Abstract
To evaluate the diagnostic performance of IOTA simple rules in predicting malignant adnexal tumors by non-expert examiners. Five obstetric/gynecologic residents, who had never performed gynecologic ultrasound examination by themselves before, were trained for IOTA simple rules by an experienced examiner. One trained resident performed ultrasound examinations including IOTA simple rules on 100 women, who were scheduled for surgery due to ovarian masses, within 24 hours of surgery. The gold standard diagnosis was based on pathological or operative findings. The five-trained residents performed IOTA simple rules on 30 patients for evaluation of inter-observer variability. A total of 100 patients underwent ultrasound examination for the IOTA simple rules. Of them, IOTA simple rules could be applied in 94 (94%) masses including 71 (71.0%) benign masses and 29 (29.0%) malignant masses. The diagnostic performance of IOTA simple rules showed sensitivity of 89.3% (95%CI, 77.8%; 100.7%), specificity 83.3% (95%CI, 74.3%; 92.3%). Inter-observer variability was analyzed using Cohen's kappa coefficient. Kappa indices of the four pairs of raters are 0.713-0.884 (0.722, 0.827, 0.713, and 0.884). IOTA simple rules have high diagnostic performance in discriminating adnexal masses even when are applied by non-expert sonographers, though a training course may be required. Nevertheless, they should be further tested by a greater number of general practitioners before widely use.
Highlights
It has been well accepted that preoperative differentiating between benign and malignant ovarian masses is important for plan of management since they need different interventions
International Ovarian Tumor Analysis (IOTA) simple rules have high diagnostic performance in discriminating adnexal masses even when are applied by non-expert sonographers, though a training course may be required
To determine whether IOTA simple rules could be applied among general practitioners or not, we conducted this study aimed to evaluate their diagnostic performance in predicting malignant adnexal tumors by non-expert examiners
Summary
It has been well accepted that preoperative differentiating between benign and malignant ovarian masses is important for plan of management since they need different interventions. IOTA simple rules, as the International Ovarian Tumor Analysis (IOTA) group (Timmerman et al, 2008; Timmerman et al, 2010; Alcazar et al, 2013), havebecome more popular in differentiating adnexal masses. IOTA simple rules are based on demonstration of the certain ultrasound characteristics, indicative of benignity (B-features) or malignancy (M-features), developed for widely use by general practitioners. In most previous studies, IOTA simple rules have been performed by highlyskilled examiners and never been tested by inexperienced hands. Before widely used by general practitioners, IOTA simple rules should be evaluated for its effectiveness when performed by non-expert examiners. To determine whether IOTA simple rules could be applied among general practitioners or not, we conducted this study aimed to evaluate their diagnostic performance in predicting malignant adnexal tumors by non-expert examiners
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have