INTERNATIONAL OVARIAN TUMOR ANALYSIS (IOTA) SIMPLE RULES FOR CLASSIFYING OVARIAN MASSES AND ITS CORRELATION WITH HISTOPATHOLOGY

Objectives: To determine the use of IOTAsimple rules for preoperative characterization of ovarian masses. To evaluate its accuracy in distinguishing between benign and malignant tumors in comparison with histopathology report. Materials & Methods: Seventy women attending Gynaecology OPD with a palpable pelvic mass were classified in accordance with IOTA (International Ovarian Tumour Analysis) simple rules by ultrasound as benign, malignant or unclassified. The IOTA findings were compared with final histopathology report. Predictive value of IOTA was determined by using appropriate statistical analysis. Results: Out of 70 study subjects, IOTAultrasound simple rules classified 59 (84.2%) masses as benign, 9 (12.9%) as malignant and 2 (2.9%) as unclassified. On correlation of IOTAsimple rules with final histopathology, out of 59 masses labelled as benign by simple rules, 58 were confirmed benign on histopathology and one was borderline tumour. All nine tumours classified as malignant on IOTA were reported as malignant on histopathology. The two unclassified masses were reported as benign on histopathology. For prediction of malignancy, the sensitivity, specificity , positive predictive value (PPV), negative predictive value (NPV) of IOTAsimple rules after exclusion of unclassified masses was 90%, 100%, 100%, 98.3% respectively with an overall accuracy of 98.5% whereas, if unclassified masses were taken as malignant the corresponding figures were 90%, 96.6%, 81.8% and 98.3% with an overall accuracy of 95.7%. Conclusion: IOTA simple rules are accurate with an excellent sensitivity and specificity in characterization of ovarian masses into benign or malignant. Keywords: Ovarian-mass; Benign; Malignant; IOTAsimple rule