Obstetrics and Gynecology Residents Can Accurately Classify Benign Ovarian Tumors Using the International Ovarian Tumor Analysis Rules

Abstract

ObjectivesRecognition of benign versus malignant tumors is essential in gynecologic ultrasound (US). The International Ovarian Tumor Analysis (IOTA) rules have been proposed as part of resident US training. The objective of this study was to examine whether they could be accurately used by obstetrics and gynecology residents in Rwanda.MethodsPatients undergoing explorative laparotomy for adnexal masses at the University Teaching Hospital of Kigali were included. Before the study, a didactic lecture on the IOTA rules for classifying adnexal masses was performed. Preoperative transabdominal US examinations were performed by residents at different levels of training, who were blinded to the results of prior US examinations. The IOTA classification was compared to the final pathologic diagnosis.ResultsThere were 72 patients who underwent 116 US examinations. Only 15.5% of US examinations were considered inconclusive. First‐year residents (12) correctly diagnosed 18 of 20 masses (90%) as benign and 4 of 4 as malignant. Second‐year residents (9) classified 29 of 29 masses correctly. Third‐year residents (10) accurately identified 21 of 22 (95.5%) as benign and 5 of 5 as malignant. Fourth‐year residents (13) accurately identified 11 of 12 (91.7%) as benign and 6 of 6 as malignant. Therefore, 74 of 78 tumors (94.9%) considered benign by IOTA rules were confirmed by histologic results. Similarly, all 20 tumors classified as malignant were confirmed. Overall, the sensitivities to diagnose benign and malignant tumors by the IOTA rules were 83.3% and 100%, respectively. The positive and negative predictive values were 100% and 94.9%. There were no significant differences noted between residency years.ConclusionsAll levels of Rwandan obstetrics and gynecology residents were able to use the IOTA rules to accurately distinguish benign from malignant tumors.

Ultrasound Assessment of Adnexal Pathology: Standardized Methods and Different Levels of Experience

“…Most of the articles available in English within the last 5 years describe the performance of IOTA, ADNEX, and GI-RADS models based only on experts’ also known as level III [ 1 ] examiners’ evaluation data. Only several [ 2 , 3 , 4 , 5 , 6 , 7 ] conduct research including less experienced trainees or residents, yet only describing the performance of SR with or without subjective evaluation. No articles were found describing GI-RADS or ADNEX performance when applied by level I or even less experienced examiners.…”

Operatives Management von Adnextumoren

“…Insgesamt scheinen diese Scoring-Systeme jedoch insbesondere bei der Beurteilung durch einen unerfahreneren Untersucher bzw. im Zeitfenster des "Erlernens" der "pattern recognition" wertvoll zu sein [23,24].…”

Propranolol-induced apoptosis via the AKT signaling pathway in epithelial ovarian cancer

“…Ovarian cancer is one of the most common gynecologic malignancies [1], with 295,400 newly diagnosed ovarian cancer cases and 184,800 deaths due to ovarian cancer worldwide in 2018 [2]. Despite the use of increasingly more chemotherapeutic drugs, the overall 5-year survival rate is still less than 30-40% [3]. Therefore, it is important to develop novel chemotherapies to improve the therapeutic effect and prolong survival.…”