Two‐Step Strategy for Optimizing the Preoperative Classification of Adnexal Masses in a University Hospital, Using <scp>International Ovarian Tumor Analysis</scp> Models

Villabona, Alba Liliana Esquivel; Rodríguez, Juan Nicolás; Ayala, Nina K.; Buritica, C.; Gómez, Ana-María; Velandia, A.; Rodríguez, N.; Alcázar, Juan Luis

doi:10.1002/jum.15728

Cited by 7 publications

(3 citation statements)

References 23 publications

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“…Two or more papillary projections (n: 21) were found in malignant masses (n: 13) most of them with vascularization (n: 8), and in eight cases of benign lesions, five of them cystoadenofibromas ( Figure 4 ). Cystadenofibromas are sometimes difficult to classify [ 23 , 24 , 31 ] as they can appear most commonly as a unilocular solid cyst with papillary projections [ 32 , 33 , 34 ]. Other authors suggested that the presence of acoustic shadows behind a papillae can distinguish cystadenofibromas from other malignant masses, specially borderline tumors [ 16 , 33 ].…”

Section: Discussionmentioning

confidence: 99%

Ultrasound Features and Ultrasound Scores in the Differentiation between Benign and Malignant Adnexal Masses

Pelayo,

Sancho-Sauco,

Sanchez-Zurdo

et al. 2023

Diagnostics

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Background: Several ultrasound (US) features help ultrasound experts in the classification of benign vs. malignant adnexal masses. US scores serve in this differentiation, but they all have misdiagnoses. The main objective of this study is to evaluate what ultrasound characteristics are associated with malignancy influencing ultrasound scores. Methods: This is a retrospective analysis of ultrasound features of adnexal lesions of women managed surgically. Ultrasound characteristics were analyzed, and masses were classified by subjective assessment of the ultrasonographer (SA) and other ultrasound scores (IOTA Simple Rules Risk Assessment SRRA, ADNEX model, and O-RADS). Results: Of a total of 187 adnexal masses studied, 134 were benign (71.7%) and 53 were malignant (28.3%). SA, IOTA SRRA, ADNEX model with or without CA125 and O-RADS had high levels of sensitivity (93.9%, 81.1%, 94.3%, 88.7%, 98.1%) but lower specificity (80.2%, 82.1%, 82.8%, 77.6%, 73.1%) with similar AUC (0.87, 0.87, 0.92, 0.90, 0.86). Ultrasound features significantly related with malignancy were the presence of irregular contour, absence of acoustic shadowing, vascularized solid areas, ≥1 papillae, vascularized septum, and moderate-severe ascites. Conclusion: IOTA SRRA, ADNEX model, and O-RADS can help in the classification of benign and malignant masses. Certain ultrasound characteristics studied in ultrasound scores are associated with malignancy.

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Section: Discussionmentioning

confidence: 99%

Ultrasound Features and Ultrasound Scores in the Differentiation between Benign and Malignant Adnexal Masses

Pelayo,

Sancho-Sauco,

Sanchez-Zurdo

et al. 2023

Diagnostics

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“…In 2016, IOTA developed the Simple Rules Risk assessment (SRR) based on SR 10 ultrasonic features and center types using logistic regression analysis. Besides, other imaging or ultrasound models have been proposed to address these masses, such as MRI, contrast-enhanced ultrasound (CEUS), the Risk of Malignancy Index (RMI), the Risk of Malignancy Algorithm (ROMA), the Assessment of Different NEoplasias in the adneXa (ADNEX) model [27][28][29][30] . A previous study [31] also exploited a logistic regression model based on SR and CA125 and validated the value.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic added-value of CA125 on O-RADS and Simple Rules in discrimination benign and malignant adnexal masses

