Evaluation of the Diagnostic Value of the Ultrasound ADNEX Model for Benign and Malignant Ovarian Tumors

Peng, Xiaoshan; Ma, Yue; Wang, Lingling; Li, Haixia; Zheng, Xiaodong; Liu, Ying

doi:10.2147/ijgm.s328010

Cited by 12 publications

(9 citation statements)

References 24 publications

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“…Chen et al found similar sensitivity and specificity in the ADNEX model with and without CA125 (91.4% vs. 91.4%; 78.9% vs. 79.5%) [ 34 ]. Peng et al also studied the sensitivity for diagnosing borderline, stage I, and metastatic ovarian tumors, and they found that it was only 60.0%, 28.6%, and 45.5%, respectively [ 35 ]. In our series, the mean percentage of probability of being a borderline tumor or stage I in the ADNEX model with/without CA125 is over 10%, while stage II-IV rises up to 53.0%.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Ultrasound Scores in Differentiating between Benign and Malignant Adnexal Masses

et al. 2023

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Subjective ultrasound assessment by an expert examiner is meant to be the best option for the differentiation between benign and malignant adnexal masses. Different ultrasound scores can help in the classification, but whether one of them is significantly better than others is still a matter of debate. The main aim of this work is to compare the diagnostic performance of some of these scores in the evaluation of adnexal masses in the same set of patients. This is a retrospective study of a consecutive series of women diagnosed as having a persistent adnexal mass and managed surgically. Ultrasound characteristics were analyzed according to IOTA criteria. Masses were classified according to the subjective impression of the sonographer and other ultrasound scores (IOTA simple rules -SR-, IOTA simple rules risk assessment -SRRA-, O-RADS classification, and ADNEX model -with and without CA125 value-). A total of 122 women were included. Sixty-two women were postmenopausal (50.8%). Eighty-one women had a benign mass (66.4%), and 41 (33.6%) had a malignant tumor. The sensitivity of subjective assessment, IOTA SR, IOTA SRRA, and ADNEX model with or without CA125 and O-RADS was 87.8%, 66.7%, 78.1%, 95.1%, 87.8%, and 90.2%, respectively. The specificity for these approaches was 69.1%, 89.2%, 72.8%, 74.1%, 67.9%, and 60.5%, respectively. All methods with similar AUC (0.81, 0.78, 0.80, 0.88, 0.84, and 0.75, respectively). We concluded that IOTA SR, IOTA SRRA, and ADNEX models with or without CA125 and O-RADS can help in the differentiation of benign and malignant masses, and their performance is similar to the subjective assessment of an experienced sonographer.

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Section: Discussionmentioning

confidence: 99%

Comparison of Ultrasound Scores in Differentiating between Benign and Malignant Adnexal Masses

et al. 2023

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“…Although CA125 is one of the clinical variables (www.iotagroup.org/adnexmodel/ ), the applications allow risk calculation even without information on serum CA-125 level despite the decrease in performance and it is important for good discrimination between stage II-IV cancer and stage I and secondary metastatic cancer in the ultrasound-based ADNEX model (10). Besides, previous studies also demonstrated that the CA125 level had no significant impact on the diagnostic accuracy of the ADNEX model (22)(23)(24). This is because CA125 is not a specific marker for ovarian cancer, and it can be increased in cases with benign lesions, such as endometriosis and uterine fibroids (25, 26).…”

Section: Discussionmentioning

confidence: 95%

Comparison of ultrasound−based ADNEX model with magnetic resonance imaging for discriminating adnexal masses: a multi-center study

Chen

Dong

et al. 2023

Front. Oncol.

