Hu Yanli, Chen Bo, Dong Hongmei, Sheng Bo, Xiao Zhibo, Li Jia, Tian Wei, Lv Furong
Department of Ultrasonography, Chongqing Health Center for Women and Children, Chongqing, China.
Department of Ultrasonography, Women and Children's Hospital of Chongqing Medical University, Chongqing, China.
Front Oncol. 2023 Apr 24;13:1101297. doi: 10.3389/fonc.2023.1101297. eCollection 2023.
The ADNEX model offered a good diagnostic performance for discriminating adnexal tumors, but research comparing the abilities of the ADNEX model and MRI for characterizing adnexal tumors has not been reported to our knowledge. The aim of this study was to evaluate the diagnostic accuracy of the ultrasound-based ADNEX (Assessment of Different NEoplasias in the adneXa) model in comparison with that of magnetic resonance imaging (MRI) for differentiating benign, borderline and malignant adnexal masses.
This prospective study included 529 women with adnexal masses who underwent assessment the ADNEX model and subjective MRI analysis before surgical treatment between October 2019 and April 2022 at two hospitals. Postoperative histological diagnosis was considered the gold standard.
Among the 529 women, 92 (17.4%) masses were diagnosed histologically as malignant tumors, 67 (12.7%) as borderline tumors, and 370 (69.9%) as benign tumors. For the diagnosis of malignancy, including borderline tumors, overall agreement between the ADNEX model and MRI pre-operation was 84.9%. The sensitivity of the ADNEX model of 0.91 (95% confidence interval [CI]: 0.85-0.95) was similar to that of MRI (0.89, 95% CI: 0.84-0.94; =0.717). However, the ADNEX model had a higher specificity (0.90, 95% CI: 0.87-0.93) than MRI (0.81, 95% CI: 0.77-0.85; =0.001). The greatest sensitivity (0.96, 95% CI: 0.92-0.99) and specificity (0.94, 95% CI: 0.91-0.96) were achieved by combining the ADNEX model and subjective MRI assessment. While the total diagnostic accuracy did not differ significantly between the two methods (=0.059), the ADNEX model showed greater diagnostic accuracy for borderline tumors (<0.001).
The ultrasound-based ADNEX model demonstrated excellent diagnostic performance for adnexal tumors, especially borderline tumors, compared with MRI. Accordingly, we recommend that the ADNEX model, alone or with subjective MRI assessment, should be used for pre-operative assessment of adnexal masses.
ADNEX模型在鉴别附件肿瘤方面具有良好的诊断性能，但据我们所知，尚未有研究比较ADNEX模型和MRI对附件肿瘤进行特征描述的能力。本研究的目的是评估基于超声的ADNEX（附件不同肿瘤评估）模型与磁共振成像（MRI）在鉴别良性、交界性和恶性附件肿块方面的诊断准确性。
这项前瞻性研究纳入了529例有附件肿块的女性，她们于2019年10月至2022年4月期间在两家医院接受手术治疗前接受了ADNEX模型评估和MRI主观分析。术后组织学诊断被视为金标准。
在这529例女性中，92例（17.4%）肿块经组织学诊断为恶性肿瘤，67例（12.7%）为交界性肿瘤，370例（69.9%）为良性肿瘤。对于包括交界性肿瘤在内的恶性肿瘤诊断，ADNEX模型与术前MRI的总体一致性为84.9%。ADNEX模型的敏感性为0.91（95%置信区间[CI]：0.85-0.95），与MRI的敏感性（0.89，95%CI：0.84-0.94；P=0.717）相似。然而，ADNEX模型的特异性（0.90，95%CI：0.87-0.93）高于MRI（0.81，95%CI：0.77-0.85；P=0.
