usfdУльтразвуковая и функциональная диагностикаUltrasound & Functional Diagnostics1607-07712408-9494RDS-Media Ltd.10.24835/1607-0771-2023-2-34-61usfd-9Research ArticleУльтразвуковая диагностика в акушерстве и гинекологииObstetrics and Gynecology UltrasoundДифференциальная ультразвуковая диагностика доброкачественных и злокачественных опухолей яичников: диагностические модели, алгоритмы, стратификационные системы, консенсусы (1990–2023)Differential ultrasound diagnosis of benign and malignant ovarian tumors: diagnostic models, algorithms, stratification systems, consensuses (1990–2023).https://orcid.org/0000-0001-8295-768XБулановМ. Н.BulanovM. N.

Буланов Михаил Николаевич – доктор мед. наук, заведующий отделением ультразвуковой диагностики; профессор кафедры внутренних болезнейИнститута медицинского образования

600023 Владимир, Судогодское шоссе, д. 41

173003 Великий Новгород, ул. Большая Санкт-Петербургская, д. 41

Mikhail N. Bulanov – Doct. of Sci. (Med.), Head of Ultrasound Diagnostics Department; Professor, Division of Internal Medicine, Institute of Medical Education

21, Sudogodskoye shosse, Vladimir 600023

41, Bolshaya St. Petersburgskaya str., Veliky Novgorod 173003

doctorbulanov@gmail.comhttps://orcid.org/0000-0002-5565-2511ЧекаловаМ. А.ChekalovaM. A.

Чекалова Марина Альбертовна – доктор мед. наук, профессор, профессор кафедры рентгенологии и ультразвуковой диагностики

115682 Москва, Ореховый бульвар, д. 28

Marina A. Chekalova – Doct. of Sci. (Med.), Professor, Professor of the Department of Radiology and Ultrasound Diagnostics of the Institute of Professional Development

28, Orehovy boulevard, Moscow 115682

https://orcid.org/0009-0002-2065-993XМазуркевичМ. В.MazurkevichM. V.

Мазуркевич Маргарита Викторовна – канд. мед. наук, доцент, заведующая отделением ультразвуковойдиагностики

123182 Москва, ул. Пехотная, д. 3

Margarita V. Mazurkevich – Cand. of Sci. (Med.), Associate Professor, Head of the Ultrasound Diagnostics Department

3, Pekhotnaya str., Moscow 123182

https://orcid.org/0000-0002-9017-9432ВетшеваН. Н.VetshevaN. N.

Ветшева Наталья Николаевна – доктор мед. наук, профессор кафедры ультразвуковой диагностики

125993 Москва, ул. Баррикадная, д. 2/1, стр. 1

Natalia N. Vetsheva – Doct. of Sci. (Med.), Professor of the Department of Ultrasound Diagnostics

2/1, bld. 1, Barrikadnaya str., Moscow 125993

ГБУЗ Владимирской области “Областная клиническая больница”; ФГБОУ ВПО “Новгородский государственный университет имени Ярослава Мудрого”Regional Clinical Hospital; Yaroslav-the-Wise Novgorod State UniversityФГБУ “Федеральный научный клинический центр специализированных видов медицинской помощи и медицинских технологий Федерального медико-биологического агентства (ФМБА)” Российской ФедерацииFederal Scientific Clinical Center for Specialized Medical Care and Medical Technologies, Federal Medical-Biological Agency (FMBA of Russia)ГБУЗ города Москвы “Городская клиническая больница № 52 ДЗ города Москвы”City Clinical Hospital No52 of Moscow Healthcare DepartmentФГБОУ ДПО “Российская медицинская академия непрерывного профессионального образования” Минздрава РоссииRussian Medical Academy of Continuous Professional Education of the Ministry of Healthcare of the Russian Federation202322122023023461Copyright © Буланов М.Н., Чекалова М.А., Мазуркевич М.В., Ветшева Н.Н., 20232023Буланов М.Н., Чекалова М.А., Мазуркевич М.В., Ветшева Н.Н.Bulanov M.N., Chekalova M.A., Mazurkevich M.V., Vetsheva N.N.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://usfd.rdsmedia.ru/jour/article/view/9

В обзоре представлены наиболее распространенные диагностические модели, алгоритмы и стратификационные системы, разработанные с целью оптимальной дифференциальной диагностики доброкачественных и злокачественных новообразований яичников с 1990 г. по настоящее время. Описаны 4 варианта индекса риска малигнизации RMI 1–4 с их сравнительными характеристиками. Описана собственная комплексная ультразвуковая шкала балльной оценки опухолей яичников. Представлены алгоритмы комплексного использования эхографии и онкомаркеров (СА-125, HE4, ROMA), в том числе компьютерная система Risk Ovarian Cancer. Описаны все существующие на сегодня диаг ностические модели IOTA: Простые правила IOTA, Простые правила IOTA с количественным расчетом риска малигнизации, Логистический регресси онный анализ IOTA LR1 & LR2, Простые дескрипторы IOTA, IOTA ADNEX. Представлены основные алгоритмы комплексного использования моделей IOTA. Изложены принципы использования диаг ностических стратификационных систем GI-RADS и O-RADS. Приведены клинические примеры использования диагностических моделей. Обзор завершается представлением консенсуса ESGO/ISUOG/ IOTA/ESGE по предоперационной диагностике опухолей яичников.

