Background: Ovarian cancers are 3rd most common cancers in females in India as of Globocan 2018. Preoperative differentiation between malignant and benign adnexal masses is necessary for choosing appropriate treatment for both. Risk of malignancy index (RMI) is a scoring system based on the combination of sonographic findings, menopausal status, and serum levels of CA 125. “IOTA Simple Rules” are a preoperative USG-based classification system for ovarian tumors, consisting of B-features, M-features.
Objective: To compare the diagnostic accuracy of International Ovarian Tumor Analysis (IOTA) simple rules and risk of malignancy index (RMI) scoring to discriminate between benign and malignant adnexal masses.
Methodology: A retrospective study, those women who fulfill the inclusion criteria were subjected to study. All recruited participants underwent either transabdominal or transvaginal ultrasound examination, or both prior to surgery. Ultrasound features of the adnexal masses used in the IOTA simple rules, RMI scoring, histopathology reports were retrospectively collected from the stored computerized database and the results were analysed.
Results: Of 75 adnexal masses, 70 (93.3%) were pathologically benign, 4 (5.3%) were malignant and 1 (1.3%) was borderline. The sensitivity and specificity of IOTA rules (100% and 97.14%, respectively) were significantly higher than RMI 1 (40% and 94%) respectively.
Conclusion: IOTA simple rules have good sensitivity and specificity when comparing with RMI, for identifying malignant adnexal masses. IOTA can be used in day today practice for assessing an adnexal mass.