Abstract
Transvaginal ultrasonography is the first-line and best imaging technique for characterising adnexal masses preoperatively. The optimal approach is the subjective assessment of ultrasound images by experts.
An alternative evidence-based approach to the pre-surgical diagnosis of adnexal tumours is to use simple ultrasound rules or logistic regression model LR2 developed by the International Ovarian Tumor Analysis (IOTA) group. Their test performance matches subjective assessment by experienced examiners and should be adopted as the principal test to characterize masses as benign or malignant.
Measurements of serum CA 125 are not necessary for characterization of ovarian pathology in premenopausal women and are unlikely to improve the performance of experienced ultrasound examiners, even in the postmenopausal group. However, in postmenopausal patients, serum CA 125 may play a role as a second-stage test, especially in centers with less- -experienced ultrasound examiners.