外部验证的IOTA两步策略在术前表征卵巢肿块

IF 2.1 4区医学 Q2 OBSTETRICS & GYNECOLOGY

European journal of obstetrics, gynecology, and reproductive biology Pub Date : 2025-04-17 DOI:10.1016/j.ejogrb.2025.113981

Sabrina Einig , Terese Puls , Hubertina Reina , Andreas Schoetzau , Céline Montavon , Annkathrin Butenschön , Viola Heinzelmann-Schwarz , Gwendolin Manegold-Brauer

{"title":"外部验证的IOTA两步策略在术前表征卵巢肿块","authors":"Sabrina Einig , Terese Puls , Hubertina Reina , Andreas Schoetzau , Céline Montavon , Annkathrin Butenschön , Viola Heinzelmann-Schwarz , Gwendolin Manegold-Brauer","doi":"10.1016/j.ejogrb.2025.113981","DOIUrl":null,"url":null,"abstract":"<div><h3>Objectives</h3><div>Preoperative sonographic evaluation of ovarian masses is crucial for improving outcomes. The Risk of Malignancy Index (RMI) has been a standard for malignancy triage, while the International Ovarian Tumor Analysis Group (IOTA) has proposed a two-step strategy to estimate the risk of malignancy and suggest management steps by translating risks to Ovarian Adnexal Reporting Data System (O-RADS) categories. This study compares the accuracy of RMI and the IOTA two-step strategy in predicting malignancy.</div></div><div><h3>Methods</h3><div>We included patients with preoperative ultrasound and pathological reports. RMI and O-RADS scores based on the IOTA two-step strategy were assessed. Performance was evaluated using receiver operating characteristic (ROC) curves and calibration plots.</div></div><div><h3>Results</h3><div>A total of 453 cases were included. Of these, 90 (19.9 %) were malignant, 21 (4.6 %) were borderline tumors (BOT), and 342 (75.5 %) were benign. The area under the ROC curve (AUC) for the IOTA two-step strategy was 0.958 (95 % CI, 0.938–0.978), compared to 0.904 (0.865–0.943) for RMI with a > 200 cut-off. The IOTA two-step strategy had a sensitivity of 96.4 %, specificity of 79.7 %, positive predictive value (PPV) 60.2 %, and negative predictive value (NPV) 98.6 %, while RMI showed sensitivity of 70.4 %, specificity 93.4 %, PPV 79.2 %, and NPV 89.8 %. For predicting BOTs, the IOTA two-step AUC was 0.902, compared to 0.719 for RMI.</div></div><div><h3>Conclusion</h3><div>The IOTA two-step strategy outperforms RMI in the preoperative assessment of adnexal masses, particularly in detecting BOTs. It should be implemented in routine clinical practice.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"310 ","pages":"Article 113981"},"PeriodicalIF":2.1000,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"External validation of the IOTA two-step strategy in the preoperative characterization of ovarian masses\",\"authors\":\"Sabrina Einig , Terese Puls , Hubertina Reina , Andreas Schoetzau , Céline Montavon , Annkathrin Butenschön , Viola Heinzelmann-Schwarz , Gwendolin Manegold-Brauer\",\"doi\":\"10.1016/j.ejogrb.2025.113981\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objectives</h3><div>Preoperative sonographic evaluation of ovarian masses is crucial for improving outcomes. The Risk of Malignancy Index (RMI) has been a standard for malignancy triage, while the International Ovarian Tumor Analysis Group (IOTA) has proposed a two-step strategy to estimate the risk of malignancy and suggest management steps by translating risks to Ovarian Adnexal Reporting Data System (O-RADS) categories. This study compares the accuracy of RMI and the IOTA two-step strategy in predicting malignancy.</div></div><div><h3>Methods</h3><div>We included patients with preoperative ultrasound and pathological reports. RMI and O-RADS scores based on the IOTA two-step strategy were assessed. Performance was evaluated using receiver operating characteristic (ROC) curves and calibration plots.</div></div><div><h3>Results</h3><div>A total of 453 cases were included. Of these, 90 (19.9 %) were malignant, 21 (4.6 %) were borderline tumors (BOT), and 342 (75.5 %) were benign. The area under the ROC curve (AUC) for the IOTA two-step strategy was 0.958 (95 % CI, 0.938–0.978), compared to 0.904 (0.865–0.943) for RMI with a > 200 cut-off. The IOTA two-step strategy had a sensitivity of 96.4 %, specificity of 79.7 %, positive predictive value (PPV) 60.2 %, and negative predictive value (NPV) 98.6 %, while RMI showed sensitivity of 70.4 %, specificity 93.4 %, PPV 79.2 %, and NPV 89.8 %. For predicting BOTs, the IOTA two-step AUC was 0.902, compared to 0.719 for RMI.</div></div><div><h3>Conclusion</h3><div>The IOTA two-step strategy outperforms RMI in the preoperative assessment of adnexal masses, particularly in detecting BOTs. It should be implemented in routine clinical practice.</div></div>\",\"PeriodicalId\":11975,\"journal\":{\"name\":\"European journal of obstetrics, gynecology, and reproductive biology\",\"volume\":\"310 \",\"pages\":\"Article 113981\"},\"PeriodicalIF\":2.1000,\"publicationDate\":\"2025-04-17\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"European journal of obstetrics, gynecology, and reproductive biology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0301211525002507\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"OBSTETRICS & GYNECOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"European journal of obstetrics, gynecology, and reproductive biology","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0301211525002507","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}

