Evaluation of IOTA-ADNEX Model and Simple Rules for Identifying Adnexal Masses by Operators with Varying Levels of Expertise: A Single-Center Diagnostic Accuracy Study.

IF 1.3 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Ultrasound International Open Pub Date : 2023-01-01 DOI:10.1055/a-2044-2855
Maria Giourga, Abraham Pouliakis, Panagiotis Vlastarakos, Sofoklis Stavrou, Maria Tsiriva, Angeliki Gerede, Georgios Daskalakis, Charalampos Voros, Petros Drakakis, Ekaterini Domali
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Abstract

Objectives The discrimination of ovarian lesions presents a significant problem in everyday clinical practice with ultrasonography appearing to be the most effective diagnostic technique. The aim of our study was to externally evaluate the performance of different diagnostic models when applied by examiners with various levels of experience. Methods This was a diagnostic accuracy study including women who were admitted for adnexal masses, between July 2018 and April 2021, to a Greek tertiary oncology center. Preoperatively sonographic data were evaluated by an expert gynecologist, a 6 th and a 1 st year gynecology resident, who applied the International Ovarian Tumor Analysis (IOTA) Simple Rules (SR) and Assessment of Different NEoplasias in the adneXa (ADNEX) model to discriminate between benign and malignant ovarian tumors. The explant pathology report was used as the reference diagnosis. Kappa statistics were used for the investigation of the level of agreement between the examined systems and the raters. Results We included 66 women, 39 with benign and 27 with malignant ovarian tumors. ADNEX (with and without "CA-125") had high sensitivity (96-100%) when applied by all raters but a rather low specificity (36%) when applied by the 1st year resident. SR could not be applied in 6% to 17% of the cases. It had slightly lower sensitivity, higher specificity, and higher overall accuracy, especially when applied by the 1st year resident (61% vs. 92%), compared to ADNEX. Conclusion Both ADNEX and SR can be utilized for screening in non-oncology centers since they offer high sensitivity even when used by less experienced examiners. In the hands of inexperienced examiners, SR appears to be the best model for assessing ovarian lesions.

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评估IOTA-ADNEX模型和简单规则识别附件肿块由操作员具有不同水平的专业知识:单中心诊断准确性研究。
目的卵巢病变的鉴别是临床实践中的一个重要问题,超声检查是最有效的诊断方法。我们研究的目的是外部评估不同的诊断模型的性能时,审查员应用不同水平的经验。方法:这是一项诊断准确性研究,包括2018年7月至2021年4月期间因附件肿块入住希腊三级肿瘤中心的女性。术前超声资料由妇科专家、第6年和第1年妇科住院医师评估,他们应用国际卵巢肿瘤分析(IOTA)简单规则(SR)和不同肿瘤在adneXa (ADNEX)模型中的评估来区分卵巢良恶性肿瘤。外植体病理报告作为诊断参考。Kappa统计用于调查被检查系统和评分者之间的协议水平。结果66例女性,其中良性卵巢肿瘤39例,恶性卵巢肿瘤27例。ADNEX(带或不带CA-125)在所有评分者中均具有高灵敏度(96-100%),但在第一年住院医师中应用时特异性较低(36%)。6% ~ 17%的病例不能应用SR。与ADNEX相比,它的敏感性略低,特异性更高,总体准确性更高,特别是在第一年住院医生中应用时(61%对92%)。结论ADNEX和SR均可用于非肿瘤中心的筛查,因为即使由经验不足的检查人员使用,它们也具有较高的灵敏度。在没有经验的检查人员手中,SR似乎是评估卵巢病变的最佳模型。
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来源期刊
Ultrasound International Open
Ultrasound International Open RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-
CiteScore
3.00
自引率
0.00%
发文量
7
审稿时长
12 weeks
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