Prospective use of O-RADS and ADNEX ultrasound systems for risk stratification of ovarian malignancies

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