Introduction/Background International Ovarian Tumor Analysis-Adnex Model (IOTA Adnex Model) and Ovarian-Adnexal Reporting and Data System (O-RADS) have been developed for the diagnostic accuracy of adnexal masses in the preoperative period. This study aimed to evaluate O-RADS and IOTA Adnex Model scores of patients who had surgery for an adnexal mass and and interpret the roles of scores in management.

Methodology The study consists patients who had surgery for an adnexal mass in Ankara City Hospital Gynecology and Obstetrics Hospital between 2019–2021 and met the inclusion criterias. Demographic characteristics, ages, parities, menopause statuses, ultrasonographic morphologies of the patients were recorded. IOTA Adnex Model and O-RADS scores calculated based on these data.

Results This study consisted of 413 patients whom 295 benign and 118 malign patients. Mean of CA 125 of the benign patients were 15,2 (2- 3096) unit/ml and mean of CA 125 of the malign patients were 72,5 (5 – 9820) unit/ml. According to the ROC analysis for CA 125 in postmenopausel patients; AUC:0,847 (%95 CI, 0,79–0,9), cut-off: 34,8 unit/ml, sensitivity:%70,8 and specificity:%83,8. In the premenopausal group; AUC: 0,727 (%95 CI, 0,65–0,80), cut-off:180,5 unit/ml, sensitivity:%32,1 and specificity:%92,7 (p<0,001). Sensitivity and specificity of the IOTA Adnex Model and O-RADS were found%78,8-%48,3 and%97,9–93,5 respectively for the distinction of the malignancy(p<0,001). There is moderate agreement between IOTA Adnex Model and O-RADS(κ = 0,53).

Conclusion IOTA Adnex Model shows similar specificity but better sensitivity than O-RADS for the distinction of the malignancy. In case of increasing sensitivity without decreasing specificity and clarifing the ultrasonographic features for the physicians who will apply the model, IOTA Adnex Model can be used widely as a ultrasonography-based risk stratification model in adnexal masses.