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Evaluation of the Performance of the IOTA ADNEX Model in Discriminating Adnexal Masses Preoperatively: An
Anupama Bahadur1, Shreya Singhvi1, Rajlaxmi Mundhra1
1Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.
Objectives:
To evaluate the performance of the International Ovarian Tumour Analysis (IOTA) Assessment of Different NEoplasias in the adneXa (ADNEX) model in discriminating adnexal masses preoperatively.
Methods:
This ambispective observational study included 112 women with at least 1 adnexal mass, from January 2016 to April 2023. Cases underwent pelvic ultrasound and CA125 level assessments prior to surgery. The masses were classified into various subcategories by the IOTA ADNEX model and compared with postoperative histopathological reports. Sensitivity, specificity, negative predictive value, positive predictive value, and diagnostic accuracy were calculated for classifying tumours into various histological subtypes.
Results:
Among the 112 women, 66 (58.9%) had benign ovarian tumours, 10 (8.9%) had borderline ovarian tumours, 17 (15.2%) had stage I ovarian cancer, 15 (13.4%) had stage II-IV ovarian cancer, and 4 (3.6%) had ovarian metastasis. The area under the receiver operating characteristic curve was 0.852 (0.772-0.912) for distinguishing between benign and malignant tumours using the IOTA ADNEX model at a 50% cut-off, with a sensitivity of 84.78%, specificity of 84.85%, positive predictive value of 79.6%, and negative predictive value of 88.9%.
Conclusions:
The IOTA ADNEX model is effective in classifying adnexal masses into benign and malignant categories, making it a valuable tool for triaging adnexal masses for further management.