The review presents the most common diagnostic models, algorithms and stratification systems developed for the purpose of optimal differential diagnosis of benign and malignant ovarian tumors from 1990 to the present. Four variants of the RMI 1–4 malignancy risk index with their comparative characteristics are described. A proprietary comprehensive ultrasound scoring scale for ovarian tumors is described. Algorithms for the integrated use of echography and tumor markers (CA-125, HE4, ROMA), including the Risk Ovarian Cancer computer system, are presented. All existing IOTA diagnostic models are described: Simple IOTA rules, Simple IOTA rules with quantitative calculation of the risk of malignancy, Logistic regression analysis IOTA LR1 & LR2, Easy IOTA descriptors, IOTA ADNEX. The main algorithms for the integrated use of IOTA models are presented. The principles of using the diagnostic stratification systems GI-RADS and O-RADS are outlined. Clinical examples of the use of diagnostic models are given. The review concludes by presenting the ESGO/ISUOG/IOTA/ESGE consensus on the preoperative diagnosis of ovarian tumors.

ультразвуковая диагностикаопухоли яичниковСА-125RMIHE4ROMAIOTA LR1 & LR2IOTA ADNEXGI-RADSO-RADSReferencesJacobs I., Oram D., Fairbanks J., Turner J., Frost C., Grudzinskas J.G. A risk of malignancy index incorporating CA 125, ultrasound and menopausal status for the accurate preoperative diagnosis of ovarian cancer. Br. J. Obstet. Gynaecol. 1990; 97: 922–929. http://doi.org/10.1111/j.1471-0528.1990.tb02448.xJacobs I., Oram D., Fairbanks J., Turner J., Frost C., Grudzinskas J.G. A risk of malignancy index incorporating CA 125, ultrasound and menopausal status for the accurate preoperative diagnosis of ovarian cancer. Br. J. Obstet. Gynaecol. 1990; 97: 922–929. http://doi.org/10.1111/j.1471-0528. 1990.tb02448.xTingulstad S., Hagen B., Skjeldestad F.E., Onsrud M., Kiserud T., Halvorsen T., Nustad K. Evaluation of a risk of malignancy index based on serum CA125, ultrasound findings and menopausal status in the pre-operative diagnosis of pelvic masses. Br. J. Obstet. Gynaecol. 1996; 103 (8): 826–831. http://doi.org/10.1111/j.1471-0528.1996.tb09882.xTingulstad S., Hagen B., Skjeldestad F.E., Onsrud M., Kiserud T., Halvorsen T., Nustad K. Evaluation of a risk of malignancy index based on serum CA125, ultrasound findings and menopausal status in the pre-operative diagnosis of pelvic masses. Br. J. Obstet. Gynaecol. 1996; 103 (8): 826–831. http://doi.org/10.1111/j.1471-0528.1996. tb09882.xTingulstad S., Hagen B., Skjeldestad F.E., Halvorsen T., Nustad K., Onsrud M. The risk-of-malignancy index to evaluate potential ovarian cancers in local hospitals. Obstet. Gynecol. 1999; 93 (3): 448–452.Tingulstad S., Hagen B., Skjeldestad F.E., Halvorsen T., Nustad K., Onsrud M. The risk-ofmalignancy index to evaluate potential ovarian cancers in local hospitals. Obstet. Gynecol. 1999; 93 (3): 448–452.Yamamoto Y., Yamada R., Oguri H., Maeda N., Fukaya T. Comparison of four malignancy risk indices in the preoperative evaluation of patients with pelvic masses. Eur. J. Obstet. Gynecol. Reprod. Biol. 2009; 144 (2): 163–167. http://doi.org/10.1016/j.ejogrb.2009.02.048Yamamoto Y., Yamada R., Oguri H., Maeda N., Fukaya T. Comparison of four malignancy risk indices in the preoperative evaluation of patients with pelvic masses. Eur. J. Obstet. Gynecol. Reprod. Biol. 2009; 144 (2): 163–167. http://doi.org/10.1016/j.ejogrb.2009.02.048Abdalla N., Piórkowski R., Stanirowski P., Cendrowski K., Sawicki W. Can Replacing CA125 with HE4 in Risk of Malignancy Indices 1-4 Improve Diagnostic Performance in the Presurgical Assessment of Adnexal Tumors? Biomed. Res. Int. 2017; 2017: 6712376. http://doi.org/10.1155/2017/6712376Abdalla