Diagnostic Performance of International Ovarian Tumor Analysis-Simple Rules versus Risk Malignancy Index 2 scoring system to differentiate between Benign and Malignant Adnexal Masses
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Abstract
Objective: To compare International ovarian tumor Analysis -Simple rules (IOTA-SR) versus Risk of malignancy index 2 (RMI 2) scoring system to differentiate benign and malignant adnexal mass.
Materials and Methods: A prospective cohort study was conducted at Gynecology department of GCS (Gujarat Cancer Society) Medical College and Research center, Ahmedabad, Gujarat, India. One hundred and twenty-four patients from period of June 2018 to Dec 2020 with persistent adnexal tumors with informed consent underwent transvaginal and transabdominal gray-scale and Doppler ultrasound examination using a standardized examination technique and standardized terms and definitions.
Results: Diagnostic accuracy of IOTA SR and RMI 2 scoring was assessed by sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV). In our study, IOTA SR had a sensitivity, specificity, PPV and NPV of 92.30%, 93.87%, 80% and 97.87%, respectively. On the other hand, RMI 2 scoring had a sensitivity, specificity, PPV and NPV of 62.50%, 91.30%, 71.42% and 87.50%, respectively. IOTA had better diagnostic performance than RMI 2 (chi square test 83.33 vs 39.31).
Conclusion: A management protocol based on triaging women using the IOTA SR performed significantly better than the RMI 2 -based protocol. IOTA SR was very easy to be done by gynecologist and could be used in practice to differentiate between benign and malignant adnexal masses ensuring timely and proper referral to gynecologic oncologists in developing country like India with burden of patients and limited resources.
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