The International Ovarian Tumor Analysis (IOTA) group was founded in 1999 by Dirk Timmerman, Lil Valentin and Tom Bourne. Its first aim was to develop standardized terminology. In 2000, IOTA published a consensus statement on terms, definitions and measurements to describe the sonographic features of adnexal masses, which is now widely used. IOTA now covers a multitude of studies examining many aspects of gynecological ultrasonography within a network of contributing centers throughout the world that are coordinated from KU Leuven.
Having agreed on standardized terminology, the principal IOTA investigators from different centers prospectively collected a large cohort of patients with a persistent adnexal mass. Accurate preoperative discrimination between benign and malignant adnexal masses is known to be of pivotal value in clinical practice. Research has focused on the development of predictive models to estimate the risk of malignancy. This database and the close involvement of the civil engineering department at KU Leuven has enabled both previously developed prediction models to be tested and novel prediction models to be developed and externally validated.
IOTA developed the simple rules and mathematical models based on logistic regression (LR 1-2), which are very easy to use in clinical practice to estimate the risk of malignancy. These models were prospectively and externally validated, and proved to have very good performances, close to that of subjective assessment of an expert sonographer. Moreover, these models keep to be performing well by users with different levels of ultrasound experience. Recently, with publication of the ADNEX-model, the first predictive multiclass model was introduced, able to differentiate between four subgroups of malignant tumors.
Currently IOTA is engaged in several new studies. The group is investigating the long-term behavior of expectantly managed adnexal pathology (IOTA phase 5). This will answer important questions about complications and malignant transformation in masses that are left in situ. Studies are being carried out to determine the best second stage test for masses that are difficult to classify by the existing models, for instance by MRI (IOTA-MRI). Other studies focus on the identification of new potential biomarkers (trans-IOTA) to be incorporated in diagnostic models.
Today there are over 50 clinical units contributing to IOTA studies, nearly every continent is represented. The group is multidisciplinary and involves gynecologists, radiologists, oncologists – as well as physicists and biologists. The group believes that good communication between all these disciplines is how ideas can be turned into improvements for patients. 2015 marks new developments for IOTA. Having focused on research, the group is now keen to communicate what it has learnt over the years on the second IOTA congress (Leuven, April 17-18th). The culture of IOTA is to be transparent and open to new collaborators. Interested units should not hesitate to contact us, as we are always interested in new ideas!