Performance of the IOTA ADNEX Model on Selected Group of Patients with Borderline Ovarian Tumours

Adrius Gaurilcikas; Migle Gedgaudaite; Arvydas Cizauskas; Vaida Atstupenaite; Saulius Paskauskas; Dovile Gaurilcikiene; Tomas Birzietis; Daiva Vaitkiene; Ruta Jolanta Nadisauskiene

doi:10.3390/medicina56120690

Performance of the IOTA ADNEX Model on Selected Group of Patients with Borderline Ovarian Tumours

Medicina (Kaunas). 2020 Dec 11;56(12):690. doi: 10.3390/medicina56120690.

Authors

Adrius Gaurilcikas¹, Migle Gedgaudaite¹, Arvydas Cizauskas², Vaida Atstupenaite³, Saulius Paskauskas¹, Dovile Gaurilcikiene¹, Tomas Birzietis¹, Daiva Vaitkiene¹, Ruta Jolanta Nadisauskiene¹

Affiliations

¹ Department of Obstetrics and Gynaecology, Medical Academy, Lithuanian University of Health Sciences, LT-44307 Kaunas, Lithuania.
² Department of Pathological Anatomy, Medical Academy, Lithuanian University of Health Sciences, LT-44307 Kaunas, Lithuania.
³ Department of Radiology, Medical Academy, Lithuanian University of Health Sciences, LT-44307 Kaunas, Lithuania.

Abstract

Background and objectives: ultrasound is considered to be the primary tool for preoperative assessment of ovarian masses; however, the discrimination of borderline ovarian tumours (BOTs) is challenging, and depends highly on the experience of the sonographer. The Assessment of Different NEoplasias in the adneXa (ADNEX) model is considered to be a valuable diagnostic tool for preoperative assessment of ovarian masses; however, its performance for BOTs has not been widely studied, due to the low prevalence of these tumours. The aim of this study was to evaluate the performance of ADNEX model for preoperative diagnosis of BOTs. Methods: retrospective analysis of preoperative ultrasound datasets of patients diagnosed with BOTs on the final histology after performed surgery was done at a tertiary oncogynaecology centre during the period of 2012-2018. Results: 85 patients were included in the study. The performance of ADNEX model based on absolute risk (AR) improved with the selection of a more inclusive cut-off value, varying from 47 (60.3%) correctly classified cases of BOTs, with the selected cut-off of 20%, up to 67 (85.9%) correctly classified cases of BOTs with the cut-off value of 3%. When relative risk (RR) was used to classify the tumours, 59 (75.6%) cases were identified correctly. Forty (70.2%) cases of serous and 16 (72.7%) cases of mucinous BOTs were identified when AR with a 10% cut-off value was applied, compared to 44 (77.2%) and 15 (68.2%) cases of serous and mucinous BOTs, correctly classified by RR. The addition of Ca125 improved the performance of ADNEX model for all BOTs in general, and for different subtypes of BOTs. However, the differences were insignificant. Conclusions: The International Ovarian Tumour Analysis (IOTA) ADNEX model performs well in discriminating BOTs from other ovarian tumours irrespective of the subtype. The calculation based on RR or AR with the cut-off value of at least 10% should be used when evaluating for BOTs.

Keywords: ADNEX; borderline ovarian tumours; preoperative assessment; transvaginal ultrasound; ultrasound.

MeSH terms

Female
Humans
Models, Theoretical
Ovarian Neoplasms* / diagnostic imaging
Ovarian Neoplasms* / surgery
Retrospective Studies
Ultrasonography