Predictive Values ◽  
Adnexal Masses ◽  
Simple Rules ◽  
Risk Of Malignancy ◽  
Risk Of Malignancy Index

Abstract Background This study aimed to compare different ultrasound-based International Ovarian Tumor Analysis (IOTA) prediction models, namely, the Simple Rules (SRs) the Assessment of Different NEoplasias in the adneXa (ADNEX) models, and the Risk of Malignancy Index (RMI), for the pre-operative diagnosis of adnexal mass. Methods This single-centre, retrospective study of diagnostic accuracy involved 486 patients. All ultrasound examinations were analyzed and the prediction models were applied. Pathology was the clinical reference standard. The diagnostic performances of prediction models were measured by evaluating receiver-operating characteristic (ROC) curves, sensitivities, specificities, positive and negative predictive values, positive and negative likelihood ratios, and diagnostic odds ratios. Results To discriminate benign and malignant tumours, areas under the ROC curves (AUCs) for ADNEX models were 0.94 (95% CI: 0.92–0.96) with CA125 and 0.94 (95% CI: 0.91–0.96) without CA125, which were significantly higher than the AUCs for RMI I-III: 0.87 (95% CI: 0.83–0.90), 0.83 (95% CI: 0.80–0.86), and 0.82 (95% CI: 0.78–0.86), (all P < 0.0001). At a cut-off of 10%, the ADNEX model with CA125 had the highest sensitivity (0.93; 95% CI: 0.87–0.97) compared with the other models. The SRs model achieved a sensitivity of 0.93 (95% CI: 0.86–0.97) and a specificity of 0.86 (95% CI: 0.82–0.89) when inconclusive diagnoses (11.7%) were classified as malignant. Conclusion ADNEX and SRs models were excellent at characterising adnexal masses which were superior to the RMI in Chinese patients.

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