Differential ultrasound diagnosis of benign and malignant ovarian tumors: diagnostic models, algorithms, stratification systems, consensuses (1990–2023).

The review presents the most common diagnostic models, algorithms and stratification systems developed for the purpose of optimal differential diagnosis of benign and malignant ovarian tumors from 1990 to the present. Four variants of the RMI 1–4 malignancy risk index with their comparative characteristics are described. A proprietary comprehensive ultrasound scoring scale for ovarian tumors is described. Algorithms for the integrated use of echography and tumor markers (CA-125, HE4, ROMA), including the Risk Ovarian Cancer computer system, are presented. All existing IOTA diagnostic models are described: Simple IOTA rules, Simple IOTA rules with quantitative calculation of the risk of malignancy, Logistic regression analysis IOTA LR1 & LR2, Easy IOTA descriptors, IOTA ADNEX. The main algorithms for the integrated use of IOTA models are presented. The principles of using the diagnostic stratification systems GI-RADS and O-RADS are outlined. Clinical examples of the use of diagnostic models are given. The review concludes by presenting the ESGO/ISUOG/IOTA/ESGE consensus on the preoperative diagnosis of ovarian tumors.