Ovarian Masses-Applicable IOTA ADNEX Model versus Morphological Findings for Accurate Diagnosis and Treatment  
[PERSON]  
1 Department of Mother and Child, \"[PERSON]\" University of Medicine and Pharmacy, 700115 Iasi, Romania; [EMAIL_ADDRESS] (T.B. ); [EMAIL_ADDRESS] (D.S. ); [EMAIL_ADDRESS] (A.U. ); [EMAIL_ADDRESS] (ID.) [PERSON]  
1 Department of Obstetrics and Gynecology, \"[PERSON]\" Matemity Hospital, 700398 Iasi, Romania; [EMAIL_ADDRESS] (D.)  
[PERSON]  
1 Department of Obstetrics and Gynecology, Hospital \"Cuza-Voda\", 700398 Iasi, Romania; [EMAIL_ADDRESS] (I.V. ); [EMAIL_ADDRESS] (D.R)  
[PERSON]  
1 Department of Mother and Child, \"[PERSON]\" University of Medicine and Pharmacy, 700115 Iasi, Romania; [EMAIL_ADDRESS] (T.B. ); [EMAIL_ADDRESS] (D.S. ); [EMAIL_ADDRESS] (A.U. ); [EMAIL_ADDRESS] (ID.) [PERSON]  
2 Department of Obstetrics and Gynecology, \"[PERSON]\" Matemity Hospital, 700398 Iasi, Romania; [EMAIL_ADDRESS] (D.)  
[PERSON]  
1 Department of Mother and Child, \"[PERSON]\" University of Medicine and Pharmacy, 700115 Iasi, Romania; [EMAIL_ADDRESS] (T.B. ); [EMAIL_ADDRESS] (D.S. ); [EMAIL_ADDRESS] (A.U. ); [EMAIL_ADDRESS] (ID.) [PERSON]  
3 Department of Obstetrics and Gynecology, \"[PERSON]\" Matemity Hospital, 700398 Iasi, Romania; [EMAIL_ADDRESS] (D.)  
[PERSON]  
4 Department of Preventive Medicine and Interdisciplinary Medical Informatics and Biostatistics, \"[PERSON]\" University of Medicine and Pharmacy, 700115 Iasi, Romania; [EMAIL_ADDRESS] (T.B. ); [EMAIL_ADDRESS] (D.S. ); [EMAIL_ADDRESS] (A.U. ); [EMAIL_ADDRESS] (ID.) [PERSON]  
5 Department of Morpho-Functional Sciences --Histology, Pathology, \"[PERSON]\" University of Medicine and Pharmacy, 700115 Iasi, Romania; [EMAIL_ADDRESS] (D.S. ); [EMAIL_ADDRESS] (D.  
extremely important to have an accurate diagnosis before the surgical intervention to ensure better patient outcomes. A pelvic ultrasound is the most important method for the diagnosis and characterization of an ovarian mass [2]. For the patients with an ovarian mass, the evaluation protocol requires the determination of the following cancer serum biomarkers: cancer antigen-125 (CA-125), carbohydrate antigen 19-9 (CA19-9), carcinoembryonic antigen (ACE) and human epididymis protein 4 (HE 4) [1]. A combination of these ovarian cancer serum biomarkers frequently used in general practice is ROMA (the Risk of Ovarian Malignancy Algorithm), a risk assessment combination of serum CA 125 and HE 4 [4; 5; 6]. It is important to have an experienced physician in the ultrasound evaluation of ovarian masses to lower the error margin and to make a correct differential diagnosis. It is true that a lot of tumors can be recognized from the beginning as benign (such as endometriosis cyst or teratoma) or malignant (advanced ovarian cancer) [1]. After a consensus conference in ultrasonography regarding the \"investigation into designed reporting of adrenal masses that allows a better communication of findings and suggestions for follow-up\", a team of specialists in gynecology, radiology and pathology established a system of criteria for a more accurate evaluation of ovarian mass [2; 7]. This system is based on recognition patterns suggested by the IOTA (International Ovarian Tumor Analysis) [2; 8]. Established in 2005, the IOTA simple rules can be used without the need to calculate, being very easy to apply and based only on ultrasound ovarian mass findings. This simple system can also be used by inexperienced clinicians. The IOTA ADNEX model, elaborated in 2014, is a more complex analysis of a patient with ovarian mass. It includes three clinical criteria (age, CA 125 serum level, and the type of center: oncological/other types of hospitals) and six ultrasound features (the maximum tumoral diameter in mm, the maximum diameter of the solid component in mm; more than 10 loculus, number of papillary projections, presence/absence of acoustic shadows and ascites) [9; 10]. Transvaginal ultrasonography is the most used investigation method for ovarian tumors [11].