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Diagnostic accuracy of ultrasound classifications - O-RADS US v2022, O-RADS US v2020, and IOTA SR - in distinguishing benign and malignant adnexal masses: Enhanced by combining O-RADS US v2022 with tumor marker HE4

  • 0State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Department of Ultrasound, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, China.
European Journal of Radiology +

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November 14, 2024

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November 14, 2024

View abstract on PubMed

Summary

This summary is machine-generated.

The O-RADS Ultrasound (O-RADS US) v2022 system accurately diagnoses adnexal masses, performing similarly to v2020 and better than IOTA SR. Combining O-RADS US v2022 with HE4 tumor marker significantly improves diagnostic accuracy for ovarian malignancy.

Area Of Science

  • Gynecologic Oncology
  • Diagnostic Imaging
  • Radiology

Background

  • Adnexal masses require accurate diagnostic tools to differentiate benign from malignant lesions.
  • Current imaging classification systems include O-RADS Ultrasound (O-RADS US) and the International Ovarian Tumor Analysis Simple Rules (IOTA SR).
  • Tumor markers can potentially augment imaging-based assessments.

Purpose Of The Study

  • To compare the diagnostic accuracy of O-RADS US v2022, O-RADS US v2020, and IOTA SR for adnexal masses.
  • To evaluate the added value of combining imaging findings with tumor markers (specifically HE4) for improved diagnosis.

Main Methods

  • Retrospective analysis of 613 women with adnexal masses undergoing surgery.
  • Histopathology served as the gold standard for diagnosis.
  • Receiver Operating Characteristic (ROC) analysis assessed diagnostic performance; Kappa statistics evaluated inter-reader agreement.

Main Results

  • O-RADS US v2022 (AUC=0.940) and v2020 (AUC=0.937) showed comparable, high diagnostic accuracy, outperforming IOTA SR (AUC=0.862).
  • O-RADS US v2022 and HE4 were significant independent predictors of malignancy.
  • The combination of O-RADS US v2022 and HE4 yielded the highest AUC (0.98), significantly improving upon either modality alone.

Conclusions

  • O-RADS US v2022 is a reliable tool for diagnosing adnexal masses, with performance similar to O-RADS US v2020 and superior to IOTA SR.
  • Integrating O-RADS US v2022 with HE4 levels enhances diagnostic accuracy for malignant adnexal lesions.

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