Assessment of different NEoplasias in the adneXa model for differentiation of benign and malignant adnexal masses in Korean women

Abstract

ObjectiveUltrasonographic differential diagnosis of ovarian tumors is important for appropriate management. We conductedstudy to compare the performance of the Assessment of Different NEoplasias in the adneXa (ADNEX) model with asubjective assessment (SA) in differentiating between benign and malignant adnexal masses in Korean women. MethodsA total of 353 patients who underwent adnexal surgery with abnormal pelvic ultrasonographic findings from August2016 to August 2017 were included in study. The presumptive diagnosis of adnexal malignancy was determined byboth SA and the ADNEX model to be >10% calculated risk of malignancy. The area under the curve (AUC) comparisonbetween the SA and ADNEX models was performed using DeLong’s method. Results340 patients with benign tumors and 13 with malignant adnexal tumors among 292 (82.72%) premenopausal and 61(17.28%) postmenopausal women were included. The AUCs of SA and the ADNEX model for discrimination betweenbenign and malignant tumors were 0.79 and 0.92, respectively (P=0.10). The sensitivity and specificity of SA andthe ADNEX model were 83.5% and 97.0%, and 90.0% and 82.0%, respectively. Comparison of the ADNEX modelregarding menopausal status revealed that the predictability was not different. The AUCs of SA and the ADNEXmodel in premenopausal women were 0.74 and 0.89, respectively (P=0.12). The AUCs of SA and the ADNEX model inpostmenopausal women were 0.86 and 0.94, respectively (P=0.60). ConclusionThe ADNEX model offers excellent discrimination between benign and malignant ovarian tumors with similarsensitivity and specificity to SA in both premenopausal and postmenopausal Korean women.