Authors: Cristianne Confessor Castilho Lopes, Izabela de Souza Campos Nogueira, Paula Barros Pereira, Bruno Alves Menezes de Lima, Ana Lang Botticelli, Marlete Scremin, Chaitanya Swaroop Puvvada, Rodayne Khouri Nascimento, Marilda Morais da Costa, Breno dos Reis Fernandes, Daiana Caide Lopes Brandenburg, Fabio Herget Pitanga, Túlio Gamio Dias.Lope
Introduction: Adnexal tumors are an important cause of gynecological care for patients in all age groups. Early diagnosis and treatment are important factors for prognosis, despite this, there is still no guideline for screening ovarian cancer. Pelvic ultrasonography (transvaginal or transabdominal) is a low-cost method of choice for assessing adnexal tumors, with a diagnostic accuracy of 89-92%.
Objectives: This study aims to analyze the ability of ultrasound exams at the Hospital Federal de Ipanema (HFI) to predict malignancy and benignity in the study of adnexal lesions using the IOTA ADNEX method and correlate its findings with histopathological results.
Methods: This is an observational and retrospective study correlating the ultrasound findings and the IOTA ADNEX calculation with the histopathological results of all patients undergoing surgery for adnexal tumor at the HFI from March 2019 to October 2020.
Results: A total of 104 patients undergoing surgery for adnexal tumor from March 2019 to October 2020. From these, 48 patients (46%) had an ultrasound performed at the service with IOTA ADNEX calculation and histopathological result available. Benign cases totaled 39 patients (81.2%) and malignant (18.8%). For the cut-off point of 10%, we had a sensitivity of 100%, specificity of 84%, positive predictive value-PPV of 60%, negative predictive value-NPV of 100% and accuracy of 87%. For the cut-off points of 20% and 30%, we found, respectively, sensitivity 100% and 88%, specificity of 95% and 95%, PPV 99% and 80%, NPV 100% and 97% and accuracy of 95 % and 93%.
Conclusion: The ADNEX model performed well in differentiating between malignant and benign lesions, especially with a 20% cut- off point. However, the cut-off point should be used in conjunction with the individualized clinical assessment of each patient. Further studies are needed to better define the cutoff point and performance of IOTA ADNEX at HFI.
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