Department of Ultrasound, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.
Department of Ultrasound, Jiangmen Central Hospital, Jiangmen, China.
Gynecol Oncol. 2021 Jul;162(1):107-112. doi: 10.1016/j.ygyno.2021.04.031. Epub 2021 May 7.
To assess the diagnostic performance and inter-observer agreement of the American College of Radiology (ACR) Ovarian-Adnexal Reporting and Data System Ultrasound (O-RADS US).
From January 2016 to December 2018 a total of 1054 adnexal lesions in 1035 patients with pathologic results from two hospitals were retrospectively included. Each lesion was assigned to an O-RADS US category according to the criteria. Kappa (κ) statistics were applied to assess inter-observer agreement between a less experienced and an expert radiologist.
Of the 1054 adnexal lesions, 750 were benign and 304 were malignant. The malignancy rates of O-RADS 5, O-RADS 4, O-RADS 3, and O-RADS 2 lesions were 89.57%, 34.46%, 1.10%, and 0.45% respectively. Area under the receiver operating characteristic curve was 0.960 (95% CI, 0.947-0.971). The optimal cutoff value for predicting malignancy was >O-RADS 3 with a sensitivity and specificity of 98.7% (95% CI, 0.964-0.996) and 83.2% (95% CI, 0.802-0.858) respectively. When sub-classifying multilocular cysts and smooth solid lesions in O-RADS 4 lesions as O-RADS 4a lesions and the rest cystic lesions with solid components as O-RADS 4b lesions, the malignancy rate were 17.02% and 42.57% respectively, which showed better risk stratification (P < 0.001). The inter-observer agreement between a less-experienced and an expert radiologist of O-RADS categorization was good (κ = 0.714).
The ACR O-RADS US provides effective malignancy risk stratification for adnexal lesions with high reliability for radiologists with different experience. Sub-grouping of O-RADS 4 lesions into two groups facilitated better stratification of the intermediate risk.
评估美国放射学院（ACR）卵巢-附件报告和数据系统超声（O-RADS US）的诊断性能和观察者间一致性。
本回顾性研究纳入了 2016 年 1 月至 2018 年 12 月期间来自两家医院的 1035 名患者的 1054 个附件病变，根据标准将每个病变分配到 O-RADS US 类别。应用 Kappa（κ）统计评估经验较少的放射科医生和专家之间的观察者间一致性。
1054 个附件病变中，750 个为良性病变，304 个为恶性病变。O-RADS 5、O-RADS 4、O-RADS 3 和 O-RADS 2 病变的恶性率分别为 89.57%、34.46%、1.10%和 0.45%。受试者工作特征曲线下面积为 0.960（95%CI，0.947-0.971）。预测恶性肿瘤的最佳截断值为>O-RADS 3，其灵敏度和特异性分别为 98.7%（95%CI，0.964-0.996）和 83.2%（95%CI，0.802-0.858）。当将 O-RADS 4 病变中的多房性囊肿和光滑实性病变亚分类为 O-RADS 4a 病变，而其余囊性病变伴实性成分归类为 O-RADS 4b 病变时，恶性率分别为 17.02%和 42.57%，显示出更好的风险分层（P<0.001）。经验较少的放射科医生和专家之间的 O-RADS 分类观察者间一致性较好（κ=0.714）。
ACR O-RADS US 为附件病变提供了有效的恶性风险分层，对于不同经验的放射科医生具有较高的可靠性。将 O-RADS 4 病变分为两组有助于更好地分层中间风险。
