Prospective use of O-RADS and ADNEX ultrasound systems for risk stratification of ovarian malignancies
https://doi.org/10.24835/1607-0771-2023-1-23-55
Abstract
Objectives. A prospective study of the diagnostic value of ultrasound ovarian cancer risk stratification systems ADNEX and O-RADS in the differential diagnosis of benign and malignant ovarian tumors.
Material and methods. 59 patients with 43 benign and 25 with malignant ovarian tumors were prospectively examined. The ultrasound diagnostic systems IOTA ADNEX (installed on the device) and O-RADS (ACR Guidance smartphone application) were used to assess the risk of ovarian cancer. An ultrasound report on the presence of a malignant tumor with appropriate routing of the patient was given when the risk of malignancy according to ADNEX was ≥10%, as well as when the risk of malignancy was ≥4 points according to O-RADS. All patients underwent surgical treatment at the Regional Clinical Hospital (Vladimir) and the Regional Clinical Oncology Hospital (Vladimir).
Results. Sensitivity, specificity, positive predictive value, negative predictive value, accuracy, and area under the curve (AUC) were respectively for ADNEX: 96, 81, 75, 97 and 87%, AUC 0.933; for O-RADS: 100, 74, 69, 10% and 90%, AUC 0.926.
Conclusion. Both ultrasound diagnostic systems demonstrated very high sensitivity in the prospective differential diagnosis of benign and malignant ovarian tumors. At the same time, O-RADS made it possible to make the correct diagnosis in all 25 cases of malignant tumors. At the same time, both systems showed low specificity, with ADNEX having a slightly higher specificity (p > 0.05). AUC values were high for both diagnostic systems. In connection with the results of the study, we currently consider it advisable to simultaneously use the ADNEX and O-RADS systems for ultrasound examination in gynecology, reflecting the results of calculating the risk of malignant neoplasms of the adnexal mass in the ultrasound examination protocol
About the Author
M. N. BulanovRussian Federation
Mikhail N. Bulanov – Doct. of Sci. (Med.), Head of Ultrasound Diagnostics Department, Professor, Division of Internal Medicine, Institute of Medical Education
21, Sudogodskoye shosse, Vladimir 600023
41, Bolshaya St. Petersburgskaya str., Veliky Novgorod 173003
References
1. Bulanov M.N., Zykin B.I., Novikova T.I. Dopplerography in the diagnosis of ovarian cancer. Ultrasound diagnostics in obstetrics, gynecology and pediatrics. 1999; 4: 35–39. (In Russian)
2. Timmerman D., Valentin L., Bourne T.H., Collins W.P., Verrelst H., Vergote I. International Ovarian Tumor Analysis (IOTA) Group. Terms, definitions and measurements to describe the sonographic features of adnexal tumors: a consensus opinion from the International Ovarian Tumor Analysis (IOTA) Group. Ultrasound Obstet. Gynecol. 2000; 16 (5): 500–505. http://doi.org/10.1046/j.1469-0705.2000.00287.x
3. Van Calster B., Van Hoorde K., Froyman W., Kaijser J., Wynants L., Landolfo C., Anthoulakis C., Vergote I., Bourne T., Timmerman D. Practical guidance for applying the ADNEX model from the IOTA group to discriminate between different subtypes of adnexal tumors. Facts Views Vis. Obgyn. 2015; 7 (1): 32–41. PMID: 25897370. PMCID: PMC4402441
4. Araujo K.G., Jales R.M., Pereira P.N., Yoshida A., de Angelo Andrade L., Sarian L.O., Derchain S. Performance of the IOTA ADNEX model in preoperative discrimination of adnexal masses in a gynecological oncology center. Ultrasound Obstet. Gynecol. 2017; 49 (6): 778–783. http://doi.org/10.1002/uog.15963
5. Landolfo C., Valentin L., Franchi D., Van Holsbeke C., Fruscio R., Froyman W., Sladkevicius P., Kaijser J., Ameye L., Bourne T., Savelli L., Coosemans A., Testa A., Timmerman D. Differences in ultrasound features of papillations in unilocularsolid adnexal cysts: a retrospective international multicenter study. Ultrasound Obstet. Gynecol. 2018; 52 (2): 269–278. http://doi.org/10.1002/uog.18951. PMID: 29119698
6. Landolfo C., Bourne T., Froyman W., Van Calster B., Ceusters J., Testa A.C., Wynants L., Sladkevicius P., Van Holsbeke C., Domali E., Fruscio R., Epstein E., Franchi D., Kudla M.J., Chiappa V., Alcazar J.L., Leone F.P.G., Buonomo F., Coccia M.E., Guerriero S., Deo N., Jokubkiene L., Savelli L., Fischerova D., Czekierdowski A., Kaijser J., Coosemans A., Scambia G., Vergote I., Timmerman D., Valentin L. Benign descriptors and ADNEX in two-step strategy to estimate risk of malignancy in ovarian tumors: retrospective validation in IOTA5 multicenter cohort. Ultrasound Obstet. Gynecol. 2023; 61 (2): 231–242. http://doi.org/10.1002/uog.26080
7. Andreotti R.F., Timmerman D., Benacerraf B.R., Bennett G.L., Bourne T., Brown D.L., Coleman B.G., Frates M.C., Froyman W., Goldstein S.R., Hamper U.M., Horrow M.M., Hernanz-Schulman M., Reinhold C., Strachowski L.M., Glanc P. Ovarian- Adnexal Reporting Lexicon for Ultrasound: A White Paper of the ACR Ovarian-Adnexal Reporting and Data System Committee. J. Am. Coll. Radiol. 2018; 15 (10): 1415–1429. http://doi.org/10.1016/j.jacr.2018.07.004 [Published correction appears in J. Am. Coll. Radiol. 2019; 16 (3): 403–406.
