Assessment of different NEoplasias in the adneXa model for differentiation of benign and malignant adnexal masses in Korean women.

Objective Ultrasonographic differential diagnosis of ovarian tumors is important for appropriate management, including diagnostic work-ups and surgical plans. We conducted this study to compare the performance of the Assessment of Different NEoplasias in the adneXa (ADNEX) model with a subjective assessment (SA) in differentiating between benign and malignant adnexal masses in Korean women. Methods A total of 353 patients who underwent adnexal surgery with abnormal pelvic ultrasonographic findings from August 2016 to August 2017 were included in this study. The presumptive diagnosis of adnexal malignancy was determined by both SA and the ADNEX model to be >10% calculated risk of malignancy. All sonographic images for SA were reviewed by a single gynecologist with more than 16 years of experience in gynecologic ultrasonography. The area under the curve (AUC) comparison between the SA and ADNEX models was performed using DeLong's method. Results Three hundred forty patients with benign tumors and 13 with malignant adnexal tumors among 292 (82.72%) premenopausal and 61 (17.28%) postmenopausal women were included. The AUCs of SA and the ADNEX model for discrimination between benign and malignant tumors were 0.79 and 0.92, respectively (P=0.10). The sensitivity and specificity of SA and the ADNEX model were 83.5% and 97.0% and 90.0% and 82.0%, respectively. A comparison of the ADNEX model regarding menopausal status revealed that the predictability was not different. The AUCs of SA and the ADNEX model in premenopausal women were 0.74 and 0.89, respectively (P=0.12). The AUCs of SA and the ADNEX model in postmenopausal women were 0.86 and 0.94, respectively (P=0.60). This is the first report on the ADNEX model in Korean women. Conclusion The ADNEX model offered excellent discrimination between benign and malignant ovarian tumors with similar sensitivity and specificity to SA in both premenopausal and postmenopausal Korean women.