A modified CEUS risk stratification model for adnexal masses with solid components: prospective multicenter study and...

Area of Science:

• Gynecologic imaging
• Oncologic diagnostics
• Medical ultrasonography

Background:

• Adnexal lesions require accurate characterization to differentiate benign from malignant conditions.
• The Ovarian-Adnexal Reporting and Data System (O-RADS) ultrasound (US) provides a standardized framework for assessment.
• Integrating advanced imaging techniques may further refine diagnostic accuracy.

Purpose of the Study:

• To evaluate the added benefits of contrast-enhanced ultrasound (CEUS) when combined with O-RADS US for characterizing adnexal lesions with solid components.
• To assess the diagnostic performance of a modified CEUS risk stratification model.

Main Methods:

• Prospective multicenter study of women with suspected adnexal lesions with solid components.
• Preoperative CEUS and US examinations followed by surgical intervention.
• O-RADS US categorization, quantitative CEUS index recording, and pathological correlation.
• Univariable, multivariable, and ROC curve analyses to identify malignancy risk factors and assess diagnostic performance.

Main Results:

• 180 lesions (80 malignant, 100 benign) were analyzed.
• Serum CA-125, acoustic shadowing, and peak intensity ratio were independent predictors of malignancy.
• The modified CEUS model showed superior diagnostic value (AUC 0.91) compared to O-RADS US (AUC 0.78) and comparable performance to the ADNEX model (AUC 0.86).

Conclusions:

• CEUS integration enhances the diagnostic precision of O-RADS US for adnexal lesions with solid components.
• The modified CEUS risk stratification model demonstrates potential for improving specificity and reducing unnecessary surgeries.