title: Comparison of Effectiveness in Differentiating Benign from Malignant Ovarian Masses between IOTA Simple Rules and Subjective Sonographic Assessment.
abstract: BACKGROUND
  To compare diagnostic performance in differentiating benign from malignant ovarian masses between IOTA (the International Ovarian Tumor Analysis) simple rules and subjective sonographic assessment.
  
  
  METHODS
  Women scheduled for elective surgery because of ovarian masses were recruited into the study and underwent ultrasound examination within 24 hours of surgery to apply the IOTA simple rules by general gynecologists and to record video clips for subjective assessment by an experienced sonographer. The diagnostic performance of the IOTA rules and subjective assessment for differentiation between benign and malignant masses was compared. The gold standard diagnosis was pathological or operative findings.
  
  
  RESULTS
  A total of 150 ovarian masses were covered, comprising 105 (70%) benign and 45 (30%) malignant. Of them, the IOTA simple rules could be applied in 119 (79.3%) and were inconclusive in 31 (20.7%) whereas subjective assessment could be applied in all cases (100%). The sensitivity and the specificity of the IOTA simple rules and subjective assessment were not significantly different, 82.9% vs 86.7% and 94.0% vs 94.3% respectively. The agreement of the two methods in prediction was high with a Kappa index of 0.835.
  
  
  CONCLUSIONS
  Both techniques had a high diagnostic performance in differentiation between benign and malignant ovarian masses but the IOTA rules had a relatively high rate of inconclusive results. The IOTA rules can be used as an effective screening technique by general gynecologists but when the results are inconclusive they should consult experienced sonographers.
authors: Department of Obstetrics and Gynecology, Chiang Mai University, Thailand E-mail : theera.t@cmu.ac.th.
authors: Theera
authors: T
authors: Tongsong
authors: Dangcheewan
authors: D
authors: Tinnangwattana
authors: Linlada
authors: L
authors: Vichak-Ururote
authors: Paponrad
authors: P
authors: Tontivuthikul
authors: Cholaros
authors: C
authors: Charoenratana
authors: Thitikarn
authors: T
authors: Lerthiranwong
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000175:diagnosis* / Q000473:pathology*; D010053:Ovary / Q000473:pathology*; D012680:Sensitivity and Specificity; D014463:Ultrasonography / Q000379:methods; D055815:Young Adult