Gong

Dong

et al. 2022

Preprint

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Objective: Since the promulgation of the International Ovarian Tumor Analysis (IOTA) Simple Rules (SR) and the American College of Radiology (ACR) Ovarian-Adnexal Reporting and Data System (O-RADS) , many studies have verified their diagnostic performance successively. But the low accuracy of masses of O-RADS 4 and SR inconclusive still perplex sonographers, thus this study aimed to settle this problem by combining Cancer Antigen 125 (CA125) with those masses, and to assess diagnostic added-value of CA125 on O-RADS and SR in discrimination benign and malignant adnexal masses. Methods: Data of women with adnexal masses recruited from a tertiary center between January 2019 and September 2021 were included in this study. All patients underwent transvaginal or transabdominal ultrasound examination as well as had complete ultrasound images and clinical data. Firstly, the masses were classified retrospectively using O-RADS and SR by two less experienced sonographers according to the corresponding criteria. Then, the masses of O-RADS 4 and SR inconclusive were reclassified according to the level of CA125,that is, the combination of O-RADS and SR with CA125. And analyzed the differences in diagnostic efficacy of the above methods for menopause status. Finally, receiver operating characteristic (ROC) curves were plotted to evaluate the diagnostic performance of CA125,O-RADS, SR, CA125 combine with O-RADS, and CA125 combine with SR, and calculate the area under the curve (AUC), sensitivity, specificity. Results: Of the 403 patients (143 premenopausal and 260 postmenopausal), 269 had benign lesions, and 134 had malignant tumors. The AUCs of CA125, O-RADS, SR, O-RADS combined with CA125, SR, SR combined with CA125,and CA125 in the whole study group were 0.842, 0.939, 0.963, 0.884, and 0.944, respectively. The findings showed that the AUCs of O-RADS and SR combined with CA125 were significantly higher than O-RADS and SR alone severally (p <0.05). The accuracy of O-RADS 4 and SR inconclusive masses were only 0.438 and 0.534, however, their accuracy has been improved to 0.829 and 0.814 when combined with CA125. Furthermore, the addition of CA125 into O-RADS and SR significantly increased the AUC to 0.930 (0.930 vs 0.712, p <0.001) and 0.931 (0.931 vs 0.774, p <0.001) separately in women with amenorrhea. Conclusions: CA125 can markedly improve the accuracy of O-RADS 4 and SR inconclusive masses, thereby improving the overall diagnostic efficiency of the O-RADS and SR classification system, especially for menopause women.

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“…ADNEX model can not only distinguish the probability of benign and malignant AMs, but also distinguish between www. journals.viamedica.pl/ginekologia_polska borderline ovarian tumors, stage I ovarian cancer, stage II-IV ovarian cancer, and secondary metastatic ovarian cancers, which includes three clinical features and six ultrasound features [4,[11][12][13]. Ovarian-adnexal Reporting and Data System (O-RADS) [14] and management system published by the American College of Radiological is modeled after IOTA and aims to provide consistent interpretation, reduce or eliminate ambiguity in ultrasound diagnosis, and provide management recommendations for each risk category.…”

Section: Introductionmentioning

confidence: 99%

Evaluating the risk of malignancy in adnexal masses: validation of O-RADS and comparison with ADNEX model, SA, and RMI

Wang

Yang

2023

Ginekol Pol

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Objectives: To evaluate the diagnostic value of Ovarian-adnexal Reporting and Data System (O-RADS), and to compare it with Assessment of Different NEoplasias in the adnexa (ADNEX) model, subjective assessment (SA), and risk of malignancy index (RMI) in differentiating benign and malignant adnexal masses (AMs).Material and methods: Ultrasound characteristics of 445 patients included in the study were retrospectively analyzed and evaluated using diagnostic models. The diagnostic performances of ultrasound diagnostic models were measured by assessing, receiver-operating characteristic curves, sensitivities, positive predictive values, positive likelihood ratios, specificities, negative predictive values, and negative likelihood ratios. Kappa values were used to evaluate inter-reviewer agreement (IRA).Results: Of the 445 AMs, 265 were benign and 180 were malignant. The area under the curve (AUC) of O-RADS (0.941), ADNEX model (0.925), and SA (0.931) were higher than RMI (0.815) (all p < 0.05). The sensitivity of O-RADS (93.3%), ADNEX model (94.4%), and SA (96.1%) were higher than RMI (70.6%) (p > 0.05), and there was no statistical significance among them (p > 0.05). The specificity of O-RADS, ADNEX model, SA, and RMI was 90.2%, 90.6%, 90.2%, and 92.5%, respectively, with no statistical significance (p > 0.05). All four ultrasound diagnostic methods showed better IRA.Conclusions: O-RADS, ADNEX model and SA have better diagnostic value in differentiating benign and malignant AMs than RMI.

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Two‐Step Strategy for Optimizing the Preoperative Classification of Adnexal Masses in a University Hospital, Using International Ovarian Tumor Analysis Models

Cited by 7 publications

References 23 publications

Ultrasound Features and Ultrasound Scores in the Differentiation between Benign and Malignant Adnexal Masses

Ultrasound Features and Ultrasound Scores in the Differentiation between Benign and Malignant Adnexal Masses

Diagnostic added-value of CA125 on O-RADS and Simple Rules in discrimination benign and malignant adnexal masses

Evaluating the risk of malignancy in adnexal masses: validation of O-RADS and comparison with ADNEX model, SA, and RMI

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