Ultrasound Assessment of Adnexal Pathology: Standardized Methods and Different Levels of Experience

Tavoraitė, Indrė; Kronlachner, Laura; Opolskiene, G.; Bartkevičienė, Daiva

doi:10.3390/medicina57070708

Cited by 14 publications

(11 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

Section: Discussionsupporting

confidence: 88%

“…The sensitivity of subjective assessment in our study to detect malignant masses is 87.8% (78.4–97.2) which is similar to other studies in which the sensitivity of this approach ranged from 56.4% to 100% [ 7 , 9 ]. However, the specificity (69.1%) is lower than expected according to the literature (84.2–99.9%) [ 7 , 9 ]. This is probably because of a selection bias in our study since many of the adnexal lesions included had been classified as suspicious and required histological study, as evidenced by the high percentage of malignancy according to the pathological study (33.6%).…”

Section: Discussionsupporting

confidence: 88%

“…The subjective assessment of the sonographer has the greatest diagnostic validity in the characterization of the adnexal masses, and it’s completely dependent on the experience and training of the examiner [ 7 , 8 , 9 ]. However, the first contact with the patient is usually with a non-expert sonographer.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Comparison of Ultrasound Scores in Differentiating between Benign and Malignant Adnexal Masses

et al. 2023

View full text Add to dashboard Cite

Subjective ultrasound assessment by an expert examiner is meant to be the best option for the differentiation between benign and malignant adnexal masses. Different ultrasound scores can help in the classification, but whether one of them is significantly better than others is still a matter of debate. The main aim of this work is to compare the diagnostic performance of some of these scores in the evaluation of adnexal masses in the same set of patients. This is a retrospective study of a consecutive series of women diagnosed as having a persistent adnexal mass and managed surgically. Ultrasound characteristics were analyzed according to IOTA criteria. Masses were classified according to the subjective impression of the sonographer and other ultrasound scores (IOTA simple rules -SR-, IOTA simple rules risk assessment -SRRA-, O-RADS classification, and ADNEX model -with and without CA125 value-). A total of 122 women were included. Sixty-two women were postmenopausal (50.8%). Eighty-one women had a benign mass (66.4%), and 41 (33.6%) had a malignant tumor. The sensitivity of subjective assessment, IOTA SR, IOTA SRRA, and ADNEX model with or without CA125 and O-RADS was 87.8%, 66.7%, 78.1%, 95.1%, 87.8%, and 90.2%, respectively. The specificity for these approaches was 69.1%, 89.2%, 72.8%, 74.1%, 67.9%, and 60.5%, respectively. All methods with similar AUC (0.81, 0.78, 0.80, 0.88, 0.84, and 0.75, respectively). We concluded that IOTA SR, IOTA SRRA, and ADNEX models with or without CA125 and O-RADS can help in the differentiation of benign and malignant masses, and their performance is similar to the subjective assessment of an experienced sonographer.

show abstract

Section: Discussionsupporting

confidence: 88%

Section: Discussionsupporting

confidence: 88%

See 1 more Smart Citation

Comparison of Ultrasound Scores in Differentiating between Benign and Malignant Adnexal Masses

et al. 2023

View full text Add to dashboard Cite

show abstract

“…For less experienced sonographers (less than 5 years of experience in gynecological ultrasound diagnosis), it is important to use objective methods to diagnose AMs [4]. Ultrasound-based diagnostic models and scoring systems [5][6][7][8] can be used to predict the malignancy of AMs to help inexperienced sonographers in the diagnosis of AMs. A commonly used diagnostic model is the Risk of Malignancy Index (RMI) [9], which is a risk index calculated based on serum CA125, menopausal status, and ultrasound characteristics to identify benign and malignant AMs, and is currently recommended by many national for AMs properties.…”

Section: Introductionmentioning

confidence: 99%

Evaluating the risk of malignancy in adnexal masses: validation of O-RADS and comparison with ADNEX model, SA, and RMI

Wang

Yang

2023

Ginekol Pol

View full text Add to dashboard Cite

Objectives: To evaluate the diagnostic value of Ovarian-adnexal Reporting and Data System (O-RADS), and to compare it with Assessment of Different NEoplasias in the adnexa (ADNEX) model, subjective assessment (SA), and risk of malignancy index (RMI) in differentiating benign and malignant adnexal masses (AMs).Material and methods: Ultrasound characteristics of 445 patients included in the study were retrospectively analyzed and evaluated using diagnostic models. The diagnostic performances of ultrasound diagnostic models were measured by assessing, receiver-operating characteristic curves, sensitivities, positive predictive values, positive likelihood ratios, specificities, negative predictive values, and negative likelihood ratios. Kappa values were used to evaluate inter-reviewer agreement (IRA).Results: Of the 445 AMs, 265 were benign and 180 were malignant. The area under the curve (AUC) of O-RADS (0.941), ADNEX model (0.925), and SA (0.931) were higher than RMI (0.815) (all p < 0.05). The sensitivity of O-RADS (93.3%), ADNEX model (94.4%), and SA (96.1%) were higher than RMI (70.6%) (p > 0.05), and there was no statistical significance among them (p > 0.05). The specificity of O-RADS, ADNEX model, SA, and RMI was 90.2%, 90.6%, 90.2%, and 92.5%, respectively, with no statistical significance (p > 0.05). All four ultrasound diagnostic methods showed better IRA.Conclusions: O-RADS, ADNEX model and SA have better diagnostic value in differentiating benign and malignant AMs than RMI.

