附件包块良恶性诊断中 O-RADS、GI-RADS 和 IOTA 简单规则的比较：恶性率、有效性和可靠性。

Comparison of O-RADS, GI-RADS, and IOTA simple rules regarding malignancy rate, validity, and reliability for diagnosis of adnexal masses.

机构信息

Department of Radio-diagnosis, Zagazig University, Zagazig, Egypt.

Department of Radio-diagnosis, Al-Ahrar Teaching Hospital, Zagazig, Egypt.

出版信息

Eur Radiol. 2021 Feb;31(2):674-684. doi: 10.1007/s00330-020-07143-7. Epub 2020 Aug 18.

DOI:10.1007/s00330-020-07143-7

PMID:32809166

Abstract

OBJECTIVE

The American College of Radiology (ACR) recently published the ovarian-adnexal reporting and data system (O-RADS) to provide guidelines to physicians who interpret ultrasound (US) examinations of adnexal masses (AM). This study aimed to compare the O-RADS with two other well-established US classification systems for diagnosis of AM.

METHODS

This retrospective multicenter study between May 2016 and December 2019 assessed consecutive women with AM detected by the US. Five experienced consultant radiologists independently categorized each AM according to O-RADS, gynecologic imaging reporting and data system (GI-RADS), and international ovarian tumor analysis (IOTA) simple rules. Pathology and adequate follow-up were used as reference standards for calculating the validity of three US classification systems for diagnosis of AM. Kappa statistics were used to assess the inter-reviewer agreement (IRA).

RESULTS

A total of 609 women (mean age, 48 ± 13.7 years; range, 18-72 years) with 647 AM were included. Of the 647 AM, 178 were malignant and 469 were benign. Malignancy rates were comparable to recommended rates by previous literature in O-RADS and IOTA, but higher in GI-RADS. O-RADS had significantly higher sensitivity for malignancy than GI-RAD and IOTA (p = 0.003 and 0.0007, respectively), but non-significant slightly lower specificity (p > 0.05). O-RADS, GI-RADS, and IOTA showed similar overall IRA (κ = 0.77, 0.69, and 0.63, respectively) with a tendency toward higher IRA with O-RADS than with GI-RADS and IOTA.

CONCLUSIONS

O-RADS compares favorably with GI-RADS and IOTA. O-RADS had higher sensitivity than GI-RADS and IOTA simple rules with relatively similar specificity and reliability.

KEY POINTS

• The malignancy rates were comparable to recommended rates by previous literature in O-RADS and IOTA, but higher in GI-RADS. • The O-RADS had significantly higher sensitivity for malignancy than GI-RADS and IOTA (96.8% vs 92.7% and 92.1%; p = 0.003 and 0.0007, respectively), but non-significant slightly lower specificity (92.8% vs 93.6% and 93.2%, respectively; p > 0.05). • The O-RADS, GI-RADS, and IOTA showed similar overall inter-reviewer agreement (IRA) (κ = 0.77, 0.69, and 0.63, respectively), with a tendency toward higher IRA with O-RADS than with GI-RADS and IOTA.

摘要

目的

美国放射学院（ACR）最近发布了卵巢-附件报告和数据系统（O-RADS），为解读附件肿块（AM）超声检查的医生提供指南。本研究旨在比较 O-RADS 与另外两种成熟的 AM 超声分类系统的诊断效能。

方法

本回顾性多中心研究于 2016 年 5 月至 2019 年 12 月间评估了连续经超声检测到 AM 的女性。5 位经验丰富的顾问放射科医生分别根据 O-RADS、妇科影像学报告和数据系统（GI-RADS）以及国际卵巢肿瘤分析（IOTA）简单规则对每个 AM 进行分类。病理学和充分的随访被用作计算三种 US 分类系统诊断 AM 效能的参考标准。Kappa 统计用于评估审查者间的一致性（IRA）。

结果

共纳入 609 名女性（平均年龄 48±13.7 岁；年龄范围 18-72 岁），共 647 个 AM。在 647 个 AM 中，178 个为恶性，469 个为良性。恶性肿瘤发生率与 O-RADS 和 IOTA 文献中推荐的发生率相当，但 GI-RADS 更高。O-RADS 对恶性肿瘤的敏感性明显高于 GI-RADS 和 IOTA（p=0.003 和 0.0007），但特异性稍低但无统计学意义（p>0.05）。O-RADS、GI-RADS 和 IOTA 的总体 IRA 相似（κ=0.77、0.69 和 0.63），O-RADS 的 IRA 有高于 GI-RADS 和 IOTA 的趋势。

结论

O-RADS 与 GI-RADS 和 IOTA 相比具有优势。O-RADS 对恶性肿瘤的敏感性高于 GI-RADS 和 IOTA 简单规则，特异性和可靠性相当。

关键点

O-RADS 中的恶性肿瘤发生率与 O-RADS 和 IOTA 文献中推荐的发生率相当，但 GI-RADS 更高。
O-RADS 对恶性肿瘤的敏感性明显高于 GI-RADS 和 IOTA（96.8% vs 92.7% 和 92.1%；p=0.003 和 0.0007），但特异性稍低但无统计学意义（92.8% vs 93.6%和 93.2%；p>0.05）。
O-RADS、GI-RADS 和 IOTA 的总体审查者间一致性（IRA）相似（κ=0.77、0.69 和 0.63），O-RADS 的 IRA 有高于 GI-RADS 和 IOTA 的趋势。