Performance of IOTA Simple Rules Risks, ADNEX Model, Subjective Assessment Compared to CA125 and HE4 with ROMA Algorithm in Discriminating between Benign, Borderline and Stage I Malignant Adnexal Lesions.

The lowest values of index tests, the ROMA and SRR, were found in women with benign masses, with the differences between this group and both borderline and early stage malignancies being highly significant ( p < 0.001).

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In a study by van Gorp et al., a clear trend could be seen from stage I to stage IV disease, where CA125 and HE4 performed significantly poorer when patients with early and late stages of diseases were compared [ 34 ].

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