8. Bulanov M.N., Chekalova M.A., Mazurkevich M.V., Vetsheva N.N. Application of the O-RADS system for ultrasound examination of the adnexal mass: Guidelines. Series “Best practices in radiation and instrumental diagnostics”. M.: GBUZ “NPKTs DiT DZM”, 2022. 28 p. (In Russian)
9. Strachowski L.M., Jha P., Phillips C.H., Blanchette Porter M.M., Froyman W., Glanc P., Guo Y., Patel M.D., Reinhold C., Suh-Burgmann E.J., Timmerman D., Andreotti R.F. O-RADS US v2022: An Update from the American College of Radiology's Ovarian-Adnexal Reporting and Data System US Committee. Radiology. 2023; 308 (3): e230685. http://doi.org/10.1148/radiol.230685
10. Andreotti R.F., Timmerman D., Strachowski L.M.,
11. Froyman W., Benacerraf B.R., Bennett G.L., Bourne T., Brown D.L., Coleman B.G., Frates M.C., Goldstein S.R., Hamper U.M., Horrow M.M., Hernanz-Schulman M., Reinhold C., Rose S.L., Whitcomb B.P., Wolfman W.L., Glanc P. O-RADS US Risk Stratification and Management System: A Consensus Guideline from the ACR Ovarian- Adnexal Reporting and Data System Committee. Radiology. 2020; 294 (1): 168–185. http://doi.org/10.1148/radiol.2019191150
12. Hack K., Gandhi K., Kahn D., Glanc P. External validation O-RADS ultrasound risk stratificationand management system. Ultrasound Obstet. Gynecol. 2021; 58 (Suppl. 1): 1–57.
13. Rodriguez N., Rodriguez N., Solano D.A., Pitalua N., Huertas B., Esquivel A., Buritica C. An external validation of the O-RADS risk stratification to differentiate between benign and malignant adnexal masses. Ultrasound Obstet. Gynecol. 2021; 58 (Suppl. 1): 1–57. https://doi.org/10.1002/uog.23787
14. Vara J., Manzour N., Chacón E., López-Picazo A., Linares M., Pascual M.Á., Guerriero S., Alcázar J.L. Ovarian Adnexal Reporting Data System (O-RADS) for Classifying Adnexal Masses: A Systematic Review and Meta-Analysis. Cancers (Basel). 2022; 14 (13): 3151. http://doi.org/10.3390/cancers14133151
15. Bulanov M.N. Ultrasound diagnostics in gynecology. Guide for doctors. Moscow: Vidar-M Publishing House, 2022. 712 p. (In Russian)
16. Hiett A.K., Sonek J.D., Guy M., Reid T.J. Performance of IOTA Simple Rules, Simple Rules risk assessment, ADNEX model and O-RADS in differentiating between benign and malignant adnexal lesions in North American women. Ultrasound Obstet. Gynecol. 2022; 59 (5): 668–676. http://doi.org/10.1002/uog.24777
17.
Review
For citations:
Bulanov M.N. Prospective use of O-RADS and ADNEX ultrasound systems for risk stratification of ovarian malignancies. Ultrasound & Functional Diagnostics. 2023;(1):23-55. (In Russ.) https://doi.org/10.24835/1607-0771-2023-1-23-55