Kılıçkap Gulsum, Dölek Betül Akdal, Kaya Serhat, Çevik Numan Ilteriş
Radiology Department, T.C. Ministry of Health, Ankara Bilkent City Hospital, Ankara, Türkiye.
Radiology Department, Basaksehir Cam and Sakura City Hospital, Istanbul, Türkiye.
Acta Radiol. 2024 Dec;65(12):1560-1568. doi: 10.1177/02841851241279897. Epub 2024 Sep 30.
The O-RADS scoring has been proposed to standardize the reporting of adnexal lesions using magnetic resonance imaging (MRI).
To assess intra- and inter-observer agreement of the O-RADS scoring using non-dynamic MRI and its agreement with pathologic diagnosis, and to provide the pitfalls in the scoring based on discordant ratings.
Adnexal lesions that were diagnosed using non-dynamic MRI at two centers were scored using O-RADS. Intra- and inter-observer agreements were assessed using kappa statistics. Cross-tabulations were made for intra- and inter-observer ratings and for O-RADS scores and pathological findings.
Intra- and inter-observer agreements were assessed for 404 lesions in 339 patients who were admitted to center 1. Intra-observer agreement was almost perfect (97.8%, kappa = 0.963) and inter-observer agreement was substantial (83.2%, kappa = 0.730). The combined data from center 1 and center 2 included 496 patients; of them, 295 (59.5%) were operated. There was no borderline or malignant pathology for the lesions with O-RADS 1 or 2. Of those with an O-RADS score of 3, 3 (4.1%) lesions were borderline and none were malignant. The O-RADS scoring in discriminating borderline/malignant lesions from benign lesions was outstanding (area under the ROC curve 0.950, 95% CI = 0.923-0.971). Sensitivity, specificity, positive, and negative predictive values of O-RADS 4/5 lesions for borderline/malignant lesions were 96.2%, 87.1%, 72.8%, and 98.4%, respectively.
The O-RADS scoring using non-dynamic MRI is a reproducible method and has good discrimination for borderline/malignant lesions. Potential factors that may lead to discordant ratings are provided here.
O-RADS评分系统已被提出用于规范附件区病变的磁共振成像（MRI）报告。
评估使用非动态MRI时O-RADS评分的观察者内和观察者间一致性，及其与病理诊断的一致性，并基于不一致的评级提供评分中的陷阱。
在两个中心使用非动态MRI诊断的附件区病变采用O-RADS评分。使用kappa统计量评估观察者内和观察者间的一致性。对观察者内和观察者间的评级以及O-RADS评分和病理结果进行交叉制表。
对中心1收治的339例患者的404个病变进行了观察者内和观察者间一致性评估。观察者内一致性几乎完美（97.8%，kappa = 0.963），观察者间一致性较高（83.2%，kappa = 0.730）。中心1和中心2的合并数据包括496例患者；其中295例（59.5%）接受了手术。O-RADS 1或2级病变无交界性或恶性病理结果。O-RADS评分为3级的病变中，3个（4.1%）为交界性，无恶性病变。O-RADS评分在区分交界性/恶性病变与良性病变方面表现出色（ROC曲线下面积为0.950，95%CI = 0.923 - 0.971）。O-RADS 4/5级病变对交界性/恶性病变的敏感性、特异性、阳性和阴性预测值分别为96.2%、87.1%、72.8%和98.4%。
使用非动态MRI的O-RADS评分是一种可重复的方法，对交界性/恶性病变具有良好的鉴别能力。本文提供了可能导致评级不一致的潜在因素。
