An Observational Study on Evaluation of IOTA Ultrasound Simple Rules to Distinguish Benign and Malignant Ovarian Masses and Histopathological Correlation in a Tertiary Care Hospita

Background: The international ovarian tumor analysis (IOTA) study technique is a specialized method for classifying and identifying adnexal growths. It employs 10 simple ultrasound directions to characterize masses as benign or malignant. Objectives: This study aims to provide pre-operative information to help gynecologists manage ovarian masses, avoiding delays in malignancy treatment and unnecessary surgery for benign lesions. Methods: This was a hospital-based observational study conducted in the radiology department on patients with clinical diagnoses of ovarian masses from August 2020 to March 2022 by prospective randomized sampling method. Patients with suspected ovarian pathology were evaluated using IOTA ultrasound rules and designated benign or malignant. The patients underwent a thorough history and clinical examination. Ultrasound was used to confirm the ovarian origin of the mass and differentiate it as benign or malignant. A transvaginal ultrasound was performed where necessary. Histopathological examination was the gold standard to confirm ultrasound and Doppler findings. Descriptive stats: Frequencies/percentages for categorical data, mean ± SD for normal, median with IQR for non-normal. Uncertainty measured by 95% CI. Results: During the study, 50 women were eligible for the study, and the mean age of the participants was 45.3 years. Of 50 patients who underwent surgery, 38 cases were considered benign based on IOTA USG rules, of which 35 were benign and 3 were malignant histologically. Eight cases were considered malignant based on IOTA USG rules, of which 6 were malignant and 2 were benign. Four cases were considered indeterminate, with two being benign and two being malignant histologically. If inconclusive cases are classified as malignant, the sensitivity and specificity are 75% and 88%, respectively. Conclusions: USG is an easily available imaging tool that can be used as an initial modality in evaluating ovarian masses. IOTA simple ultrasound rules have diagnostic accuracy in distinguishing benign and malignant ovarian masses and help in management.