Evaluation of simple International ovarian tumor analysis ultra sound rules in differentiating between benign and malignant ovarian tumors and their histopathological correlation

Abstract

Background: IOTA (International ovarian tumor analysis) study is considered one of the largest studies on ultrasound diagnosis of ovarian pathology conducted in literature till date. It was started in 1999 and included nine European countries. It is a standardized technique for preoperative classification of ovarian pathology defined by IOTA group.Methods: A retrospective study was analyzed from a period of January 2016 to December 2017 (2-year period). The records of all the patients operated for benign and malignant ovarian pathology in the gynae department of hospital were retrieved from medical record sections. USG findings were redefined as per IOTA simple rules by sonologist and its histopathological correlation was done using kappa statistical method.Results: In the present study, out of 61 patients IOTA was applicable to 57 patients. The sensitivity where IOTA simple rules were applicable was 92.8% and the specificity was 93%. The accuracy turned out to be 92.9%. If inconclusive results were taken as malignant then sensitivity increased to 94% and specificity decreased to 87%. Good level of agreement was found between sonological and histopathological findings with Kappa statistics application (K = 0.59).Conclusions: The IOTA simple rules can be considered as an important diagnostic modality in differentiation of benign and malignant ovarian tumors, it has an added advantage of abolishing the subjectivity of routine ultrasound. However inconclusive results demand further expertise in the field and need to be taken care of before interpretation of ovarian pathologies.

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

“…In our study we included 78 patients, in whom 49 (62.8%) masses were suggested to be benign, 24 (30.7%) malignant and 5 (6.4%) inconclusive according to IOTA simple rules. This was almost similar to Sharma B et al, [5] where according to usg IOTA rules 67.2% masses seemed benign and 26.2% as malignant. Timmerman D et al, [6] in their study found out the sensitivity and specificity of IOTA simple rules as 91% and 96% excluding inconclusive masses respectively and 94% and 80% taking inconclusive masses as malignant.…”

“…In a similar study by Sharma B et al, [5] the sensitivity of IOTA simple rules for the detection of malignancy was 92.8%, whereas the specificity was 93%, it had the positive predictive value of 81.2%, with a comparatively high negative predictive value of 97.5% and the accuracy of 92.9%. Our study showed positive predictive value of 87.5%, negative predictive value of 95.9% and accuracy of 93.2% excluding the inconclusive masses.…”