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ObjectivesThe ADNEX model offered a good diagnostic performance for discriminating adnexal tumors, but research comparing the abilities of the ADNEX model and MRI for characterizing adnexal tumors has not been reported to our knowledge. The aim of this study was to evaluate the diagnostic accuracy of the ultrasound-based ADNEX (Assessment of Different NEoplasias in the adneXa) model in comparison with that of magnetic resonance imaging (MRI) for differentiating benign, borderline and malignant adnexal masses.MethodsThis prospective study included 529 women with adnexal masses who underwent assessment via the ADNEX model and subjective MRI analysis before surgical treatment between October 2019 and April 2022 at two hospitals. Postoperative histological diagnosis was considered the gold standard.ResultsAmong the 529 women, 92 (17.4%) masses were diagnosed histologically as malignant tumors, 67 (12.7%) as borderline tumors, and 370 (69.9%) as benign tumors. For the diagnosis of malignancy, including borderline tumors, overall agreement between the ADNEX model and MRI pre-operation was 84.9%. The sensitivity of the ADNEX model of 0.91 (95% confidence interval [CI]: 0.85–0.95) was similar to that of MRI (0.89, 95% CI: 0.84–0.94; P=0.717). However, the ADNEX model had a higher specificity (0.90, 95% CI: 0.87–0.93) than MRI (0.81, 95% CI: 0.77–0.85; P=0.001). The greatest sensitivity (0.96, 95% CI: 0.92–0.99) and specificity (0.94, 95% CI: 0.91–0.96) were achieved by combining the ADNEX model and subjective MRI assessment. While the total diagnostic accuracy did not differ significantly between the two methods (P=0.059), the ADNEX model showed greater diagnostic accuracy for borderline tumors (P<0.001).ConclusionThe ultrasound-based ADNEX model demonstrated excellent diagnostic performance for adnexal tumors, especially borderline tumors, compared with MRI. Accordingly, we recommend that the ADNEX model, alone or with subjective MRI assessment, should be used for pre-operative assessment of adnexal masses.

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“…They concluded that a cut-off value of 10% should be utilized for AR and RR for diagnosing the BOT [ 19 ]. Another study conducted by Peng XS et al on evaluating diagnostic values for differentiating benign and malignancy suggested that a universal fixed value cannot be assigned for all the setups [ 20 ]. It depends upon the population, settings, clinicians, and local protocols.…”

Section: Reviewmentioning

confidence: 99%

“…It depends upon the population, settings, clinicians, and local protocols. They also found that this model gives accurate results without using the Serum CA-125 marker [ 20 ]. They also found that results via the ADNEX model and those with histopathology were similar, hence proving that this tool is effective and can be considered as best among all other tools.…”

Section: Reviewmentioning

confidence: 99%

The International Ovarian Tumor Analysis-Assessment of Different Neoplasias in the Adnexa (IOTA-ADNEX) Model Assessment for Risk of Ovarian Malignancy in Adnexal Masses

Cherukuri¹,

Jajoo²,

Dewani³

2022

Cureus

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Ovarian cancers are one of the major leading causes of death across the world. In addition to many challenges to diagnose the disease, it is also hard to predict the type of cancer with effective tools and technology. Many attempts have been made to diagnose ovarian malignancies using ultrasonography, MRI, and CT scans, but seldom will they give the clinician a clear understanding of cancer's type and stage. It is of utmost importance to understand the mass peri-operatively, which will help the clinicians to decide on the course of management mortality. With technological advancements, many predictive models have come into the picture. Many of those were dependent on the Serum CA-125 markers. With ultrasonography machine usage, the International Ovarian Tumor Analysis (IOTA) group has developed a Simple Rules model, Logistic Regression (LR) models, and, most recently, the IOTA-assessment of different neoplasias in the adnexa (IOTA-ADNEX) model. It has been found to be effective and reliable among all the tools developed in the past. The ADNEX predicts the type of cancer (benign or malignant) and stages of cancer (borderline, Stage I, Stages II-IV, and secondary metastatic). These models can be used for people who are coming with persistent adnexal masses in the ovarian region, para ovarian region, or in the tubes and are recommended for the surgeries. The model is developed by a team of clinicians and statisticians, based on ultrasound and clinical data. This article reviews the IOTA-ADNEX model as a tool for predicting ovarian malignancies in people coming with adnexal masses, especially in comparison with other methods and models. It also tests its effectiveness in the hands of experienced technicians and non-expert technicians.

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Evaluation of the Diagnostic Value of the Ultrasound ADNEX Model for Benign and Malignant Ovarian Tumors

Cited by 12 publications

References 24 publications

Comparison of Ultrasound Scores in Differentiating between Benign and Malignant Adnexal Masses

Comparison of Ultrasound Scores in Differentiating between Benign and Malignant Adnexal Masses

Comparison of ultrasound−based ADNEX model with magnetic resonance imaging for discriminating adnexal masses: a multi-center study

The International Ovarian Tumor Analysis-Assessment of Different Neoplasias in the Adnexa (IOTA-ADNEX) Model Assessment for Risk of Ovarian Malignancy in Adnexal Masses

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