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Strategies to diagnose ovarian cancer: new evidence from phase 3 of the multicentre international IOTA study.

Testa, A ; Kaijser, J ; Wynants, L ; Fischerova, D ; Van Holsbeke, C ; Franchi, D ; Savelli, L ; Epstein, Elisabeth LU ; Czekierdowski, A and Guerriero, S , et al. (2014) In British Journal of Cancer 111(4). p.680-688
Abstract
Background:To compare different ultrasound-based international ovarian tumour analysis (IOTA) strategies and risk of malignancy index (RMI) for ovarian cancer diagnosis using a meta-analysis approach of centre-specific data from IOTA3.Methods:This prospective multicentre diagnostic accuracy study included 2403 patients with 1423 benign and 980 malignant adnexal masses from 2009 until 2012. All patients underwent standardised transvaginal ultrasonography. Test performance of RMI, subjective assessment (SA) of ultrasound findings, two IOTA risk models (LR1 and LR2), and strategies involving combinations of IOTA simple rules (SRs), simple descriptors (SDs) and LR2 with and without SA was estimated using a meta-analysis approach. Reference... (More)
Background:To compare different ultrasound-based international ovarian tumour analysis (IOTA) strategies and risk of malignancy index (RMI) for ovarian cancer diagnosis using a meta-analysis approach of centre-specific data from IOTA3.Methods:This prospective multicentre diagnostic accuracy study included 2403 patients with 1423 benign and 980 malignant adnexal masses from 2009 until 2012. All patients underwent standardised transvaginal ultrasonography. Test performance of RMI, subjective assessment (SA) of ultrasound findings, two IOTA risk models (LR1 and LR2), and strategies involving combinations of IOTA simple rules (SRs), simple descriptors (SDs) and LR2 with and without SA was estimated using a meta-analysis approach. Reference standard was histology after surgery.Results:The areas under the receiver operator characteristic curves of LR1, LR2, SA and RMI were 0.930 (0.917-0.942), 0.918 (0.905-0.930), 0.914 (0.886-0.936) and 0.875 (0.853-0.894). Diagnostic one-step and two-step strategies using LR1, LR2, SR and SD achieved summary estimates for sensitivity 90-96%, specificity 74-79% and diagnostic odds ratio (DOR) 32.8-50.5. Adding SA when IOTA methods yielded equivocal results improved performance (DOR 57.6-75.7). Risk of Malignancy Index had sensitivity 67%, specificity 91% and DOR 17.5.Conclusions:This study shows all IOTA strategies had excellent diagnostic performance in comparison with RMI. The IOTA strategy chosen may be determined by clinical preference.British Journal of Cancer advance online publication 17 June 2014; doi:10.1038/bjc.2014.333 www.bjcancer.com. (Less)
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organization
publishing date
type
Contribution to journal
publication status
published
subject
in
British Journal of Cancer
volume
111
issue
4
pages
680 - 688
publisher
Nature Publishing Group
external identifiers
  • pmid:24937676
  • wos:000341024100008
  • scopus:84906091549
  • pmid:24937676
ISSN
1532-1827
DOI
10.1038/bjc.2014.333
language
English
LU publication?
yes
id
d974669a-c3ae-4a91-a71d-1557c42a093c (old id 4528289)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/24937676?dopt=Abstract
date added to LUP
2016-04-01 10:08:16
date last changed
2022-04-19 22:56:21
@article{d974669a-c3ae-4a91-a71d-1557c42a093c,
  abstract     = {{Background:To compare different ultrasound-based international ovarian tumour analysis (IOTA) strategies and risk of malignancy index (RMI) for ovarian cancer diagnosis using a meta-analysis approach of centre-specific data from IOTA3.Methods:This prospective multicentre diagnostic accuracy study included 2403 patients with 1423 benign and 980 malignant adnexal masses from 2009 until 2012. All patients underwent standardised transvaginal ultrasonography. Test performance of RMI, subjective assessment (SA) of ultrasound findings, two IOTA risk models (LR1 and LR2), and strategies involving combinations of IOTA simple rules (SRs), simple descriptors (SDs) and LR2 with and without SA was estimated using a meta-analysis approach. Reference standard was histology after surgery.Results:The areas under the receiver operator characteristic curves of LR1, LR2, SA and RMI were 0.930 (0.917-0.942), 0.918 (0.905-0.930), 0.914 (0.886-0.936) and 0.875 (0.853-0.894). Diagnostic one-step and two-step strategies using LR1, LR2, SR and SD achieved summary estimates for sensitivity 90-96%, specificity 74-79% and diagnostic odds ratio (DOR) 32.8-50.5. Adding SA when IOTA methods yielded equivocal results improved performance (DOR 57.6-75.7). Risk of Malignancy Index had sensitivity 67%, specificity 91% and DOR 17.5.Conclusions:This study shows all IOTA strategies had excellent diagnostic performance in comparison with RMI. The IOTA strategy chosen may be determined by clinical preference.British Journal of Cancer advance online publication 17 June 2014; doi:10.1038/bjc.2014.333 www.bjcancer.com.}},
  author       = {{Testa, A and Kaijser, J and Wynants, L and Fischerova, D and Van Holsbeke, C and Franchi, D and Savelli, L and Epstein, Elisabeth and Czekierdowski, A and Guerriero, S and Fruscio, R and Leone, F P G and Vergote, I and Bourne, T and Valentin, Lil and Van Calster, B and Timmerman, D}},
  issn         = {{1532-1827}},
  language     = {{eng}},
  number       = {{4}},
  pages        = {{680--688}},
  publisher    = {{Nature Publishing Group}},
  series       = {{British Journal of Cancer}},
  title        = {{Strategies to diagnose ovarian cancer: new evidence from phase 3 of the multicentre international IOTA study.}},
  url          = {{https://lup.lub.lu.se/search/files/1595724/5365035.pdf}},
  doi          = {{10.1038/bjc.2014.333}},
  volume       = {{111}},
  year         = {{2014}},
}