Performance of the IOTA ADNEX model in preoperative assessment of suspicious adnexal masses with high-risk of malignancy index in Alexandria University Gynecology Oncology Center: a prospective study

Objective.Despite the advanced surgical techniques in managing ovarian cancer, there is no improvement in its early detection.This study aims to evaluate the performance of the IOTA-ADNEX Model in adnexal masses with high-risk malignancy index in correlation with the gold standard histopathological diagnosis in Egyptian sitting. Materials and Methods.A prospective study included 150 women with ultrasound diagnosis of unilateral or bilateral adnexal mass and had a high-risk malignancy index, for which surgery was planned.Ultrasound was performed using the IOTA-ADNEX model and a total score was given to each patient.All patients had surgical staging, and a definitive histopathological diagnosis was reached.Results.Moderate agreement between the IOTA-ADNEX Model and the histopathological results where the Kappa coefficient = 0.487.The IOTA score cut-off value of 42 had a sensitivity of 83.6% and a specificity of 75%.The performance of the IOTA-ADNEX model showed excellent discrimination between benign ovarian and malignant ovarian stage II-IV and between borderline and stage II-IV with AUC 0.877 and 0.875, respectively.The performance was good effective in distinguishing between benign and malignant stage I with AUC 0.82 and less effective in distinguishing borderline and stage II-IV.However, it showed fair discrimination between benign and borderline and between stage I and stage II-IV with AUC 0.564 and 0.681, respectively.