Proposed Model Clarifies Ovarian Risk Assessment By Ultrasound

Dirk Timmerman, MD PhD Department of Development and Regeneration Department of Obstetrics and Gynecology University Hospitals Leuven Leuven, Belgium

Dr. Dirk Timmerman

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Dirk Timmerman, MD PhD

Department of Development and Regeneration
Department of Obstetrics and Gynecology
University Hospitals Leuven
Leuven, Belgium

Medical Research: What is the background for this study? What are the main findings?

Dr. Timmerman: Ovarian cancer is the most aggressive and lethal gynecological malignant neoplasm. The prognosis of ovarian cancer is poor, with only about 40% of patients still alive five years after being diagnosed. The preoperative characterization of an adnexal tumor is fundamental for selecting the optimal management strategy. An accurate differentiation between benign and malignant masses can lead to optimal referral of patients with malignant diseases to gynecological oncology centers for further diagnostics and treatment, which positively influences the prognosis. On the other hand, it may help in safely selecting patients with benign ovarian masses for minimally invasive or fertility sparing surgery, and in some cases maybe even conservative follow-up. The International Ovarian Tumor Analysis (IOTA) study is the largest diagnostic accuracy study of its kind. Transvaginal ultrasound is a cheap and very accessible imaging technique. Using ultrasound features, which are easy to assess by a trained examiner, we proposed a model to define the individual risk of malignancy for each patient presenting with an adnexal tumor. This could considerably impact on the morbidity and mortality associated with adnexal pathology.

Medical Research: What should clinicians and patients take away from your report?

Dr. Timmerman: We developed a simplified classification system, where risk groups are defined depending on the combination of observed ultrasound features. This allows clinicians to obtain the risk range of the patient without any external computers. No additional investment in technology is needed.

Personalized risk estimates can be obtained in a second step calculation, which is a very useful tool for patient counseling and hopefully assisting in choosing the optimal patient specific management strategy. Depending on the local healthcare policy, cut-offs for the individual risk may be defined or risk ranges of the simplified classification model may be used and incorporated into national and international guidelines.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Timmerman: Further research is needed in order to validate this model, to assess its performance in a different population and to test how this model performs in the hands of less experienced examiners. Moreover, newly collected data could be used to update the model. Finally, it could be optimized to be used as a second stage test if screening is introduced for ovarian cancer.


Predicting the risk of malignancy in adnexal masses based on the Simple Rules from the International Ovarian Tumor Analysis (IOTA) group

Timmerman, Dirk et al.

American Journal of Obstetrics & Gynecology , Volume 0 , Issue 0 , January 18, 2016
Dirk Timmerman, MD PhD (2016). Proposed Model Clarifies Ovarian Risk Assessment By Ultrasound 

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