Use of <scp>IOTA</scp> simple rules for diagnosis of ovarian cancer: meta‐analysis

Nunes, Natalie; Ambler, Gareth; Foo, X.; Naftalin, J.; Widschwendter, Martin; Jurkovic, D.

doi:10.1002/uog.13437

Cited by 110 publications

(96 citation statements)

References 32 publications

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“…Therefore, we believe that the simple rules are a user-friendly tool for both experienced and less-experienced examiners. For the masses with conclusive results, the sensitivity in this study was lower than that in Nunes [19] reported in their meta-analysis, while the specificity was higher. This difference may be partly explained by the fact that this study was performed in a tertiary care university-affiliated hospital, which was considered to be the best hospital in Qingdao, and partly because the simple rule diagnosis was conducted by a trainee with little clinical experience.…”

Section: Discussioncontrasting

confidence: 89%

Association between the sonographer’s experience and diagnostic performance of IOTA simple rules

Ning

Wang

et al. 2018

World J Surg Onc

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BackgroundTo validate the clinical value of simple rules in distinguishing malignant adnexal masses from benign ones and to explore the effect of simple rules for experienced and less-experienced sonographers.MethodsPatients with persistent adnexal masses were enrolled between November 2013 and December 2015. All masses were proven through histological examinations. Five sets of diagnoses were made and compared with one another. Diagnosis 1 was made, according to the simple rules, by a trainee with little clinical diagnostic experience. Diagnoses 2 and 3 were made by experienced and less-experienced sonographers, respectively, according to their clinical experiences. With diagnosis 1 as a reference, the two sonographers were asked to provide a second diagnosis, which were diagnoses 4 and 5. The efficiency of the five sets of diagnoses was compared using ROC curves.ResultsIn total, 75 malignant (37.7%) and 124 benign lesions (62.3%) were enrolled in this study. The mean diameter of the benign masses was obviously smaller than that of the malignant ones (6.8 ± 3.4 cm vs. 9.3 ± 4.9 cm, p < 0.01). The malignant ratio in postmenopausal women was much higher (66.1%) than that in the premenopausal population (25.7%) (p < 0.0001). Totally, 156 of the 199 cases (79.4%) resulted in conclusive diagnoses. Sensitivity and specificity were 98.4% and 73.9%, respectively, among the conclusive cases. The area under the ROC curve (Az) for the simple rule diagnosis was significantly lower than that for the experienced sonographer diagnosis (0.85 vs. 0.96, p < 0.0001); compared with the less-experienced sonographer, this difference was not significant (0.85 vs. 0.86, p = 0.9776). No significant difference was found in the comparison between the diagnoses made by the experienced sonographer before and after referencing the simple rule diagnosis (Az, 0.96 vs. 0.97, p = 0.2055). Using diagnosis 1 as a reference, the diagnostic performance of the less-experienced sonographer increased (from 0.86 to 0.92, p = 0.012); however, it was still lower than that of the experienced sonographer (Az, 96% vs. 92%, p = 0.0241).ConclusionsThe simple rules was an appealing method for discriminating malignant masses from benign ones, particularly for a less-experienced sonographer.

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Section: Discussioncontrasting

confidence: 89%

Association between the sonographer’s experience and diagnostic performance of IOTA simple rules

Ning

Wang

et al. 2018

World J Surg Onc

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“…Specificity was similar in both centers. This is in agreement with the conclusion drawn by Nunes et al in their recent metaanalysis, that found out that sensitivity of simple rules were higher in papers with higher malignancy rate [12].…”

Section: Commentssupporting

confidence: 87%

“…Several papers have been reported so far validating these SR, used by expert and non-expert examiners [8][9][10][11]. Nunes et al have recently reported a meta-analysis about the use of IOTA simple rules, which conclude that the simple rules can be used in routine clinical practice being an accurate test [12]. However, data about whether these simple rules perform similarly in different clinical settings according to malignancy rate are still scanty.…”

Section: Introductionmentioning

confidence: 96%

Diagnostic performance of IOTA simple rules for adnexal masses classification: a comparison between two centers with different ovarian cancer prevalence

Gauna

Rodríguez

Olartecoechea

et al. 2015

European Journal of Obstetrics & Gynecology and Reproductiv

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“…Ultrasonography is the first choice imaging for assessing a pelvic mass. The simple IOTA rules have an accuracy of 76-89% for the diagnosis of ovarian cancer [23].…”

Section: Resultsmentioning

confidence: 99%

Immature Ovarian Teratoma in a 21 Year –Old Woman: A Case Report and Review of the Literature.

Stavrou¹

2015

J Gen Pract

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with specific tumor markers .So, tumor markers Ca 15-3, Ca19-9, Ca 125, and CEA were fluctuated in normal ranges. Serum levels of alphafetoprotein (a-FP) were significantly elevated reaching the plateau of 392 iu/ ml (normal ranges: <9.5 iu/ml), supporting the sonographically evoked opinion of underlying malignancy. Except that AST (62 IU/L), ALT (73 IU/L) and LDH (309 IU/L) were mildly increased.Because of the young profile of the patient, MRI of upper and lower abdomen has been also performed; similarly to ultrasonographic report, MRI noticed the presence of excessive ascites; it also described a heterogeneous right ovarian mass of 88 × 81 × 100 mm presenting cystic, solid and hemorrhagic contents, fixed to the broad ligament of the uterus. It also revealed 2 thin walled cysts of 4, 3 cm and 2, 4 cm in the left ovary without solid parts. Intraperitoneal tissue in the region of upper abdomen was described, implying the possibility of underlying peritoneal carcinomatosis. The liver, the biliary system, the spleen, the pancreas and the adrenals were normal. MRI didn't reveal enlarged paraaortic, mesenteric, iliac or inguinal lymph nodes (Figure 2). Chest X-ray and ultrasonographically breast examination were normal. Initially, ascites suction was realized in order to alleviate from pressing symptoms. In the operation theater under general anesthesia, laparoscopy was performed with the technique of the four ports for better abdominal exploration in the overweight patient; 4 to 5 liters of ascites were aspirated for cytological examination. The organs of the upper abdomen were normal, without implantations in the peritoneum or omental disease. The uterus and the left adnexa were normal but a mass 10-12 cm of right ovary characterized by abnormal surface was revealed. So exploratory laparotomy followed with vertical incision .Then the cystic lesion was removed and sent for frozen section. The rapid biopsy was positive for

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Use of IOTA simple rules for diagnosis of ovarian cancer: meta‐analysis

Abstract: Objectives

Cited by 110 publications

References 32 publications

Association between the sonographer’s experience and diagnostic performance of IOTA simple rules

Association between the sonographer’s experience and diagnostic performance of IOTA simple rules

Diagnostic performance of IOTA simple rules for adnexal masses classification: a comparison between two centers with different ovarian cancer prevalence

Immature Ovarian Teratoma in a 21 Year –Old Woman: A Case Report and Review of the Literature.

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