N., Piórkowski R., Stanirowski P., Cendrowski K., Sawicki W. Can Replacing CA125 with HE4 in Risk of Malignancy Indices 1-4 Improve Diagnostic Performance in the Presurgical Assessment of Adnexal Tumors? Biomed. Res. Int. 2017; 2017: 6712376. http://doi.org/10.1155/2017/6712376Zhang S., Yu S., Hou W., Li X., Ning C., Wu Y., Zhang F., Jiao Y.F., Lee L.T.O., Sun L. Diagnostic extended usefulness of RMI: comparison of four risk of malignancy index in preoperative differentiation of borderline ovarian tumors and benign ovarian tumors. J. Ovarian Res. 2019; 12 (1): 87. http://doi.org/10.1186/s13048-019-0568-3Zhang S., Yu S., Hou W., Li X., Ning C., Wu Y., Zhang F., Jiao Y.F., Lee L.T.O., Sun L. Diagnostic extended usefulness of RMI: comparison of four risk of malignancy index in preoperative differentiation of borderline ovarian tumors and benign ovarian tumors. J. Ovarian Res. 2019; 12 (1): 87. http://doi.org/10.1186/s13048-019-0568-3Ульянова А.В., Пономарева Ю.Н., Манухин И.Б., Капустин В.В. Сравнительная оценка алгоритмов дифференциальной диагностики образований яичников (ROMA, RMI). Ультразвуковая и функциональная диагностика. 2020; 2: 48–59. http://doi.org/10.24835/1607-0771-2020-2-48-59Ulyanova A.V., Ponomareva Yu.N., Manukhin I.B., Kapustin V.V. Comparative assessment of algorithms for differential diagnosis of ovarian formations (ROMA, RMI). Ultrasound and Functional Diagnostics. 2020; 2: 48–59. http://doi.org/10.24835/1607-0771-2020-2-48-59 (In Russian)Ulyanova A.V., Ponomareva Yu.N., Manukhin I.B., Kapustin V.V. Comparative assessment of algorithms for differential diagnosis of ovarian formations (ROMA, RMI). Ultrasound and Functional Diagnostics. 2020; 2: 48–59. http://doi.org/10.24835/1607-0771-2020-2-48-59 (In Russian)Bulanov M.N. The value of transvaginal color Dopplerography in combination with pulsed Doppler for the differential diagnosis of benign and malignant ovarian tumors: Dis. ... Candidate of Medical Sciences. Moscow, 1999. 165 p. (In Russian)Буланов М.Н. Значение трансвагинальной цветовой допплерографии в сочетании с импульсной допплерометрией для дифференциальной диагностики доброкачественных и злокачественных новообразований яичников. Диссертация на соискание ученой степени канд. мед. наук. Москва. 1999. 165 c.Borisova E.A. Complex differential diagnosis of tumors of the uterine appendages: Dis. ... of Candidate of Medical Sciences. Irkutsk, 2018. 156 p. (In Russian)Bulanov M.N. The value of transvaginal color Dopplerography in combination with pulsed Doppler for the differential diagnosis of benign and malignant ovarian tumors. Dissertation for the scientific degree of Candidate of Medical Sciences. Moscow, 1999. 165 p. (In Russian)Borisova E.A., Bulanov M.N., Makarenko T.A., Kirichenko O.N. New algorithm for differential diagnosis of benign and malignant ovarian tumors, printed. Ultrasound and Functional Diagnostics. 2015; 4 (Supplement. Abstracts of the II Congress of the Russian Association of Ultrasound Diagnostics in Medicine (November 10–13, 2015, Moscow)): 28. (In Russian)Борисова Е. А. Комплексная дифференциальная диагностика опухолей придатков матки. Диссертация на соискание ученой степени кандидата медицинских наук. Иркутск. 2018. 156 с.Borisova E.A., Bulanov M.N., Pashov A.I., Makarenko T.A., Narkevich A.N. Possibilities of integrated use of echography and tumor markers (CA-125, HE4, ROMA) for differential diagnosis of ovarian tumors printed. Ultrasound and Functional Diagnostics. 2015; 6: 56–65. (In Russian)Borisova E. A. Complex differential diagnosis of tumors of the uterine appendages. Dissertation for the scientific degree of Candidate of Medical Sciences. Irkutsk, 2018. 