Comparison Of International Ovarian Tumour Analysis (IOTA) Adnex Model With Iota Simple Rules And Risk Of Malignancy Index (RMI) For Preoperative Prediction Of Benign And Malignant Adnexal Masses.

Abstract

Background: Accurate preoperative differentiation of benign and malignant adnexal masses is essential for proper clinical management. Traditional diagnostic methods often lack the necessary sensitivity and specificity, leading to unnecessary surgeries or delayed treatments. This study evaluates the diagnostic performance of the IOTA ADNEX model and the Risk of Malignancy Index (RMI) in predicting the nature of adnexal masses, using histopathological findings as the gold standard.

Methodology: A hospital-based prospective observational study was conducted at Mahatma Gandhi Medical College and Hospital from October 2022 to January 2024. Patients aged over 18 years, admitted for elective surgery for adnexal masses, were included. The sample size was 102 participants. Historical, clinical, and ultrasonographic evaluations adhering to the IOTA protocol were performed. RMI scores and IOTA ADNEX model predictions were calculated, with histopathological findings post-surgery serving as the gold standard.

Results: Of the 102 cases, the majority were benign, including Serous Cystadenoma (20.6%) and Simple Cyst (39.2%). Malignant cases were rare, with High Grade Serous Adenocarcinoma present in 1% of cases. The IOTA ADNEX model demonstrated 100% sensitivity, specificity, and predictive values. The RMI showed high sensitivity (95.83%) but low specificity (16.67%). Age and BMI did not significantly differ between benign and malignant groups (p > 0.05).

Conclusion: The IOTA ADNEX model outperforms the RMI in preoperative differentiation of adnexal masses, offering superior accuracy and reliability. Its incorporation into clinical practice could reduce unnecessary surgeries and improve patient outcomes.