The comparison of diagnostic accuracy of risk of malignancy index to IOTA simple rules in diagnosing adnexal masses

Suzanna Patricia Mongan; Yosep Sutandar; Bismarck Joel Laihad

doi:10.15562/bmj.v10i2.2591

The comparison of diagnostic accuracy of risk of malignancy index to IOTA simple rules in diagnosing adnexal masses

Suzanna Patricia Mongan ,

Yosep Sutandar ,

Bismarck Joel Laihad ,

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DOI: https://doi.org/10.15562/bmj.v10i2.2591 |
Published: 2021-07-25

Abstract

Introduction: Ovarian cancer is one of the top three deadliest cancer in women and diagnosing this disease still leaves some challenges to overcome. Therefore, this study aimed to compare the diagnostic accuracy of the Risk of Malignancy Index (RMI) to International Ovarian Tumor Analysis (IOTA) simple rules in adnexal masses.

Methods: A retrospective study was conducted involving 29 patients diagnosed with ovarian tumors. RMI and IOTA Simple Rules were determined preoperatively and compared with histopathology examination as the gold standard. The accuracy of both methods was analyzed using SPSS.

Results: The mean age of the patients in this study was 45 years old. The sensitivity and specificity of RMI were 65% and 55,5%, respectively. The sensitivity and specificity of the IOTA SR were 90% and 55,5%, respectively. The values for the AUC for RMI and IOTA SR are 0.342 and 0.728, respectively. The AUC of the IOTA SR was significantly higher than the RMI (P < 0.005).

Conclusions: IOTA SR is a relatively useful diagnostic model in characterizing adnexal masses, while the RMI only performs fairly.

References

IARC. Indonesia GLOBOCAN 2018 [Internet]. Global Cancer Observatory WHO. 2018 [cited 1BC Sep 4]. Available from: https://gco.iarc.fr/today/data/factsheets/populations/360-indonesia-fact-sheets.pdf
RCOG. The management of ovarian cysts in premenopausal women. Green-top Guidel No62.
RCOG. The management of ovarian cysts in postmenopausal women. Green-top Guidel No34.
ACOG. Practice Bulletin No. 174: Evaluation and Management of Adnexal Masses. Obstet Gynecol. 2016 Nov;128(5):e210–26.
Timmerman D, Van Calster B, Testa A, Savelli L, Fischerova D, Froyman W, et al. Predicting the risk of malignancy in adnexal masses based on the Simple Rules from the International Ovarian Tumour Analysis group. Am J Obstet Gynecol. 2016 Apr;214(4):424–37.
Jacobs I, Oram D, Fairbanks J, Turner J, Frost C, Grudzinskas JG. A risk of malignancy index incorporating CA 125, ultrasound and menopausal status for the accurate preoperative diagnosis of ovarian cancer. Br J Obstet Gynaecol. 1990 Oct;97(10):922–9.
Timmerman D, Testa AC, Bourne T, Ameye L, Jurkovic D, Van Holsbeke C, et al. Simple ultrasound-based rules for the diagnosis of ovarian cancer. Ultrasound Obstet Gynecol Off J Int Soc Ultrasound Obstet Gynecol. 2008 Jun;31(6):681–90.
Timmerman D, Valentin L, Verrelst H, Vergote I. Terms , definitions and measurements to describe the sonographic features of adnexal tumours : a consensus opinion from the International Ovarian Tumour Analysis ( IOTA ) group. 2000;500–5.
Sayasneh A, Ekechi C, Ferrara L, Kaijser J, Stalder C, Sur S, et al. The characteristic ultrasound features of specific types of ovarian pathology (review). Int J Oncol. 2015 Feb;46(2):445–58.
Geomini P, Kruitwagen R, Bremer GL, Cnossen J, Mol BWJ. The accuracy of risk scores in predicting ovarian malignancy: a systematic review. Obstet Gynecol. 2009 Feb;113(2 Pt 1):384–94.
Timmerman D, Ameye L, Fischerova D, Epstein E, Melis GB, Guerriero S, et al. Simple ultrasound rules to distinguish between benign and malignant adnexal masses before surgery: prospective validation by IOTA group. BMJ. 2010 Dec;341:c6839.
Sayasneh A, Wynants L, Preisler J, Kaijser J, Johnson S, Stalder C, et al. Multicentre external validation of IOTA prediction models and RMI by operators with varied training. Br J Cancer. 2013 Jun;108(12):2448–54.
Mulder EE, Gelderblom ME, Schoot D, Vergeldt TF, Nijssen DL, Piek JM. External validation of Risk of Malignancy Index compared to IOTA Simple Rules. Acta Radiol. 2020 Jun;284185120933990.
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;20(3):449–62.
Timmerman D, Van Calster B, Jurkovic D, Valentin L, Testa AC, Bernard J-P, et al. Inclusion of CA-125 does not improve mathematical models developed to distinguish between benign and malignant adnexal tumours. J Clin Oncol Off J Am Soc Clin Oncol. 2007 Sep;25(27):4194–200.