156 p. (In Russian)Timmerman D., Valentin L., Bourne T.H., Collins W.P., Verrelst H., Vergote I. International Ovarian Tumor Analysis (IOTA) Group. Terms, definitions and measurements to describe the sonographic features of adnexal tumors: a consensus opinion from the International Ovarian Tumor Analysis (IOTA) Group. Ultrasound Obstet. Gynecol. 2000; 16 (5): 500–505. http://doi.org/10.1046/j.1469-0705.2000.00287.xБорисова Е.А., Буланов М.Н., Макаренко Т.А., Кириченко О.Н. Новый алгоритм дифференциальной диагностики доброкачественных и злокачественных опухолей яичников печатная. Ультразвуковая и функциональная диагностика. 2015; 4 (Приложение. Тезисы II Съезда Российской ассоциации специалистов ультразвуковой диагностики в медицине (10–13 ноября 2015 года, г. Москва)): 28.Timmerman D., Testa A.C., Bourne T., Ameye L., Jurkovic D., Van Holsbeke C., Paladini D., Van Calster B., Vergote I., Van Huffel S., Valentin L. Simple ultrasound-based rules for the diagnosis of ovarian cancer. Ultrasound Obstet. Gynecol. 2008; 31 (6): 681–690. http://doi.org/10.1002/uog.5365Borisova E.A., Bulanov M.N., Makarenko T.A., Kirichenko O.N. New algorithm for differential diagnosis of benign and malignant ovarian tumors, printed. Ultrasound and functional diagnostics. 2015; 4 (Supplement. Abstracts of the II Congress of the Russian Association of Ultrasound Diagnostics in Medicine (November 10–13, 2015, Moscow)): 28. (In Russian)Nunes N., Ambler G., Foo X., Naftalin J., Widschwendter M., Jurkovic D. Use of IOTA simple rules for diagnosis of ovarian cancer: metaanalysis. Ultrasound Obstet. Gynecol. 2014; 44 (5): 503–514. http://doi.org/10.1002/uog.13437Борисова Е.А., Буланов М.Н., Пашов А.И., Макаренко Т.А., Наркевич А.Н. Возможности комплексного использования эхографии и онкомаркеров (СА125, HE4, ROMA) для дифференциальной диагностики опухолей яичников печатная. Ультразвуковая и функциональная диагностика. 2015; 6: 56–65.Meys E., Rutten I., Kruitwagen R., Slangen B., Lambrechts S., Mertens H., Nolting E., Boskamp D., Van Gorp T. Simple Rules, Not So Simple: The Use of International Ovarian Tumor Analysis (IOTA) Terminology and Simple Rules in Inexperienced Hands in a Prospective Multicenter Cohort Study. Ultraschall Med. 2017; 38 (6): 633– 641. http://doi.org/10.1055/s-0043-113819Borisova E.A., Bulanov M.N., Pashov A.I., Makarenko T.A., Narkevich A.N. Possibilities of integrated use of echography and tumor markers (CA125, HE4, ROMA) for differential diagnosis of ovarian tumors printed. Ultrasound and functional diagnostics. 2015; 6: 56–65. (In Russian)Timmerman D., Van Calster B., Testa A., Savelli L., Fischerova D., Froyman W., Wynants L., Van Holsbeke C., Epstein E., Franchi D., Kaijser J., Czekierdowski A., Guerriero S., Fruscio R., Leone F.P.G., Rossi A., Landolfo C., Vergote I., Bourne T., Valentin L. Predicting the risk of malignancy in adnexal masses based on the Simple Rules from the International Ovarian Tumor Analysis group. Am. J. Obstet. Gynecol. 2016; 214 (4): 424– 437. http://doi.org/10.1016/j.ajog.2016.01.007Timmerman D., Valentin L., Bourne T.H., Collins W.P., Verrelst H., Vergote I. International Ovarian Tumor Analysis (IOTA) Group. Terms, definitions and measurements to describe the sonographic features of adnexal tumors: a consensus opinion from the International Ovarian Tumor Analysis (IOTA) Group. Ultrasound Obstet. Gynecol. 2000; 16 (5): 500–505. http://doi.org/10.1046/j.1469-0705.2000.00287. xHidalgo J.J., Ros F., Aubá M., Errasti T., Olartecoechea B., Ruiz-Zambrana Á., Alcázar J.L. Prospective external validation of IOTA three-step strategy for characterizing and classifying adnexal masses and retrospective assessment of alternative two-step strategy using simple-rules risk. Ultrasound Obstet. Gynecol. 