IOTA Simple Ultrasound Rules for Triage of Adnexal Mass: Experience from South India

Abstract

Objective: To assess the diagnostic performance of International Ovarian Tumor Analysis (IOTA) simple ultrasound rules to discriminate adnexal masses as benign or malignant. Methods: A cross-sectional prospective study was conducted on women scheduled for elective surgery due to adnexal masses. Ultrasound examiner systematically assessed the tumors according to the IOTA simple rules to determine the risk of the tumor being malignant. If the simple rules yielded inconclusive result, pattern recognition was used to categorize the mass. Results were then compared with histologic findings after surgery. Diagnostic performance was assessed by calculating sensitivity and specificity. Results: Two hundred and five women undergoing surgery were included. The rules were applicable in 183 (89.3%) of the tumors; and for these tumors, sensitivity was 92.8% (95% CI 77–99%) and specificity was 92.9% (95% CI 88–96.4%). Of the tumors, 144 were benign and 39 were malignant. The simple rules yielded inconclusive results in 22 masses which were analyzed by pattern recognition. Conclusion: IOTA simple rules provide excellent discrimination between benign and malignant adnexal masses.