Objective
This study aimed to assess the diagnostic efficacy of the Ovarian-Adnexal Reporting and Data System (O-RADS) and Ultrasound (US) and its sub-classification system for distinguishing ovarian masses.
Methods
O-RADS US was used for the retrospective analysis of 606 ovarian masses of Chinese from two medical centers by two gynecologic sonographers with varying experience. The O-RADS 4 categories masses were further sub-classified into O-RADS 4a and O-RADS 4 b through three different approaches(O-RADS A1/A2/A3).
Results
The AUC of O-RADS US for differentiating benign from malignant ovarian masses was 0.927 (95% CI, 0.903—0.946, P < 0.001). The optimal cut-off value for predicting malignancy was>O-RADS 3, with sensitivity and specificity of 98.60% and 68.90%,respectively. The diagnostic efficacy of the three sub-classification systems surpassed that of O-RADS US(P < 0.05). Specifically, A2 approach（Within O-RADS 4 lesions, unilocular and multilocular cysts with solid components were sub-classified as O-RADS 4 b, whereas the remaining O-RADS 4 lesions were sub-classified as O-RADS 4a) resulted in an AUC of 0.942(95% CI, 0.921—0.960, P＜0．001). The best cut-off value predicting malignancy was>O-RADS 4a, exhibiting relatively high specificity (82.51%) and maintaining a high sensitivity (93.01%).
Conclusion
The diagnostic efficacy of O-RADS US for identifying ovarian tumors is good, but specificity is slightly lower. This study enhanced diagnostic specificity after subclassifying O-RADS 4 lesions, especially A2 approach. It holds significant clinical value for Chinese women and merits further clinical promotion and application.
Advances in knowledge
The sub-classification of O-RADS US allow better identifying ovarian tumors, facilitating informed preoperative clinical management and diagnosis.