2019; 53 (5): 693–700. http://doi.org/10.1002/uog.20163Timmerman D., Testa A.C., Bourne T., Ameye L., Jurkovic D., Van Holsbeke C., Paladini D., Van Calster B., Vergote I., Van Huffel S., Valentin L. Simple ultrasound-based rules for the diagnosis of ovarian cancer. Ultrasound Obstet. Gynecol. 2008; 31 (6): 681–690. http://doi.org/10.1002/uog.5365Timmerman D., Van Calster B., Testa A.C., Guerriero S., Fischerova D., Lissoni A.A., Van Holsbeke C., Fruscio R., Czekierdowski A., Jurkovic D., Savelli L., Vergote I., Bourne T., Van Huffel S., Valentin L. Ovarian cancer prediction in adnexal masses using ultrasound-based logistic regression models: a temporal and external validation study by the IOTA group. Ultrasound Obstet. Gynecol. 2010; 36: 226–234. http://doi.org/10.1002/uog.7636Nunes N., Ambler G., Foo X., Naftalin J., Widschwendter M., Jurkovic D. Use of IOTA simple rules for diagnosis of ovarian cancer: meta-analysis. Ultrasound Obstet. Gynecol. 2014; 44 (5): 503–514. http://doi.org/10.1002/uog.13437Nunes N., Ambler G., Foo X., Widschwendter M., Jurkovic D. Prospective evaluation of IOTA logistic regression models LR1 and LR2 in comparison with subjective pattern recognition for diagnosis of ovarian cancer in an outpatient setting. Ultrasound Obstet. Gynecol. 2018; 51 (6): 829–835. http://doi.org/10.1002/uog.18918Meys E., Rutten I., Kruitwagen R., Slangen B., Lambrechts S., Mertens H., Nolting E., Boskamp D., Van Gorp T. Simple Rules, Not So Simple: The Use of International Ovarian Tumor Analysis (IOTA) Terminology and Simple Rules in Inexperienced Hands in a Prospective Multicenter Cohort Study. Ultraschall Med. 2017; 38 (6): 633–641. http://doi.org/10.1055/s-0043-113819Ameye L., Timmerman D., Valentin L., Paladini D., Zhang J., Van Holsbeke C., Lissoni A.A., Savelli L., Veldman J., Testa A.C., Amant F., Van Huffel S., Bourne T. Clinically oriented three-step strategy for assessment of adnexal pathology. Ultrasound Obstet. Gynecol. 2012; 40 (5): 582–591. http://doi.org/10.1002/uog.11177Timmerman D., Van Calster B., Testa A., Savelli L., Fischerova D., Froyman W., Wynants L., Van Holsbeke C., Epstein E., Franchi D., Kaijser J., Czekierdowski A., Guerriero S., Fruscio R., Leone F.P.G., Rossi A., Landolfo C., Vergote I., Bourne T., Valentin L. Predicting the risk of malignancy in adnexal masses based on the Simple Rules from the International Ovarian Tumor Analysis group. Am. J. Obstet. Gynecol. 2016; 214 (4): 424–437. http://doi.org/10.1016/j.ajog.2016.01.007Van Calster B., Van Hoorde K., Froyman W., Kaijser J., Wynants L., Landolfo C., Anthoulakis C., Vergote I., Bourne T., Timmerman D. Practical guidance for applying the ADNEX model from the IOTA groBenign discriminate between different subtypes of adnexal tumors. Facts. Views Vis. Obgyn. 2015; 7 (1): 32–41. PMID: 25897370Hidalgo J.J., Ros F., Aubá M., Errasti T., Olartecoechea B., Ruiz-Zambrana Á., Alcázar J.L. Prospective external validation of IOTA three-step strategy for characterizing and classifying adnexal masses and retrospective assessment of alternative two-step strategy using simple-rules risk. Ultrasound Obstet. Gynecol. 2019; 53 (5): 693–700. http://doi.org/10.1002/uog.20163Araujo K.G., Jales R.M., Pereira P.N., Yoshida A., de Angelo Andrade L., Sarian L.O., Derchain S. Performance of the IOTA ADNEX model in preoperative discrimination of adnexal masses in a gynecological oncology center. Ultrasound Obstet. Gynecol. 2017; 49 (6): 778–783. http://doi.org/10.1002/uog.15963Timmerman D., Van Calster B., Testa A.C., Guerriero S., Fischerova D., Lissoni A.A., Van Holsbeke C., Fruscio R., Czekierdowski A., Jurkovic D., Savelli L., Vergote I., Bourne T., Van Huffel S., Valentin L. Ovarian cancer prediction in adnexal masses using ultrasound-based logistic regression models: a temporal and external validation study by the IOTA group. Ultrasound Obstet. Gynecol. 