Dang Thi Minh Nguyet, Nguyen Van Thi, Duong Duc Huu, Nguyen Tuan Minh, Duong Thi Tra Giang, Do Tuan Dat, Nguyen Tai Duc
Department of Obstetrics and Gynecology, Hanoi Medical University, 1 Ton That Tung Street, Dong Da District, Hanoi, 100000, Viet Nam.
Department of Quan Su Radiology, K Hospital 43 Quan su Street, Hoan Kiem district, Hanoi, 100000, Viet Nam.
Heliyon. 2024 Jan 7;10(2):e24262. doi: 10.1016/j.heliyon.2024.e24262. eCollection 2024 Jan 30.
A simple and efficient tool for evaluating ovarian tumors in general hospitals where radiologists without experience in gynecological ultrasound is necessary. This study aims to evaluate the diagnostic performance of IOTA simple rules in initial classification of ovarian tumors by non-experienced examiners who have received simple training.
A prospective single-center study was conducted at Hanoi Obstetrics and Gynecology Hospital. Three resident gynecologists trained themselves for two weeks and then received hands-on practice under the supervision of experts for another two weeks. The examiners performed ultrasound on 424 eligible women scheduled for surgery for ovarian tumors and classified the tumors based on IOTA simple rules. The postoperative pathology of ovarian tumors was used as the gold standard.
90.8 % (385/424) of the tumors were benign. Simple rules were applicable in 399/424 (94.1 %) tumors, with a sensitivity of 84.8 % (95 % CI, 70.2-94.3), specificity of 98.9 % (95 % CI, 97.5-99.7), positive predictive value of 87.5 % (95 % CI, 73.3-95.9), and negative predictive value of 98.6 % (95 % CI, 97.1-99.5). The sensitivity of IOTA simple rules was higher in postmenopausal women (91.7 % vs. 81.0 %), while the specificity was higher in premenopausal women (99.4 % vs. 95.8 %). Accuracy was 100 % in all ten pregnant women were assessed using these rules.
In conclusion, in the hands of non-expert examiners who were trained thoroughly, IOTA simple rules are a simple and efficient tool for clinical practice in centers where expert radiologists in gynecology are not always available. The training program is simple and could be applied widely in other clinical centers. Further studies are necessary to evaluate the effectiveness of the IOTA simple rules in assessing ovarian tumors among pregnant women.
在普通医院中，需要一种简单有效的工具来评估卵巢肿瘤，因为这些医院的放射科医生可能没有妇科超声经验。本研究旨在评估国际卵巢肿瘤分析（IOTA）简单规则在接受过简单培训的非经验丰富的检查人员对卵巢肿瘤进行初始分类时的诊断性能。
在河内妇产科医院进行了一项前瞻性单中心研究。三名住院妇科医生自行培训两周，然后在专家监督下进行另外两周的实践操作。检查人员对424名计划接受卵巢肿瘤手术的符合条件的女性进行超声检查，并根据IOTA简单规则对肿瘤进行分类。卵巢肿瘤的术后病理作为金标准。
90.8%（385/424）的肿瘤为良性。简单规则适用于424例肿瘤中的399例（94.1%），敏感性为84.8%（95%CI，70.2 - 94.3），特异性为98.9%（95%CI，97.5 - 99.7），阳性预测值为87.5%（95%CI，73.3 - 95.9），阴性预测值为98.6%（95%CI，97.1 - 99.5）。IOTA简单规则在绝经后女性中的敏感性更高（91.7%对81.0%），而在绝经前女性中特异性更高（99.4%对95.8%）。使用这些规则对所有十名孕妇进行评估时，准确性为100%。
总之，在经过充分培训的非专家检查人员手中，IOTA简单规则是在妇科专家放射科医生不总是可用的中心进行临床实践的简单有效工具。培训计划简单，可在其他临床中心广泛应用。需要进一步研究来评估IOTA简单规则在评估孕妇卵巢肿瘤中的有效性。
