Evaluation of International Ovarian Tumour Analysis Simple Rules and Risk of Malignancy Index to distinguish benign and malignant adnexal masses in the local scenario

Abstract

Purpose: Adnexal masses are a common gynaecological problem. Early diagnosis of the nature of the adnexal mass is imperative in order to guide the patient’s management and improve prognosis. Ultrasound! is an important tool in the diagnosis of adnexal masses. A number of ultrasound scoring systems have been proposed to facilitate the discrimination between benign and malignant adnexal masses. The IOTA Simple Rules are a set of rules which can be used to predict benignity or malignancy. The RMI is a model incorporating ultrasound features, serum level of Ca125 and menopausal status, which may be used as a risk assessment tool. Objectives: To evaluate the efficacy of the IOTA Simple Rules and RMI in discriminating benign and malignant adnexal masses and establish. Their use as a tool in the early diagnosis of adnexal masses in the local clinical scenario. Methodology: A hospital-based prospective, quantitative, analytical, interventional, correlational study was carried out. Women who were diagnosed with an adnexal mass were scanned by an ultrasonographer and the mass was categorised into benign or malignant categories according to the IOTA Simple Rules and RMI. After the women underwent surgery, the predicted diagnosis by ultrasound was correlated with the goldstandard of histopathological diagnosis. The collected data was statistically analysed using the independent samples t-test and chi-square test. Results: Twenty-two women with adnexal masses were recruited for the study. The IOTA Simple Rules were applicable in nineteen adnexal masses. All twenty-two cases were classified by RMI. The sensitivity, specificity, positive predictive value and negative predictive value of the IOTA Simple Rules and RMI were 100%, 100%,100% and 100%, respectively. Conclusion: Both the IOTA Simple Rules and RMI were equally efficient in differentiating benign and malignant adnexal masses preoperatively with satisfactory reproducibility and ease of use.