2010; 36: 226–234. http://doi.org/10.1002/uog.7636Landolfo C., Valentin L., Franchi D., Van Holsbeke C., Fruscio R., Froyman W., Sladkevicius P., Kaijser J., Ameye L., Bourne T., Savelli L., Coosemans A., Testa A., Timmerman D. Differences in ultrasound features of papillations in unilocular-solid adnexal cysts: a retrospective international multicenter study. Ultrasound Obstet. Gynecol. 2018; 52 (2): 269–278. http://doi.org/10.1002/uog.18951Nunes N., Ambler G., Foo X., Widschwendter M., Jurkovic D. Prospective evaluation of IOTA logistic regression models LR1 and LR2 in comparison with subjective pattern recognition for diagnosis of ovarian cancer in an outpatient setting. Ultrasound. Obstet Gynecol. 2018; 51 (6): 829–835. http://doi.org/10.1002/uog.18918Esquivel Villabona A.L., Rodríguez J.N., Ayala N., Buriticá C., Gómez A.C., Velandia A.M., Rodríguez N., Alcázar J.L. Two-Step Strategy for Optimizing the Preoperative Classification of Adnexal Masses in a University Hospital, Using International Ovarian Tumor Analysis Models: Simple Rules and Assessment of Different NEoplasias in the adneXa Model. J. Ultrasound Med. 2022; 41 (2): 471–482. http://doi.org/10.1002/jum.15728Ameye L., Timmerman D., Valentin L., Paladini D., Zhang J., Van Holsbeke C., Lissoni A.A., Savelli L., Veldman J., Testa A.C., Amant F., Van Huffel S., Bourne T. Clinically oriented three-step strategy for assessment of adnexal pathology. Ultrasound Obstet. Gynecol. 2012; 40 (5): 582–591. http://doi.org/10.1002/uog.11177Amor F., Vaccaro H., Alcázar J.L., León M., Craig J.M., Martinez J. Gynecologic imaging reporting and data system: a new proposal for classifying adnexal masses on the basis of sonographic findings. J. Ultrasound Med. 2009; 28 (3): 285– 291. http://doi.org/10.7863/jum.2009.28.3.285Van Calster B., Van Hoorde K., Froyman W., Kaijser J., Wynants L., Landolfo C., Anthoulakis C., Vergote I., Bourne T., Timmerman D. Practical guidance for applying the ADNEX model from the IOTA groBenign discriminate between different subtypes of adnexal tumors. Facts. Views Vis. Obgyn. 2015; 7 (1): 32–41. PMID: 25897370Liberman L., Menell J.H. Breast imaging reporting and data system (BI-RADS). Radiol. Clin. N. Am. 2002; 40 (3): 409–430, v. http://doi.org/10.1016/s0033-8389(01)00017-3Araujo K.G., Jales R.M., Pereira P.N., Yoshida A., de Angelo Andrade L., Sarian L.O., Derchain S. Performance of the IOTA ADNEX model in preoperative discrimination of adnexal masses in a gynecological oncology center. Ultrasound Obstet. Gynecol. 2017; 49 (6): 778–783. http://doi.org/10.1002/uog.15963Amor F., Alcázar J.L., Vaccaro H., León M., Iturra A. GI-RADS reporting system for ultrasound evaluation of adnexal masses in clinical practice: a prospective multicenter study. Ultrasound Obstet. Gynecol. 2011; 38 (4): 450–455. http://doi.org/10.1002/uog.9012Landolfo C., Valentin L., Franchi D., Van Holsbeke C., Fruscio R., Froyman W., Sladkevicius P., Kaijser J., Ameye L., Bourne T., Savelli L., Coosemans A., Testa A., Timmerman D. Differences in ultrasound features of papillations in unilocular-solid adnexal cysts: a retrospective international multicenter study. Ultrasound Obstet. Gynecol. 