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Title: A comparison between an ultrasound based prediction model (LR2) and the Risk of Ovarian Malignancy Algorithm (ROMA) to assess the risk of malignancy in women with an adnexal mass
Authors: Kaijser, Jeroen ×
Van Gorp, Toon
Van Hoorde, Kirsten
Van Holsbeke, Caroline
Sayasneh, Ahmad
Vergote, Ignace
Bourne, Tom
Timmerman, Dirk
Van Calster, Ben #
Issue Date: May-2013
Publisher: Academic Press
Series Title: Gynecologic oncology vol:129 issue:2 pages:377-83
Article number: S0090-8258(13)00028-0
Abstract: OBJECTIVE: The identification of novel biomarkers led to the development of the ROMA algorithm incorporating both HE4 and CA125 to predict malignancy in women with a pelvic mass. An ultrasound based prediction model (LR2) developed by the International Ovarian Tumor Analysis (IOTA) study offers better diagnostic performance than CA125 alone. In this study we compared the diagnostic accuracy between LR2 and ROMA. METHODS: This study included women with a pelvic mass scheduled for surgery and enrolled in a previous prospective diagnostic accuracy study. Experienced ultrasound examiners, general gynecologists and trainees supervised by one of the experts performed the preoperative transvaginal ultrasound examinations. Serum biomarkers were taken prior to surgery. Accuracy of LR2 and ROMA was estimated at completion of this study and did not form part of the decision making process. Final outcome was histology of removed tissues and surgical stage if relevant. RESULTS: In total 360 women were evaluated. 216 women had benign disease and 144 a malignancy. Overall test performance of LR2 (AUC 0.952) with 94% sensitivity and 82% specificity was significantly better than ROMA (AUC 0.893) with 84% sensitivity and 80% specificity. Difference in AUC was 0.059 (95% CI: 0.026-0.091; P-value 0.0004). Similar results were obtained when stratified for menopausal status. CONCLUSION: LR2 shows better diagnostic performance than ROMA for the characterization of a pelvic mass in both pre- and postmenopausal women. These findings suggest that HE4 and CA125 may not play an important role in the diagnosis of ovarian cancer if good quality ultrasonography is available.
URI: 
ISSN: 0090-8258
Publication status: published
KU Leuven publication type: IT
Appears in Collections:Screening, Diagnostics and Biomarkers (-)
Interdepartmental Platform Hospital Care
Gynaecological Oncology
Organ Systems (+)
× corresponding author
# (joint) last author

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