Ultrasound-based IOTA simple rules allow accurate malignancy risk estimation for adnexal masses.

Commentary on : Timmerman D, Van Calster B, Testa A, et al. Predicting the risk of malignancy in adnexal masses based on the simple rules from the international ovarian tumor analysis group. Am J Obstet Gynecol 2016;214:424–37. Adnexal masses are a common clinical problem, with ovarian cancer remaining as the most lethal gynaecological malignancy. Evidence shows that women with ovarian cancer should be primarily treated at specialised centres,1 while women with benign adnexal masses can be treated by general gynaecologists.2 Accurate diagnosis is essential for adequate triage. Currently, the best method for discriminating benign from malignant adnexal masses is ultrasound assessment by an expert examiner.3 The international ovarian tumour analysis (IOTA) group has proposed a simple risk estimation approach based on ultrasound features of the ovarian tumours (five benign and five malignant), the so-called …