Use of ultrasonographic rules and tumour marker HE4 level to predict malignancy of a pelvic mass: abridged secondary publication
KKL Chan, VYK Chai, VYT Cheung, CKM Choi, MMY Chu, MKY Siu, KY Tse, HYS Ngan
Department of Obstetrics and Gynaecology, The University of Hong Kong
1. In Hong Kong women, the International Ovarian Tumor Analysis (IOTA) simple rules are 94% accurate in diagnosing malignancy of a pelvic mass detected on ultrasound when the IOTA results are conclusive.
2. IOTA simple rules are more accurate than other assessment methods such as the Risk of Malignancy Index (RMI) and the Risk of Malignancy Algorithm (ROMA).
3. When results of IOTA simple rules are inconclusive in 25% of patients, addition of ultrasound assessment by an expert results in higher sensitivity than addition of ROMA or RMI, despite similar specificity and accuracy.
4. Our findings suggest that pelvic masses detected on ultrasound should be assessed by the IOTA simple rules first. If results are inconclusive, ultrasound assessment by an expert should be added. If expertise is not available, RMI or ROMA should be added to improve accuracy.