2018; 52 (2): 269–278. http://doi.org/10.1002/uog.18951Migda M., Bartosz M., Migda M.S., Kierszk M., Katarzyna G., Maleńczyk M. Diagnostic value of the gynecology imaging reporting and data system (GI-RADS) with the ovarian malignancy marker CA-125 in preoperative adnexal tumor assessment. J. Ovarian Res. 2018; 11 (1): 92. http://doi.org/10.1186/s13048-018-0465-1Esquivel Villabona A.L., Rodríguez J.N., Ayala N., Buriticá C., Gómez A.C., Velandia A.M., Rodríguez N., Alcázar J.L. Two-Step Strategy for Optimizing the Preoperative Classification of Adnexal Masses in a University Hospital, Using International Ovarian Tumor Analysis Models: Simple Rules and Assessment of Different NEoplasias in the adneXa Model. J. Ultrasound Med. 2022; 41 (2): 471–482. http://doi.org/10.1002/jum.15728Andreotti R.F., Timmerman D., Benacerraf B.R., Bennett G.L., Bourne T., Brown D.L., Coleman B.G., Frates M.C., Froyman W., Goldstein S.R., Hamper U.M., Horrow M.M., HernanzSchulman M., Reinhold C., Strachowski L.M., Glanc P. Ovarian-Adnexal Reporting Lexicon for Ultrasound: A White Paper of the ACR OvarianAdnexal Reporting and Data System Committee. J. Am. Coll. Radiol. 2018; 15 (10): 1415–1429. [Published correction appears in J. Am. Coll. Radiol. 2019; 16 (3): 403–406.]Amor F., Vaccaro H., Alcázar J.L., León M., Craig J.M., Martinez J. Gynecologic imaging reporting and data system: a new proposal for classifying adnexal masses on the basis of sonographic findings. J. Ultrasound Med. 2009; 28 (3): 285–291. http://doi.org/10.7863/jum.2009.28.3.285Strachowski L.M., Jha P., Phillips C.H., Blanchette Porter M.M., Froyman W., Glanc P., Guo Y., Patel M.D., Reinhold C., Suh-Burgmann E.J., Timmerman D., Andreotti R.F. O-RADS US v2022: An Update from the American College of Radiology's Ovarian-Adnexal Reporting and Data System US Committee. Radiology. 2023; 308 (3): e230685. http://doi.org/10.1148/radiol.230685Liberman L., Menell J.H. Breast imaging reporting and data system (BI-RADS). Radiol. Clin. North. Am. 2002; 40 (3): 409–430, v. http://doi.org/10.1016/s0033-8389(01)00017-3Andreotti R.F., Timmerman D., Strachowski L.M., Froyman W., Benacerraf B.R., Bennett G.L., Bourne T., Brown D.L., Coleman B.G., Frates M.C., Goldstein S.R., Hamper U.M., Horrow M.M., Hernanz-Schulman M., Reinhold C., Rose S.L., Whitcomb B.P., Wolfman W.L., Glanc P. O-RADS US Risk Stratification and Management System: A Consensus Guideline from the ACR OvarianAdnexal Reporting and Data System Committee. Radiology. 2020; 294 (1): 168–185. http://doi.org/10.1148/radiol.2019191150Amor F., Alcázar J.L., Vaccaro H., León M., Iturra A. GI-RADS reporting system for ultrasound evaluation of adnexal masses in clinical practice: a prospective multicenter study. Ultrasound Obstet. Gynecol. 2011; 38 (4): 450–455. http://doi.org/10.1002/uog.9012Hack K., Gandhi K., Kahn D., Glanc P. External validation O-RADS ultrasound risk stratificationand management system. Ultrasound Obstet. Gynecol. 2021; 58 (Suppl. 1): 1–57.Migda M., Bartosz M., Migda M.S., Kierszk M., Katarzyna G., Maleńczyk M. Diagnostic value of the gynecology imaging reporting and data system (GI-RADS) with the ovarian malignancy marker CA-125 in preoperative adnexal tumor assessment. J. Ovarian Res. 2018; 11 (1): 92. http://doi.org/10.1186/s13048-018-0465-1Rodriguez N., Rodriguez N., Solano D.A., Pitalua N., Huertas B., Esquivel A., Buritica C. An external validation of the O-RADS risk stratification todifferentiate between benign and malignant adnexal masses. Ultrasound Obstet. Gynecol. 2021; 58 (Suppl. 1): 1–57. https://doi.org/10.1002/uog.23787Andreotti R.F., Timmerman D., Benacerraf B.R., Bennett G.L., Bourne T., Brown D.L., Coleman B.G., Frates M.C., Froyman W., Goldstein S.R., Hamper U.M., Horrow M.M., Hernanz-Schulman M., Reinhold C., Strachowski L.M., Glanc P. Ovarian-Adnexal Reporting Lexicon for Ultrasound: A White Paper of the ACR Ovarian-Adnexal Reporting and Data System Committee. J. Am. Coll. Radiol. 2018; 15 (10): 1415–1429. [Published correction appears in J. Am. Coll. Radiol. 2019; 16 (3): 403–406.]Timmerman D., Planchamp F., Bourne T., Landolfo C., du Bois A., Chiva L., Cibula D., Concin N., Fischerova D., Froyman W., Gallardo Madueño G., Lemley B., Loft A., Mereu L., Morice P., Querleu D., Testa A.C., Vergote I., Vandecaveye V., Scambia G., Fotopoulou C. ESGO/ISUOG/IOTA/ESGE Con sensus Statement on pre-operative diagnosis of ovarian tumors. Int. J. Gynecol. Cancer. 