Diagnostic Value of International Ovarian Tumor Analysis Simple Rules (IOTA-SR) In Iranian Patients with Ovarian Mass

Abstract

Background: Among gynecologic malignancies, ovarian cancer has the highest mortality rate per case. The most important prognostic feature of ovarian cancer is an early diagnosis. The IOTA-SR is an ultrasound exam criterion for classifying benign or malignant ovarian tumors, which could be used effectively by an inexperienced radiologist. This study aimed to evaluate the diagnostic value of IOTA-SR in Iranian patients with ovarian tumors. Methods: In this cross-sectional study, considering inclusion and exclusion criteria, 60 females enrolled (from 2019-1 to 2019-12). Patients were evaluated with ultrasound by an experienced radiologist. Tumors were classified, as benign or malignant according to the IOTA-SR criteria. After laparotomy, histological and ultrasond examination findings were compared. Results: According to histopathologic results, the prevalence of malignancy was 63.3% (38 malignant and 22 benign tumors). The IOTA-SR could be applied in all the participants as 21 tumors (35%) were classified as benign and 39 (65%) as malignant. Compared with histopathologic results, the IOTA-SR yielded 36 true positives, three false positives, 19 true negatives, and two false negatives. Thus, assessing ovarian mass using IOTA-SR achieved a sensitivity of 94.7%, a specificity of 86.3%, a positive predictive value of 92.3%, a negative predictive value of 90.47%, positive likelihood ratio of 6.91, negative likelihood ratio of 0.091, overall accuracy of 91.6%, and kappa coefficient of 0.819 (P<0.001). Conclusions: IOTA-SR criteria have a high diagnostic value in differentiation of the malignant and benign ovarian tumors and can be applied in daily practice.