引用次数: 0

摘要

目的术前超声评估卵巢肿块对改善预后至关重要。恶性肿瘤风险指数（RMI）一直是恶性肿瘤分类的标准，而国际卵巢肿瘤分析组织（IOTA）提出了一种两步策略来评估恶性肿瘤风险，并通过将风险转化为卵巢附件报告数据系统（O-RADS）类别来建议管理步骤。本研究比较了RMI和IOTA两步预测恶性肿瘤的准确性。方法收集术前超声和病理报告。评估基于IOTA两步策略的RMI和O-RADS评分。采用受试者工作特征（ROC）曲线和标定图对其进行评价。结果共纳入病例453例。其中恶性90例（19.9%），交界性肿瘤21例（4.6%），良性342例（75.5%）。IOTA两步策略的ROC曲线下面积（AUC）为0.958 (95% CI, 0.938-0.978)，而RMI与>；200年截止。IOTA两步策略的敏感性为96.4%，特异性为79.7%，阳性预测值（PPV）为60.2%，阴性预测值（NPV）为98.6%，而RMI的敏感性为70.4%，特异性为93.4%，PPV为79.2%，NPV为89.8%。对于预测bot， IOTA两步AUC为0.902，而RMI为0.719。结论IOTA两步策略在术前评估附件肿块方面优于RMI，特别是在检测bot方面。应在常规临床实践中实施。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

External validation of the IOTA two-step strategy in the preoperative characterization of ovarian masses

Objectives

Preoperative sonographic evaluation of ovarian masses is crucial for improving outcomes. The Risk of Malignancy Index (RMI) has been a standard for malignancy triage, while the International Ovarian Tumor Analysis Group (IOTA) has proposed a two-step strategy to estimate the risk of malignancy and suggest management steps by translating risks to Ovarian Adnexal Reporting Data System (O-RADS) categories. This study compares the accuracy of RMI and the IOTA two-step strategy in predicting malignancy.

Methods

We included patients with preoperative ultrasound and pathological reports. RMI and O-RADS scores based on the IOTA two-step strategy were assessed. Performance was evaluated using receiver operating characteristic (ROC) curves and calibration plots.

Results

A total of 453 cases were included. Of these, 90 (19.9 %) were malignant, 21 (4.6 %) were borderline tumors (BOT), and 342 (75.5 %) were benign. The area under the ROC curve (AUC) for the IOTA two-step strategy was 0.958 (95 % CI, 0.938–0.978), compared to 0.904 (0.865–0.943) for RMI with a > 200 cut-off. The IOTA two-step strategy had a sensitivity of 96.4 %, specificity of 79.7 %, positive predictive value (PPV) 60.2 %, and negative predictive value (NPV) 98.6 %, while RMI showed sensitivity of 70.4 %, specificity 93.4 %, PPV 79.2 %, and NPV 89.8 %. For predicting BOTs, the IOTA two-step AUC was 0.902, compared to 0.719 for RMI.

Conclusion

The IOTA two-step strategy outperforms RMI in the preoperative assessment of adnexal masses, particularly in detecting BOTs. It should be implemented in routine clinical practice.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

European journal of obstetrics, gynecology, and reproductive biology 医学-妇产科学

CiteScore

4.60

自引率

3.80%

发文量

898

审稿时长

8.3 weeks

期刊介绍： The European Journal of Obstetrics & Gynecology and Reproductive Biology is the leading general clinical journal covering the continent. It publishes peer reviewed original research articles, as well as a wide range of news, book reviews, biographical, historical and educational articles and a lively correspondence section. Fields covered include obstetrics, prenatal diagnosis, maternal-fetal medicine, perinatology, general gynecology, gynecologic oncology, uro-gynecology, reproductive medicine, infertility, reproductive endocrinology, sexual medicine and reproductive ethics. The European Journal of Obstetrics & Gynecology and Reproductive Biology provides a forum for scientific and clinical professional communication in obstetrics and gynecology throughout Europe and the world.