Ovarian cancer tends to be diagnosed late and currently lacks effective screening tests, unlike breast cancer. Newly published research reports a promising model to aid diagnosis.

An algorithm for the assessment of adnexal masses with ultrasound allows quantification of the risk of malignancy, according to work published in the American Journal of Obstetrics and Gynecology. The method, based on the “Simple Rules” criteria developed by the International Ovarian Tumor Analysis (IOTA) group, identified between 89-99% of patients with ovarian cancer. As ultrasound is widely available, this promises improved diagnosis.

The IOTA group’s study, led by Professor Dirk Timmerman, MD, PhD, of the Department of Obstetrics and Gynecology, University Hospitals Leuven, Belgium, validates this model to predict the risk of malignancy in adnexal masses, and represents the culmination of studies involving approximately 5,000 patients with adnexal masses.

The investigators examined patients prior to surgery with a standardised examination technique and standardised terms and definitions to describe ultrasound findings. The predictions were compared with the histological findings and the risk of malignancy was calculated.

See Also: Robots Raise Adnexal Surgery Costs, Complications

Prof. Timmerman noted that the risk estimates derived from the 5 US features in the Simple Rules perform similarly to the best algorithms previously published. He suggested: "A simple classification based on these risk estimates may form the basis of a clinical management approach. This will hopefully facilitate choosing optimal treatment for all patients presenting with adnexal masses."

Beryl Benacerraf, MD, President of the American Institute of Ultrasound in Medicine (AIUM) and Clinical Professor of Radiology and OB GYN at Brigham and Women's Hospital, Harvard Medical School, Boston, commented in an editorial: “I applaud this group for grappling with the challenging problem of the variability of ultrasound diagnoses of adnexal masses depending on the expertise of acquisition and interpretation, and succeeding in developing a simple, standardized, and scalable solution. By at once leveling and elevating the playing field, application of this method places expert interpretation and improved diagnostic ability within reach of all practitioners."

Source: American Journal of Obstetrics and Gynecology, Elsevier Health Sciences


References:

Timmerman D, Van Calster B,  Testa A et al. (2016) Predicting the risk of malignancy in adnexal masses based on the Simple Rules from the International Ovarian Tumor Analysis (IOTA) group. DOI: http://dx.doi.org/10.1016/j.ajog.2016.01.007.

Benacerraf B Ultrasonic diagnosis of ovarian masses: Can the playing field be leveled and raised at the same time?(2016), DOI: http://dx.doi.org/10.1016/j.ajog.2015.12.045.

Published online in advance of Volume 214, Issue 4 (April 2016) of the American Journal of Obstetrics and Gynecology.



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US, Ovarian cancer, Diagnosis, Algorithm A new method based on US can improve ovarian cancer diagnosis, and can be used in any setting.