show abstract

“…It has already been demonstrated that a US study undertaken by an experienced sonographer (Subjective Assessment) is the best choice for classifying adnexal masses [2][3][4]. However, other US scores have been developed to help non-expert sonographers to classify adnexal masses such as IOTA Simple Rules Risk Assessment (2016), available as a digital version of the IOTA Simple Rules (2008) [5], which predicts the risk of malignancy in an online calculator [6]; the ADNEX model (Assessment of Different Neoplasia in the Adnexa) (2014) [7] with or without CA125; or the O-RADS system (Ovarian Adnexal Reporting and Data System) [8], introduced in 2020 by the American College of Radiology (ACR) [9] with an updated version in November 2022, which classifies adnexal masses into five categories according to lexicon descriptors and includes management options.…”

Section: Introductionmentioning

confidence: 99%

Application of Ultrasound Scores (Subjective Assessment, Simple Rules Risk Assessment, ADNEX Model, O-RADS) to Adnexal Masses of Difficult Classification

Pelayo,

Sancho-Sauco,

Sánchez-Zurdo

et al. 2023

Diagnostics

View full text Add to dashboard Cite

Background: Ultrasound features help to differentiate benign from malignant masses, and some of them are included in the ultrasound (US) scores. The main aim of this work is to describe the ultrasound features of certain adnexal masses of difficult classification and to analyse them according to the most frequently used US scores. Methods: Retrospective studies of adnexal lesions are difficult to classify by US scores in women undergoing surgery. Ultrasound characteristics were analysed, and masses were classified according to the Subjective Assessment of the ultrasonographer (SA) and other US scores (IOTA Simple Rules Risk Assessment-SRRA, ADNEX model with and without CA125 and O-RADS). Results: A total of 133 adnexal masses were studied (benign: 66.2%, n:88; malignant: 33.8%, n:45) in a sample of women with mean age 56.5 ± 7.8 years. Malignant lesions were identified by SA in all cases. Borderline ovarian tumors (n:13) were not always detected by some US scores (SRRA: 76.9%, ADNEX model without and with CA125: 76.9% and 84.6%) nor were serous carcinoma (n:19) (SRRA: 89.5%), clear cell carcinoma (n:9) (SRRA: 66.7%) or endometrioid carcinoma (n:4) (ADNEX model without CA125: 75.0%). While most teratomas and serous cystadenomas have been correctly differentiated, other benign lesions were misclassified because of the presence of solid areas or papillae. Fibromas (n:13) were better identified by SA (23.1% malignancy), but worse with the other US scores (SRRA: 69.2%, ADNEX model without and with CA125: 84.6% and 69.2%, O-RADS: 53.8%). Cystoadenofibromas (n:10) were difficult to distinguish from malignant masses via all scores except SRRA (SA: 70.0%, SRRA: 20.0%, ADNEX model without and with CA125: 60.0% and 50.0%, O-RADS: 90.0%). Mucinous cystadenomas (n:12) were misdiagnosed as malignant in more than 15% of the cases in all US scores (SA: 33.3%, SRRA: 16.7%, ADNEX model without and with CA125: 16.7% and 16.7%, O-RADS:41.7%). Brenner tumors are also difficult to classify using all scores. Conclusion: Some malignant masses (borderline ovarian tumors, serous carcinoma, clear cell carcinoma, endometrioid carcinomas) are not always detected by US scores. Fibromas, cystoadenofibromas, some mucinous cystadenomas and Brenner tumors may present solid components/papillae that may induce confusion with malignant lesions. Most teratomas and serous cystadenomas are usually correctly classified.

show abstract

Ultrasound Assessment of Adnexal Pathology: Standardized Methods and Different Levels of Experience

Cited by 14 publications

References 20 publications

Comparison of Ultrasound Scores in Differentiating between Benign and Malignant Adnexal Masses

Comparison of Ultrasound Scores in Differentiating between Benign and Malignant Adnexal Masses

Evaluating the risk of malignancy in adnexal masses: validation of O-RADS and comparison with ADNEX model, SA, and RMI

Application of Ultrasound Scores (Subjective Assessment, Simple Rules Risk Assessment, ADNEX Model, O-RADS) to Adnexal Masses of Difficult Classification

Contact Info

Product

Resources

About