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CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2024; 34(04): 588-595
DOI: 10.1055/s-0044-1779734
Original Article

Comparison of Two-Dimensional IOTA Simple Rules and Three-Dimensional Ultrasonography in Preoperative Assessment of Adnexal Masses

Rishu Goel
1   Department of Obstetrics & Gynaecology, All India Institute of Medical Sciences, New Delhi, India
,
Seema Singhal
1   Department of Obstetrics & Gynaecology, All India Institute of Medical Sciences, New Delhi, India
,
Smita Manchanda 
2   Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India
,
Saroj Rajan
1   Department of Obstetrics & Gynaecology, All India Institute of Medical Sciences, New Delhi, India
,
Jyoti Meena
1   Department of Obstetrics & Gynaecology, All India Institute of Medical Sciences, New Delhi, India
,
Juhi Bharti
1   Department of Obstetrics & Gynaecology, All India Institute of Medical Sciences, New Delhi, India
› Author Affiliations Funding None.
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Abstract

Objective Accurate preoperative characterization of adnexal masses is essential for optimal patient management. Two-dimensional ultrasonography (USG) based “International Ovarian Tumuor Analysis Simple Rules (IOTA-SR)” are used primarily in clinical practice. Three-dimensional (3D) USG is an emerging modality. The authors conducted this study to compare the performance of 3D USG with IOTA-SR for preoperative differentiation of benign and malignant adnexal masses.

Methods This prospective observational study recruited 84 patients with adnexal masses undergoing surgical management. IOTA-SR and 3D USG with power Doppler examination were applied to characterize the masses and correlated with histopathology. Logistic regression analysis defined individual 2D and 3D USG parameters' significance in predicting malignancy. The receiver operating characteristic (ROC) curve was plotted for significant variables, and area under the curves (AUCs) with cut-off values were calculated using the Youden index.

Results Out of the 84 adnexal masses, 41 were benign and 43 were malignant. IOTA-SR were conclusive in 88.1% (74/84) cases, with a sensitivity of 83.78% (95% confidence interval [CI]: 67.99–93.81%) and specificity of 89.19% (95% CI: 74.58–96.97%). The sensitivity and specificity of 3D USG with power Doppler were 84% and 88%, respectively, with an AUC of 0.96 (95% CI: 0.92–0.99). Ten cases were inconclusive by the IOTA-SR, and 3D USG could further correctly differentiate four of these cases.

Conclusion The diagnostic performance of both techniques is comparable. With good diagnostic performance and easy applicability, IOTA-SR remain the standard of care. 3D USG, although a more objective assessment, requires further validation and standardization.

Keywords

benign adnexal mass - International Ovarian Tumour Analysis - IOTA simple rules - malignant adnexal mass - three-dimensional ultrasound - power Doppler


Publication History

Article published online:
17 March 2024

© 2024. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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