Evaluation of International Ovarian Tumor Analysis Group (Iota) Simple Ultrasound Rules to Distinguish Between Benign and Malignant Ovarian Tumors in Tertiary Care Centre

Introduction: Ovary is a totipotential organ by totipotential meaning egg which is released form ovary has potential to fuse with sperm and can construct a complete, viable organism. Cells produced by first divisions of fertilised egg are also totipotent. with a propensity for developing cysts or masses. An adnexal mass (mass of ovary, fallopian tube, or surrounding connective tissues) is a common gynaecological problem. Adnexal masses present a diagnostic dilemma; the differential diagnosis is extensive, and most masses are benign. Ultrasound is typically the first-line imaging tool, and several ultrasound- based scoring system exists for assessing the risk of an ovarian tumor to be malignant. The IOTA group published ultrasound simple rules to distinguish adnexal mass into benign malignant or intermediate.To assess diagnostic performance of International OvarianTumor Analysis (IOTA) simple ultrasound rules to distinguish ovarian masses and benign or malignant, and to correlate ultrasound findings with histopathology report. Material and Methods: This is a prospective based study was conducted in Obstetrics and gynaecology department of tertiary care hospital. Total 75 patients were evaluated, who fulfilled all inclusion criteria.On these patients transvaginal ultrasonography was performed. IOTA simple rules check list filled and at the end mass was classified as benign if one or more B features were present in the absence of M features. Mass was classified as malignant if one or more M features were present in the absence of B features. If both B and M rules were applied or none were present, the mass was classified inconclusive. And after surgery histopathological co-relation was done. Results: Out of 75 patients evaluated with ultrasonographically with IOTA simple rules 52 were benign, 14 were malignant, and 9 were found inconclusive.Out of total 75 patients studied on IOTA findings 52 patient's a d benign mass of only 51 were confirmed Histopathologically. And 1 mass was found to be malignant on histopathologically which prior on USG IOTA showed B features.Out of 14 malignant patients diagnosed from IOTA, 8 patients had benign mass which was found on histopathology report and 6 were confirmed malignant histopathologically. Sensitivity for detection of malignancy in cases where IOTA simple ultrasound rules were applicable was 85.71%, and specificity is 86.44% Conclusion: Our study shows that the IOTA simple ultrasound rules are able to differentiate more accurately between benign, borderline and malignant ovarian tumors. Therefore, it improves the decisions of patient triage and management.