IOTA classification of ovarian cysts

Question 1

B-Mode (benign) features

Answer 1

• Unilocular cysts

- Presence of solid components where the largest solid component where the largest is

Question 2

M-Mode (malignant) features

Any M - mode needs referral to gynae onc

Answer 2

• Irregular solid tumour
• Ascitis
• At least four papillary structures
• Irregular multilocular solid tumour with largest diameter > 100 mm
• Prominent blood flow on colour Doppler

Question 3

ROMA score for malignancy

Answer 3

• Ca125 + HE4
• Cut off 2.27
• Not recommended

Question 4

OVA 1 score for malignancy

Answer 4

• CA125, transthyretin [prealbumin], apolipoprotein A1, beta-2-microglobulin and transferrin
• Algorithm
• Cut off > 4.4 high risk of malignancy
• Poor specificity compared to RMI