Cabedo Lledó, Sebastià Carmen, Munmany Meritxell, Fusté Pere, Gaba Lydia, Saco Adela, Rodriguez Adela, Paño Blanca, Nicolau Carlos
Department of Radiology, Hospital Clínic de Barcelona, C/Villarroel, Barcelona, 170 08036, Spain.
Department of Gynaecology and Obstetrics, Hospital Clínic de Barcelona, C/Villarroel, Barcelona, 170 08036, Spain.
Insights Imaging. 2024 Apr 12;15(1):107. doi: 10.1186/s13244-024-01670-3.
To evaluate the efficacy of the O-RADS MRI criteria in the stratification of risk of malignancy of solid or sonographically indeterminate ovarian masses and assess the interobserver agreement of this classification between experienced and inexperienced radiologists.
This single-centre retrospective study included patients from 2019 to 2022 with sonographically indeterminate or solid ovarian masses who underwent MRI with a specific protocol for characterisation according to O-RADS MRI specifications. Each study was evaluated using O-RADS lexicon by two radiologists, one with 17 years of experience in gynaecological radiology and another with 4 years of experience in general radiology. Findings were classified as benign, borderline, or malignant according to histology or stability over time. Diagnostic performance and interobserver agreement were assessed.
A total of 183 patients with US indeterminate or solid adnexal masses were included. Fifty-seven (31%) did not have ovarian masses, classified as O-RADS 1. The diagnostic performance for scores 2-5 was excellent with a sensitivity, specificity, PPV, and NPV of 97.4%, 100%, 96.2%, and 100%, respectively by the experienced radiologist and 96.1%, 92.0%, 93.9%, and 94.8% by the inexperienced radiologist. Interobserver concordance was very high (Kappa index 0.92). Almost all the misclassified cases were due to misinterpretation of the classification similar to reports in the literature.
The diagnostic performance of O-RADS MRI determined by either experienced or inexperienced radiologists is excellent, facilitating decision-making with high diagnostic accuracy and high reproducibility. Knowledge of this classification and use of assessment tools could avoid frequent errors due to misinterpretation.
Up to 31% of ovarian masses are considered indeterminate by transvaginal US and 32% of solid lesions considered malignant by transvaginal US are benign. The O-RADs MRI accurately classifies these masses, even when used by inexperienced radiologists, thereby avoiding incorrect surgical approaches.
• O-RADS MRI accurately classifies indeterminate and solid ovarian masses by ultrasound. • There is excellent interobserver agreement between experienced and non-experienced radiologists. • O-RADS MRI is a helpful tool to assess clinical decision-making in ovarian tumours.
评估O-RADS MRI标准在实性或超声检查结果不明确的卵巢肿块恶性风险分层中的有效性，并评估经验丰富和经验不足的放射科医生之间对该分类的观察者间一致性。
这项单中心回顾性研究纳入了2019年至2022年期间超声检查结果不明确或实性卵巢肿块的患者，这些患者按照O-RADS MRI规范接受了特定方案的MRI检查以进行特征描述。每项研究由两名放射科医生使用O-RADS词汇表进行评估，一名在妇科放射学方面有17年经验，另一名在普通放射学方面有4年经验。根据组织学或随时间的稳定性，将检查结果分类为良性、交界性或恶性。评估诊断性能和观察者间一致性。
共纳入183例超声检查结果不明确或实性附件肿块的患者。57例（31%）没有卵巢肿块，分类为O-RADS 1。经验丰富的放射科医生对2-5分的诊断性能极佳，敏感性、特异性、阳性预测值和阴性预测值分别为97.4%、100%、96.2%和100%，经验不足的放射科医生分别为96.1%、92.0%、93.9%和94.8%。观察者间一致性非常高（kappa指数为0.92）。几乎所有错误分类的病例都是由于对分类的错误解读，与文献报道相似。
经验丰富或经验不足的放射科医生所确定的O-RADS MRI诊断性能极佳，有助于以高诊断准确性和高可重复性进行决策。了解这种分类并使用评估工具可以避免因错误解读而频繁出现的错误。
经阴道超声检查认为高达31%的卵巢肿块不明确，经阴道超声检查认为恶性的实性病变中有32%是良性的。即使由经验不足的放射科医生使用，O-RADs MRI也能准确地对这些肿块进行分类，从而避免不正确的手术方法。
• O-RADS MRI通过超声准确地对不明确和实性卵巢肿块进行分类。• 经验丰富和经验不足的放射科医生之间观察者间一致性极佳。• O-RADS MRI是评估卵巢肿瘤临床决策的有用工具。