2021; 31 (7): 961–982. http://doi.org/10.1136/ijgc-2021-002565Strachowski L.M., Jha P., Phillips C.H., Blanchette Porter M.M., Froyman W., Glanc P., Guo Y., Patel M.D., Reinhold C., Suh-Burgmann E.J., Timmerman D., Andreotti R.F. O-RADS US v2022: An Update from the American College of Radiology's Ovarian-Adnexal Reporting and Data System US Committee. Radiology. 2023; 308 (3): e230685. http://doi.org/10.1148/radiol.230685Strachowski L.M., Jha P., Phillips C.H., Blanchette Porter M.M., Froyman W., Glanc P., Guo Y., Patel M.D., Reinhold C., Suh-Burgmann E.J., Timmerman D., Andreotti R.F. O-RADS US v2022: An Update from the American College of Radiology's Ovarian-Adnexal Reporting and Data System US Committee. Radiology. 2023; 308 (3): e230685. http://doi.org/10.1148/radiol.230685Andreotti R.F., Timmerman D., Strachowski L.M., Froyman W., Benacerraf B.R., Bennett G.L., Bourne T., Brown D.L., Coleman B.G., Frates M.C., Goldstein S.R., Hamper U.M., Horrow M.M., Hernanz-Schulman M., Reinhold C., Rose S.L., Whitcomb B.P., Wolfman W.L., Glanc P. O-RADS US Risk Stratification and Management System: A Consensus Guideline from the ACR Ovarian-Adnexal Reporting and Data System Committee. Radiology. 2020; 294 (1): 168–185. http://doi.org/10.1148/radiol.2019191150Andreotti R.F., Timmerman D., Strachowski L.M., Froyman W., Benacerraf B.R., Bennett G.L., Bourne T., Brown D.L., Coleman B.G., Frates M.C., Goldstein S.R., Hamper U.M., Horrow M.M., Hernanz-Schulman M., Reinhold C., Rose S.L., Whitcomb B.P., Wolfman W.L., Glanc P. O-RADS US Risk Stratification and Management System: A Consensus Guideline from the ACR Ovarian-Adnexal Reporting and Data System Committee. Radiology. 2020; 294 (1): 168–185. http://doi.org/10.1148/radiol.2019191150Hack K., Gandhi K., Kahn D., Glanc P. External validation O-RADS ultrasound risk stratificationand management system. Ultrasound Obstet. Gynecol. 2021; 58 (Suppl. 1): 1–57.Hack K., Gandhi K., Kahn D., Glanc P. External validation O-RADS ultrasound risk stratificationand management system. Ultrasound Obstet. Gynecol. 2021; 58 (Suppl. 1): 1–57.Rodriguez N., Rodr ́ıguez N., Solano D.A., Pitalua N., Huertas B., Esquivel A., Buritica C. An external validation of the O-RADS risk stratification todifferentiate between benign and malignant adnexal masses. Ultrasound Obstet. Gynecol. 2021; 58 (Suppl. 1): 1–57. https://doi.org/10.1002/uog.23787Rodriguez N., Rodr ́ıguez N., Solano D.A., Pitalua N., Huertas B., Esquivel A., Buritica C. An external validation of the O-RADS risk stratification todifferentiate between benign and malignant adnexal masses. Ultrasound Obstet. Gynecol. 2021; 58 (Suppl. 1): 1–57. https://doi.org/10.1002/uog.23787Timmerman D., Planchamp F., Bourne T., Landolfo C., du Bois A., Chiva L., Cibula D., Concin N., Fischerova D., Froyman W., Gallardo Madueño G., Lemley B., Loft A., Mereu L., Morice P., Querleu D., Testa A.C., Vergote I., Vandecaveye V., Scambia G., Fotopoulou C. ESGO/ISUOG/IOTA/ESGE Consensus Statement on pre-operative diagnosis of ovarian tumors. Int. J. Gynecol. Cancer. 2021; 31 (7): 961–982. http://doi.org/10.1136/ijgc-2021-002565Timmerman D., Planchamp F., Bourne T., Landolfo C., du Bois A., Chiva L., Cibula D., Concin N., Fischerova D., Froyman W., Gallardo Madueño G., Lemley B., Loft A., Mereu L., Morice P., Querleu D., Testa A.C., Vergote I., Vandecaveye V., Scambia G., Fotopoulou C. ESGO/ISUOG/IOTA/ESGE Consensus Statement on pre-operative diagnosis of ovarian tumors. Int. J. Gynecol. Cancer. 2021; 31 (7): 961–982. http://doi.org/10.1136/ijgc-2021-002565

The authors declare that there are no conflicts of interest present.