Abstract
ObjectiveOvarian cancer is the most deadly deadliest gynecological tumor in the female reproductive system. Therefore, the present study sought to determine the diagnostic performance of International Ovarian Tumor Analysis Simple Rules (IOTA SR), the Ovarian-Adnexal Reporting and Data System (O-RADS), and Cancer Antigen 125 (CA125) in discriminating benign and malignant ovarian tumors. The study also assessed whether a combination of the two ultrasound categories systems and CA125 can improve the diagnostic performance.MethodsA total of 453 patients diagnosed with ovarian tumors were retrospectively enrolled from Fujian Cancer Hospital between January 2017 and September 2020. The data collected from patients included age, maximum lesion diameter, location, histopathology, levels of CA125, and detailed ultrasound reports. Additionally, all ultrasound images were independently assessed by two ultrasound physicians with more than 5 years of experience in the field, according to the IOTA simple rules and O-RADS guidelines. Furthermore, the area under the curve (AUC), sensitivity, and specificity of the above mentioned predictors were calculated using the receiver operating characteristic curve.ResultsOut of the 453 patients, 184 had benign lesions, while 269 had malignant ovarian tumors. In addition, the AUCs of IOTA SR, O-RADS, and CA125 in the overall population were 0.831, 0.804, and 0.812, respectively, and the sensitivities of IOTA SR, O-RADS, and CA125 were 94.42, 94.42, and 80.30%, respectively. On the other hand, the AUCs of IOTA SR combined with CA125, O-RADS combined with CA125, and IOTA SR plus O-RADS combined with CA125 were 0.900, 0.891, and 0.909, respectively. The findings also showed that the AUCs of a combination of the three approaches were significantly higher than those of individual strategies (p<0.05) but not significantly higher than the AUC of a combination of two methods (p>0.05).ConclusionThe findings showed that a combination of IOTA SR or O-RADS in combination with CA125 may improve the ability to distinguish benign from malignant ovarian tumors.
Highlights
Ovarian cancer is one of the deadliest gynecological tumors and one of the three most common malignancies in the female reproductive system [15]
The findings showed that the area under the curve (AUC) for the International Ovarian Tumor Analysis Simple Rules (IOTA Simple Rules (SR)), Ovarian-Adnexal Reporting and Data System (O-RADS), and CA-125 in discriminating benign from malignant adnexal masses were 0.831, 0.804 and 0.812, respectively
The findings showed that International Ovarian Tumor Analysis (IOTA) SR was more effective than O-RADS and Cancer Antigen 125 (CA125) in the preoperative diagnosis of adnexal tumors
Summary
Ovarian cancer is one of the deadliest gynecological tumors and one of the three most common malignancies in the female reproductive system [15]. Most women with ovarian cancer are diagnosed at an advanced stage due to the lack of early symptoms related to the malignancy [10]. Identification of malignant and benign ovarian tumors is essential to guide therapeutic decisions and prognosis. Ultrasound (US) is a non-invasive imaging method used in the identification of benign and malignant adnexal masses [16]. Several guidelines and structured reporting based on ultrasound characterization have been proposed to help assess the risk of malignancy in ovarian masses. The Ovarian-Adnexal Reporting and Data System (O-RADS) was published by the American College of Radiology (ACR) and provides guidelines for ovarian management in high-risk categories [2]
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