 Hello, I'm Dr. Rukthi Popaiway from KM Hospital Monomai. We'll be presenting paper on the topic, Validation of International Ovidian Tumor Analysis Model for Evaluation of Ovidian Legions with ultrasound and ultrapathological correlation under the guidance of Dr. Hemangini Thakraman. The aim of my study is to validate the auto model for evaluation of ovidian legions with ultrasound on colored Doppler and its ultrapathological correlation. In detection, the ovidian cancer is considered the most aggressive gynecological malignancy, constituting the sixth most common cancer occurring worldwide among the women in a developed country. At the time of diagnosis, the majority of the women have an advanced disease oving to its aggressive nature. Despite the surgeon and chemotherapy, the diagnosis of the women is poor, with five years' arrival rate less than 30%. Effective prevention and the early diagnosis have been shown to increase the survival rate up to 80 sites to 90%. The trans-adrenaline sonography can identify the changes in the ovidian sizes, structure, and thereby detect the early ovidian malignancy. The limiting factor in the characterization of the ovidian masses is the lack of standardized protocol in gynecological ultrasound. Hence, the standardized method for pre-operative assessment of the ovidian masses was defined by the AOTA. The International Ovidian Tumor Analysis Group was founded in 1999 by the term Timmerman, Billid Valentine, and the Tom Bourne. AOTA developed various models, the simple rules, mathematical models based on the logistical regression, the ADNECS, the assessment of a different neoplasis and ADNECSA models, the first protective multi-class model. The AOTA simple rule consists of the five ultrasound features of the benign tumor, that is the B features, and five ultrasound features of the malignant tumor, M features. The tumors are classified as the benign if only the B features are found, and the malignant only if the M features are found. If no features are observed, or both are observed, the simple rule cannot be classified as the benign on the malignant. This inconclusive visual can be classified using the subjective assessment by an experienced neurologist, or it can all be classified as the malignant to increase the sensitivity for the ovidian cancer. The ADNECS model was developed on 2005-2006 patients studied between the 1999 and 2007. This model can differentiate between the four subgroups of the malignant tumor, namely benign, borderline, stage one, stage two to four, or the metastatic. The study method, the study designed a single-fantral prospective of the clinical study for diagnostic activities of ovata models with the ultrasound and color Doppler. The population, the patient underwent the preoperative ultrasound for ovidian reason, participating in tertiary care hospital, period 12 months, number of patients 25, which were studied over a period of 12 months. Inflation criteria, the patient aged between the 18 to 90 years, patient crescented with the ADNECS model. For the bilateral ADNECS model, the mask with the most complex ultrasound features was included. If both the masses are similar ultrasound mass, which is the largest mass, or the one with the most accessible was included. Exclusion criteria, diagnosed at the time of examination, or if you look for transfigural ultrasonography, declining participation, patient with a previous bilateral oeparctoma, non-availability of a CA-125 report. The study procedure, the study was transduced over the 12 months after the approval of the IEP. Epidemiological factors, such as the eels, were included. The necessary history on the investigations reports were noted. The relevant laboratory investigations include CA-125 levels, and the post-operative list of pathological reports. The data collection and the ultrason examination were done in the USG department using a Samsung ultrasound machine in a grayscale, and the color Doppler mode using a curvilinear and the transfigural proof. References, the reference standard was the pathological diagnosis of the mass after the surgical infection. Data analysis, the data was collected and compiled using the microscope Excel 2019 and entered into SKS's way version 2, 26.0. And the p-value less than 0.05 was taken as the level of significance. The representative cases, case 1, this is the case of 35-year-old women which present a width at a level mark and CA-125 levels for the 50 international units per mm. The above lesions shows the maximum diameter of the lesion was 91 mm. The lesion is a multi-local with a less than 10 local. There is a presence of a solid compared with the maximum diameter of less than 20 mm and there is no acoustic shadow and no acytos. However, there is a minimal curve. The classification of the baggy, the simple rule, is implicitly as this. There is fast. This person, staged by the next model, is 24.2. The benign lesion cutoff was taken as 29.3,000. And the anthropological diagnosis of this lesion was the benign, that is the menopause study. Case 2, of the 48-year-old women who presented the bilateral adnexil ovarian masses, however, the largest lesion on the right ovary was selected for the study and the CA-125 levels were raised on, was 119 international units per mm. This lesion was showing a maximum diameter of the 94 mm and it was a solid lesion with the acytos and high flow on the Doppler. The classification by the simple rule is the malignant lesion. A risk percentage by the adnex is a 98.8 and the anthropological correlation was the malignant lesion. With the metastatic ovarian carcinoma. Case 3, the 35-year-old women presented with the left ovarian lesion, CA-125 was 1998 international units per mm. This lesion is of the size 83 mm. It is a unilocalare lesion, presence of the solid component with a maximum diameter was the 98.8 mm, no acytos, no flow on the Doppler. The classification by the simple rule is benign. This percentage by the adnex model is 10.3% and the anthropological diagnosis is the benign Case 4, of a 32-year-old woman, CA-125 level was 60. The maximum diameter of the lesion was 65 mm. Multilocalare lesion with a less than 10 locus, no solid component presence of the acoustic shadowing, no acytos, minimal flow on the Doppler. The classification by the simple rule is benign lesion. This percentage by the adnex model was 4.1% and his anthropological diagnosis was the benign that is the Schumauer use. This is by taking into consideration the characteristic lesion. The simple rules of the AUTA were applied. 15 lesions were the classified as the benign. 5% were malignant and the 5% were the instantial lesion. On HP reports the four subjects reported having the malignancy. Among this percentage of the benign lesion was 11.4 and the malignant lesion was 18.4. The unfair data showed the difference in the mean between these two was statistically significant. The ROC is interpreted by the area undercurve. The area undercurve ranges from the 0 to 1 higher the AUT higher the prediction. This percentage using adnex model with the cutoff of continent is 0.98 which is a very good predictor of the malignant lesion. Result by taking into consideration the characteristics of the discussion by applying the simple rules the sensitivity specificity positive predictive and negative predictive values were 100% 95% 80% and 100% respectively. That is the high sensitivity and the negative predictive values are particularly helpful in detecting the malignancy and I separately. Furthermore, the adnex model can separate the stage 2 to 4 ovarian samples on this other tumor. Limitations of the study were the limited sample size, limited availability of C1 and 25 did not take count of interobservant variability. Hence, the ultrasound is an easily available modality with the low cost of probability compared to the CT and MRI. AUT model can be helpful in differentiating specificity good specificity. Simple rules are simple to apply even by the non-expert examiner with the excellent sensitivity and the adnex model covers this percentage of the malignancy with the better specificity. Thank you.