Relevance of International Ovarian Tumor Analysis (IOTA) ultrasound rules and ADNEX risk calculator in the investigation of ovarian masses in a semi-rural Indian population

Abstract

Aims: The study was undertaken to assess the efficacy of the International Ovarian Tumor Analysis (IOTA) ultrasound rules and the IOTA- Assessment of Different NEoplasias in the adneXa (ADNEX) model risk calculator in the investigation of ovarian masses in a semi-rural Indian population. Methods and Material: The study was a retrospective study. The pre-operative ultrasound images of all patients who had surgery for an adnexal mass over a two year period were looked at and classified according to the IOTA-ADNEX model calculator. Results: There were 45 patients who had surgery for an adnexal mass of which 78% had benign findings, 15% were malignant, and 6% were borderline on the final histological diagnosis. After retrospectively applying the ADNEX calculator, the study confirmed the low false positive (4%) and false negative (2%) rates, and this was despite not having cancer antigen 125(CA125) in hand at the time of the scan. There was one case where an adnexal lesion was classified benign on ultrasound, but was proven to be malignant on histology and as per the ADNEX model risk calculator. Conclusions: The study results showed vast potential in the management of adnexal masses in countries where costs, healthcare providers, infrastructure, and patient follow-up can be limited. The use of a predictive algorithm like the ADNEX model can help reduce anxiety, provide reassurance, and importantly avoid unwarranted surgery in patients with benign pathologies.