IOTA simple ultrasound rules for triage of ovarian masses: A prospective cross-sectional study in a tertiary care hospital

Abstract

Background: A woman presenting with an adnexal mass is a common clinical problem. Correctly characterizing ovarian tumors is critical as it helps in recognizing benign ovarian masses, conservative management may be adopted, leading to reduced morbidity. In 2008, IOTA group proposed simple ultrasound rules for the diagnosis of ovarian cancer by demonstration of certain sonographic findings, indicative of benignity (B features) and some of which are suggestive of malignancy (M features).Aim: The aim of this study was to establish the diagnostic utility of IOTA ultrasound rules, to estimate and compare the sensitivity and specificity of given rules with histological diagnosis and establish their use as a tool in early diagnosis of ovarian malignancy in our tertiary care centre.Methods: This was a prospective cross-sectional study conducted in SMGS hospital, Jammu, J&K from Jan 2019 to 2020. Women with at least one adnexal mass were recruited into the study. In the case of bilateral adnexal masses, the mass with the most complex ultrasound morphology was included in the analysis. Assessment of sonographic morphology of the masses together with color Doppler study was performed to characterize the masses. Sonological and histopathological correlation was established appropriate statistics methods.Result: In a total of 79 patients with USG using iota rules: 49 were benign, 24 were malignant whereas 5 were inconclusive. On final HPE report of the 49 masses predicted to be benign by the simple rules, 47 were benign according to histopathology. Of the 24 masses predicted to be malignant by the simple rules, 21 were malignant according to histology.Conclusion: IOTA simple rules provide excellent discrimination between benign and malignant adnexal masses.