[1] IARC. Indonesia GLOBOCAN 2018 [Internet]. Global Cancer Observatory WHO. 2018 [cited 1BC Sep 4]. Available from: https://gco.iarc.fr/today/data/factsheets/populations/360-indonesia-fact-sheets.pdf

[2] RCOG. The management of ovarian cysts in premenopausal women. Green-top Guidel No62.

[3] RCOG. The management of ovarian cysts in postmenopausal women. Green-top Guidel No34.

[4] ACOG. Practice Bulletin No. 174: Evaluation and Management of Adnexal Masses. Obstet Gynecol. 2016 Nov;128(5):e210–26.

[5] Timmerman D, Van Calster B, Testa A, Savelli L, Fischerova D, Froyman W, et al. Predicting the risk of malignancy in adnexal masses based on the Simple Rules from the International Ovarian Tumour Analysis group. Am J Obstet Gynecol. 2016 Apr;214(4):424–37.

[6] Jacobs I, Oram D, Fairbanks J, Turner J, Frost C, Grudzinskas JG. A risk of malignancy index incorporating CA 125, ultrasound and menopausal status for the accurate preoperative diagnosis of ovarian cancer. Br J Obstet Gynaecol. 1990 Oct;97(10):922–9.

[7] Timmerman D, Testa AC, Bourne T, Ameye L, Jurkovic D, Van Holsbeke C, et al. Simple ultrasound-based rules for the diagnosis of ovarian cancer. Ultrasound Obstet Gynecol Off J Int Soc Ultrasound Obstet Gynecol. 2008 Jun;31(6):681–90.

[8] Timmerman D, Valentin L, Verrelst H, Vergote I. Terms , definitions and measurements to describe the sonographic features of adnexal tumours : a consensus opinion from the International Ovarian Tumour Analysis ( IOTA ) group. 2000;500–5.

[9] Sayasneh A, Ekechi C, Ferrara L, Kaijser J, Stalder C, Sur S, et al. The characteristic ultrasound features of specific types of ovarian pathology (review). Int J Oncol. 2015 Feb;46(2):445–58.

[10] Geomini P, Kruitwagen R, Bremer GL, Cnossen J, Mol BWJ. The accuracy of risk scores in predicting ovarian malignancy: a systematic review. Obstet Gynecol. 2009 Feb;113(2 Pt 1):384–94.

[11] Timmerman D, Ameye L, Fischerova D, Epstein E, Melis GB, Guerriero S, et al. Simple ultrasound rules to distinguish between benign and malignant adnexal masses before surgery: prospective validation by IOTA group. BMJ. 2010 Dec;341:c6839.

[12] Sayasneh A, Wynants L, Preisler J, Kaijser J, Johnson S, Stalder C, et al. Multicentre external validation of IOTA prediction models and RMI by operators with varied training. Br J Cancer. 2013 Jun;108(12):2448–54.

[13] Mulder EE, Gelderblom ME, Schoot D, Vergeldt TF, Nijssen DL, Piek JM. External validation of Risk of Malignancy Index compared to IOTA Simple Rules. Acta Radiol. 2020 Jun;284185120933990.

[14] 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;20(3):449–62.

[15] Timmerman D, Van Calster B, Jurkovic D, Valentin L, Testa AC, Bernard J-P, et al. Inclusion of CA-125 does not improve mathematical models developed to distinguish between benign and malignant adnexal tumours. J Clin Oncol Off J Am Soc Clin Oncol. 2007 Sep;25(27):4194–200.

The comparison of diagnostic accuracy of risk of malignancy index to IOTA simple rules in diagnosing adnexal masses

Abstract

References

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