IOTA GUIDELINES AUDIT
Muna Farah, University Hospital Coventry and Warwrickshire
Aim of the study:
To standardise reporting of ovarian pathology amongst sonographers, by implementing the International Ovarian Tumour Analysis (IOTA) guidelines at University Hospital Coventry and Warwickshire (UHCW) Ultrasound department.
Methods:
6-month prospective audit from September 2022 to March 2023. Cases were sent by sonographers and reviewed at the end of each month by a consultant to assess compliance with IOTA rules. Individual feedback was given at the end of each month to the sonographers to increase confidence and consistency of reports. Specific reporting codes were created to identify the ovarian tumour as benign, indeterminate, or malignant. Data collected on Excel worksheet. Any follow up imaging and histology reports were also collected to assess the correlation between US imaging and MRI/tissue diagnosis.
Results:
73 cases were collected over a 6-month period. Gradual improvements were seen in the consistent use of IOTA rules amongst the sonographers during this time.
48 GP referrals and 26 were hospital-based. Out of the 73 cases, 34 patients were classified as having benign lesions, 27 had indeterminate lesions and 12 had malignant appearances.
Regarding follow up of patients, 19 were discharged due to either benign appearances or deemed low risk after seen by Gynaecology. The majority of patients were followed up by imaging alone (n=41) and the remaining had histology and imaging follow up (n=13). This latter group had 2 confirmed malignant histology samples, one of which was identified on imaging as malignant and the other as benign.
Conclusion:
Successful implementation of the IOTA rules at UHCW US department. Any discrepancies between sonographer and consultant were fed back individually, with an overall improvement in consistency of the IOTA rules at the end of the 6-month period. Discrepancies between imaging and histology were investigated further details and cases discussed on an individual basis at Gynaecology MDT and Radiology quality improvement meeting.