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IOTA-ADNEX模型在鉴别附件包块特征方面的验证:与主观评估的比较

Validation of IOTA-ADNEX Model in Discriminating Characteristics of Adnexal Masses: A Comparison with Subjective Assessment.

作者信息

Jeong Soo Young, Park Byung Kwan, Lee Yoo Young, Kim Tae-Joong

机构信息

Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea.

Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea.

出版信息

J Clin Med. 2020 Jun 26;9(6):2010. doi: 10.3390/jcm9062010.

Abstract

(1) Background: The aim of this study is to compare the IOTA-ADNEX (international ovarian tumor analysis-assessment of different neoplasias in the adnexa) model with gynecologic experts in differentiating ovarian diseases. (2) Methods: All participants in this prospective study underwent ultrasonography (US) equipped with the IOTA-ADNEX model and subjective assessment by a sonographic expert. Receiver operating characteristic (ROC) curves were also generated to compare overall accuracies. The optimal cut-off value of the ADNEX model for excluding benign diseases was calculated. (3) Results: Fifty-nine participants were eligible: 54 and 5 underwent surgery and follow-up computed tomography (CT), respectively. Benign and malignant diseases were confirmed in 49 (83.1%) and 10 (16.9%) participants, respectively. The specificity of the ADNEX model was 0.816 (95% confidence interval (CI): 0.680-0.912) in all participants and 0.795 (95% CI, 0.647-0.902) in the surgical group. The area under the ROC curve of the ADNEX model (0.924) was not significantly different from that of subjective assessment (0.953 in all participants, 0.951 in the surgical group; = 0.391 in all participants, = 0.407 in the surgical group). The optimal cut-off point using the ADNEX model was 47.3%, with a specificity of 0.977 (95% CI: 0.880-0.999). (4) Conclusions: The IOTA-ADNEX model is equal to gynecologic US experts in excluding benign ovarian tumors. Subsequently, being familiar with this US software may help gynecologic beginners to reduce unnecessary surgery.

摘要

(1) 背景:本研究旨在比较IOTA-ADNEX(国际卵巢肿瘤分析——附件区不同肿瘤的评估)模型与妇科专家在鉴别卵巢疾病方面的能力。(2) 方法:本前瞻性研究的所有参与者均接受了配备IOTA-ADNEX模型的超声检查(US)以及超声专家的主观评估。还生成了受试者工作特征(ROC)曲线以比较总体准确性。计算了ADNEX模型排除良性疾病的最佳截断值。(3) 结果:59名参与者符合条件:分别有54名和5名接受了手术及后续计算机断层扫描(CT)检查。分别在49名(83.1%)和10名(16.9%)参与者中确诊为良性和恶性疾病。ADNEX模型在所有参与者中的特异性为0.816(95%置信区间(CI):0.680 - 0.912),在手术组中为0.795(95%CI,0.647 - 0.902)。ADNEX模型的ROC曲线下面积(0.924)与主观评估的面积(所有参与者中为0.953,手术组中为0.951;所有参与者中P = 0.391,手术组中P = 0.407)无显著差异。使用ADNEX模型的最佳截断点为47.3%,特异性为0.977(95%CI:0.880 - 0.999)。(4) 结论:IOTA-ADNEX模型在排除良性卵巢肿瘤方面与妇科超声专家相当。因此,熟悉该超声软件可能有助于妇科新手减少不必要的手术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f0e4/7356034/9d48bf35fd40/jcm-09-02010-g001.jpg

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