External Validation of O-RADS US Risk Stratification and Management System

被引：56

作者：

Hack, Kalesha ^{[1
]}

Gandhi, Niket ^{[2
]}

Bouchard-Fortier, Genevieve ^{[3
,4
]}

Chawla, Tanya P. ^{[5
]}

Ferguson, Sarah E. ^{[4
,6
]}

Li, Siying ^{[7
,8
]}

Kahn, Daniel ^{[9
]}

Tyrrell, Pascal N. ^{[7
,8
,10
]}

Glanc, Phyllis ^{[11
]}

机构：

[1] Univ Toronto, Sunnybrook Hlth Sci Ctr, Dept Med Imaging, 2075 Bayview Ave,MG-130c, Toronto, ON M4N 3M5, Canada

[2] Peterborough Reg Hlth Ctr, Dept Med Imaging, Peterborough, ON, Canada

[3] Univ Toronto, Princess Margaret Canc Ctr, Dept Obstet & Gynecol, Div Gynecol Oncol,Univ Hlth Network, Toronto, ON, Canada

[4] Sinai Hlth Syst, Toronto, ON, Canada

[5] Univ Toronto, Dept Med Imaging, Joint Dept Med Imaging, Div Abdominal Imaging, Toronto, ON, Canada

[6] Univ Toronto, Univ Hlth Network, Div Gynecol Oncol, Ontario Hlth Canc Care Ontario,Dept Obstet & Gyne, Toronto, ON, Canada

[7] Univ Toronto, Dept Med Imaging, Toronto, ON, Canada

[8] Univ Toronto, Dept Stat Sci, Toronto, ON, Canada

[9] Wilfrid Laurier Univ, Dept Business Adm, Waterloo, ON, Canada

[10] Univ Toronto, Inst Med Sci, Toronto, ON, Canada

[11] Univ Toronto, Sunnybrook Hlth Sci Ctr, Sunnybrook Res Inst, Dept Med Imaging,Body Div,Dept Obstet & Gynecol, Toronto, ON, Canada

来源：

RADIOLOGY | 2022年 / 304卷 / 01期

关键词：

OVARIAN-CANCER; MULTICENTER; MALIGNANCY;

D O I：

10.1148/radiol.211868

中图分类号：

R8 [特种医学]; R445 [影像诊断学];

学科分类号：

1002 ; 100207 ; 1009 ;

摘要：

Background: The Ovarian-Adnexal Reporting and Data System (O-RADS) US risk stratification and management system (O-RADS US) was designed to improve risk assessment and management of ovarian and adnexal lesions. Validation studies including both surgical and nonsurgical treatment as the reference standard remain lacking. Purpose: To externally validate O-RADS US in women who underwent either surgical or nonsurgical treatment and to determine if incorporating acoustic shadowing as a benign finding improves diagnostic performance. Materials and Methods: This retrospective study included consecutive women who underwent pelvic US between August 2015 and April 2017 at a tertiary referral oncology center. Two independent readers blinded to clinical and histologic outcome assigned an O-RADS risk category and an International Ovarian Tumor Analysis (IOTA) Assessment of Different NEoplasias in the adneXa (ADNEX) model risk of malignancy score to assessable lesions. Reference standards were surgical histopathology or 2-year imaging follow-up. Receiver operating characteristic (ROC) curve analysis was used to evaluate performance of the O-RADS US, ADNEX, and modified O-RADS models incorporating acoustic shadowing. Results: In total, 227 women (mean age, 52 years 6 16 [SD]) with 262 ovarian or adnexal lesions were evaluated. Of these lesions, 187 (71%) were benign and 75 (29%) were malignant. The proportion of malignancy was 0% (0 of 100) for O-RADS 2, 3% (one of 32) for O-RADS 3, 35% (22 of 63) for O-RADS 4, and 78% (52 of 67) for O-RADS 5. The area under the ROC curve (AUC) for O-RADS and ADNEX was 0.91 (95% CI: 0.88, 0.94) and 0.95 (95% CI: 0.92, 0.97; P = .01), respectively. The addition of acoustic shadowing as a benign finding improved O-RADS AUC to 0.94 (95% CI: 0.91, 0.96; P = .01). Use of O-RADS 4 as a threshold yielded a sensitivity of 99% (74 of 75; 95% CI: 96, 100) and a specificity of 70% (131 of 187; 95% CI: 64, 77). Conclusion: In a tertiary referral oncology center, the Ovarian-Adnexal Reporting and Data System US risk stratification and management system enabled accurate distinction of benign from malignant ovarian and adnexal lesions. Adding acoustic shadowing as a benign finding improved its diagnostic performance. (c) RSNA, 2022

引用

页码：114 / 120

页数：7