Journal of Clinical Gynecology and Obstetrics, ISSN 1927-1271 print, 1927-128X online, Open Access
Article copyright, the authors; Journal compilation copyright, J Clin Gynecol Obstet and Elmer Press Inc
Journal website https://www.jcgo.org

Original Article

Volume 10, Number 3, September 2021, pages 67-72

Diagnostic Performance of International Ovarian Tumor Analysis Logistic Regression Model LR2 for Adnexal Masses Classification at a Tertiary Gynecology Center in Singapore

Figures

Figure 1.
Figure 1. Flowchart of patient numbers.
Figure 2.
Figure 2. Receiver-operating characteristics (ROC) curve, showing the ability of the International Ovarian Tumor Analysis (IOTA) logistic regression model LR2 in predicting the presence of ovarian malignancy in 353 women with an adnexal mass. Area under the curve was 0.84.

Tables

Table 1. Histological Diagnosis of Ovarian Masses Included in the Study (n = 353)
 
Histological diagnosisn (%)
aTwo cases of mesothelial inclusion cyst, one Brenner tumor, one right ovarian leiomyoma, and one adenomatoid tumor of the ovary. bCarcinosarcoma (n = 1), leiomyosarcoma (n = 1), Mullerian adenosarcoma (n = 1).
Benign223 (63.2)
  Mature cystic teratoma56 (15.9)
  Fibroma6 (1.7)
  Endometrioma30 (8.5)
  Cystadenoma (serous, mucinous, seromucinous)74 (21.0)
  Cystadenofibroma (serous, mucinous, seromucinous)15 (4.2)
  Hemorrhagic cyst5 (1.4)
  Simple ovarian cyst2 (0.6)
  Hydrosalpinx1 (0.3)
  Tubo-ovarian abscess5 (1.4)
  Paraovarian/paratubal cyst6 (1.7)
  Functional cyst8 (2.3)
  Fibrothecoma3 (0.8)
  Rare benign tumorsa5 (1.4)
  Peritoneal inclusion cyst3 (0.8)
Borderline29 (8.2)
  Mucinous19 (5.4)
  Serous6 (1.7)
  Seromucinous3 (0.8)
  Endometrioid1 (0.2)
Primary invasive ovarian carcinoma87 (24.6)
  Epithelial carcinoma
    High-grade serous carcinoma19 (5.4)
    Endometrioid carcinoma26 (7.4)
    Clear cell carcinoma18 (5.1)
    Mucinous carcinoma14 (4.0)
    Low-grade serous carcinoma3 (0.8)
  Germ cell tumor4 (1.1)
    Immature teratoma
  Sex cord stromal tumor1 (0.3)
    Adult granulosa cell tumor
  Carcinosarcoma2 (0.6)
Primary uterine carcinomab3 (0.8)
Metastatic11 (3.1)

 

Table 2. Histological Outcomes in Women With a False-Positive Finding Using IOTA Model LR2 (n = 60)
 
Histological diagnosisn (%)
IOTA: International Ovarian Tumor Analysis.
Cystadenofibroma4 (6.7)
Cystadenoma16 (26.7)
Endometrioma7 (11.7)
Fibroma3 (5.0)
Fibrothecoma1 (1.7)
Functional cyst5 (8.3)
Hemorrhagic cyst3 (5.0)
Broad ligament leiomyoma2 (3.3)
Peritoneal inclusion cyst1 (1.7)
Rare benign1 (1.7)
Teratoma16 (26.7)
Tubo-ovarian abscess1 (1.7)

 

Table 3. Comparison of the Results of Diagnostic Performance of IOTA Logistic Regression Model LR2 in Our Study With the Original and Validation IOTA Studies (Temporal and External Validation Studies) [8, 9]
 
StudyAUC (95% CI)Sensitivity (%)Specificity (%)LR+LR-
IOTA: International Ovarian Tumor Analysis; AUC: area under receiver-operating characteristics; CI: confidence interval; LR-: negative likelihood ratio; LR+: positive likelihood ratio.
Current study (n = 353)0.84 (0.80 - 0.89)79.279.43.840.26
Original IOTA study (n = 312) [8]0.9289.073.03.30.15
Temporal validation study (n = 941) [9]0.92 (0.90 - 0.94)89.279.84.40.14
External validation study (n = 997) [9]0.95 (0.93 - 0.96)91.885.66.360.10