Last revised by Henry Knipe on 3 Mar 2023

The ADNEX (Assessment of Different NEoplasias in the adneXa) model is a risk model developed by the IOTA (International Ovarian Tumor Analysis) group to differentiate benign and malignant neoplasms of the ovary and, among them, four different subgroups (borderline, stage I cancer, stage II-IV cancer, and secondary metastatic cancer).

The model uses nine different predictors, three clinical and six ultrasound variables with an online calculator available.

Clinical variable
  • age

  • serum CA-125 level

  • the type of center (oncology centers vs other hospitals)

Ultrasound predictors
  • maximum diameter of the lesion

  • the proportion of solid tissue

  • more than ten cyst locules

  • number of papillary projections

  • acoustic shadows

  • ascites

History and epidemiology 

The ADNEX model was developed in 2014 by the IOTA group. In contrast to existing models (e.g., IOTA ultrasound rules for ovarian masses), which only allowed differential diagnosis between benign and malignant neoplasms of the ovary, this model also assesses the stage of the disease. This is important because a correct characterization of the lesion allows different lesion management.

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