Skip to main content
Erschienen in: Abdominal Radiology 10/2020

03.09.2019 | Pelvis

Improving the performance of IOTA simple rules: sonographic assessment of adnexal masses with resource-effective use of a magnetic resonance scoring (ADNEX MR scoring system)

verfasst von: Patrick Nunes Pereira, Luís Otavio Sarian, Adriana Yoshida, Karla Galvão Araújo, Ana Carolina Baião Silva, Ricardo Hoelz de Oliveira Barros, Rodrigo Menezes Jales, Sophie Derchain

Erschienen in: Abdominal Radiology | Ausgabe 10/2020

Einloggen, um Zugang zu erhalten

Abstract

Purpose

To compare the International Ovarian Tumor Analysis (IOTA) simple rules, simple rules risk ultrasound models, alone or in combination with magnetic resonance (MR) score to predict malignancy in women with adnexal masses.

Methods

171 women with adnexal masses were included from February 2014 to February 2016. 120 women had histopathological diagnosis obtained from surgery or percutaneous biopsy. The other 51 women were submitted to surveillance with ultrasound (US) for at least 1 year. Patients were examined with US and MR. US reports were rendered using IOTA systems. We compared five diagnostic approaches, aimed at diagnosing women with malignant tumors among those with adnexal masses: We calculated the performance and net benefits (decision curve analysis) for five distinct diagnostic approaches: (1) US simple rules (SR), (2) simple rules risk score (SRRisk), (3) US SR followed by subjective assessment (SA) of indeterminate cases, (4) SR followed by MR score for the indeterminate cases, and (5) MR score for all women.

Results

The MR score for all patients was the approach that yielded the best-standardized net benefit regardless of the risk threshold. However, referring women with indeterminate masses on SR to MR score yielded the second-best net benefit.

Conclusion

Although this study leaves no doubt about the superiority of MR score over US-based methods for the discrimination of malignant tumors in women with adnexal masses, restricting the use of MR score only to women with indeterminate masses on US SR is a safe, appropriate way to triage women with adnexal masses.
Literatur
7.
Zurück zum Zitat Kaijser J, Sayasneh A, Van Hoorde K, Ghaem-Maghami S, Bourne T, Timmerman D et al. Presurgical diagnosis of adnexal tumours using mathematical models and scoring systems: a systematic review and meta-analysis. Hum Reprod Update. 2014 May-Jun;20(3):449-62. https://doi.org/10.1093/humupd/dmt059 Kaijser J, Sayasneh A, Van Hoorde K, Ghaem-Maghami S, Bourne T, Timmerman D et al. Presurgical diagnosis of adnexal tumours using mathematical models and scoring systems: a systematic review and meta-analysis. Hum Reprod Update. 2014 May-Jun;20(3):449-62. https://​doi.​org/​10.​1093/​humupd/​dmt059
12.
15.
Zurück zum Zitat Kurman RJ, Carcangiu ML, Herrington CS, Young RH. World Health Organization Classification of Tumours of Female Reproductive Organs. 4th ed. Lyon: International Agency for Research on Cancer; 2014. Kurman RJ, Carcangiu ML, Herrington CS, Young RH. World Health Organization Classification of Tumours of Female Reproductive Organs. 4th ed. Lyon: International Agency for Research on Cancer; 2014.
17.
Zurück zum Zitat Timmerman D, Valentin L, Bourne TH, Collins WP, Verrelst H, Vergote I et al. Terms, definitions and measurements to describe the sonographic features of adnexal tumors: a consensus opinion from the International Ovarian Tumor Analysis (IOTA) Group. Ultrasound Obstet Gynecol 2000; 16: 500-505. https://doi.org/10.1046/j.1469-0705.2000.00287.x Timmerman D, Valentin L, Bourne TH, Collins WP, Verrelst H, Vergote I et al. Terms, definitions and measurements to describe the sonographic features of adnexal tumors: a consensus opinion from the International Ovarian Tumor Analysis (IOTA) Group. Ultrasound Obstet Gynecol 2000; 16: 500-505. https://​doi.​org/​10.​1046/​j.​1469-0705.​2000.​00287.​x
23.
Zurück zum Zitat Peces Rama A, Llanos Llanos MC, Sánchez Ferrer ML, Alcázar Zambrano JL, Martínez Mendoza A, Nieto Díaz A. Simple descriptors and simple rules of the International Ovarian Tumor Analysis (IOTA) Group: a prospective study of combined use for the description of adnexal masses. Eur J Obstet Gynecol Reprod Biol. 2015 Dec;195:7-11. https://doi.org/10.1016/j.ejogrb.2015.07.010CrossRefPubMed Peces Rama A, Llanos Llanos MC, Sánchez Ferrer ML, Alcázar Zambrano JL, Martínez Mendoza A, Nieto Díaz A. Simple descriptors and simple rules of the International Ovarian Tumor Analysis (IOTA) Group: a prospective study of combined use for the description of adnexal masses. Eur J Obstet Gynecol Reprod Biol. 2015 Dec;195:7-11. https://​doi.​org/​10.​1016/​j.​ejogrb.​2015.​07.​010CrossRefPubMed
24.
Zurück zum Zitat Ruiz de Gauna B, Rodriguez D, Olartecoechea B, Aubá M, Jurado M, Gómez Roig MD et al. Diagnostic performance of IOTA simple rules for adnexal masses classification: a comparison between two centers with different ovarian cancer prevalence. Eur J Obstet Gynecol Reprod Biol. 2015 Aug;191:10-4. https://doi.org/10.1016/j.ejogrb.2015.05.024 Ruiz de Gauna B, Rodriguez D, Olartecoechea B, Aubá M, Jurado M, Gómez Roig MD et al. Diagnostic performance of IOTA simple rules for adnexal masses classification: a comparison between two centers with different ovarian cancer prevalence. Eur J Obstet Gynecol Reprod Biol. 2015 Aug;191:10-4. https://​doi.​org/​10.​1016/​j.​ejogrb.​2015.​05.​024
Metadaten
Titel
Improving the performance of IOTA simple rules: sonographic assessment of adnexal masses with resource-effective use of a magnetic resonance scoring (ADNEX MR scoring system)
verfasst von
Patrick Nunes Pereira
Luís Otavio Sarian
Adriana Yoshida
Karla Galvão Araújo
Ana Carolina Baião Silva
Ricardo Hoelz de Oliveira Barros
Rodrigo Menezes Jales
Sophie Derchain
Publikationsdatum
03.09.2019
Verlag
Springer US
Erschienen in
Abdominal Radiology / Ausgabe 10/2020
Print ISSN: 2366-004X
Elektronische ISSN: 2366-0058
DOI
https://doi.org/10.1007/s00261-019-02207-9

Weitere Artikel der Ausgabe 10/2020

Abdominal Radiology 10/2020 Zur Ausgabe

Classics in Abdominal Radiology

“Corn-on-the-cob” sign

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.