Diagnostic performance of ultrasound reporting systems in evaluation of adnexal masses: A prospective observational study.

Autor: Kapoor S; Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi 110029, India., Singhal S; Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi 110029, India. Electronic address: drseemasinghal@gmail.com., Dhamija E; Department of Radiodiagnosis, DrBRAIRCH, All India Institute of Medical Sciences, New Delhi 110029, India., Manchanda S; Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi 110029, India., Malhotra N; Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi 110029, India., Bhatla N; Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi 110029, India.
Jazyk: angličtina
Zdroj: European journal of obstetrics, gynecology, and reproductive biology [Eur J Obstet Gynecol Reprod Biol] 2024 Oct; Vol. 301, pp. 186-193. Date of Electronic Publication: 2024 Aug 13.
DOI: 10.1016/j.ejogrb.2024.08.023
Abstrakt: Objective(s): To evaluate and compare diagnostic performance of ultrasound-based reporting systems IOTA SR, ADNEX, GIRADS, ORADS for discrimination between benign and malignant adnexal masses.
Study Design: A prospective observational study in a tertiary care hospital's Obstetrics and Gynaecology department evaluated pre-operative ultrasound imaging for adnexal masses in 80 cases, comparing various reporting systems' sensitivity and specificity against histopathology as gold standard using STATA version 17.0 for data analysis.
Results: Among the 80 masses, 55 % (44/80) were confirmed as benign on histopathology, while 45 % were identified as malignant. The sensitivity and specificity of SR was 100 % (95 %CI: 90.0-100) and 97.1 % (95 %CI: 84.7-99.9) respectively. Eleven masses (13.8 %) were inconclusive, reducing specificity to 75 % (95 %CI:59.7-86.8).In ADNEX optimal cut-off for risk of malignancy was 34.1 % with sensitivity of 86.1 % (95 % CI: 70.5-95.3) and specificity of 90.9 % (95 % CI: 78.3-97.5). Considering GIRADS 4-5 and risk threshold of ≥10 % (ORADS 4-5) as predictors of malignancy sensitivity was 100 % (95 %CI: 90.3-100) and specificity was 70.5 % (95 %CI: 54.8-83.2) for GIRADS and ORADS. All reporting systems were comparable (p = 0.7). ADNEX identified 72.7 % (8/11) of inconclusive cases, outperforming GIRADS/ORADS which correctly classified 27.2 % (3/11) cases. When applied to misclassified GIRADS/ORADS 4-5 category, ADNEX demonstrated superior performance by correctly classifying 76.9 % (10/13) masses, while SR achieved correct classification in only 38.5 % (5/13) masses.
Conclusion(s): All classification systems showed comparable accuracy in malignancy risk identification on imaging. GIRADS/ORADS tended to overestimate malignancy risk. The present study recommends a two-step strategy, leveraging higher specificity of ADNEX model for improved stratification of adnexal masses.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2024 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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