Comparison Of Value Of GI-RADS,IOTA LR2 Model And ADNEX Model In The Diagnosis Of Adnexal Tumors

Objective:To assess the diagnostic value of Gynecologic Imaging Reporting and Data System(GI-RADS),International Ovarian Tumor Analysis(IOTA)logistic regression model 2(LR2)and Assessment of Different NEoplasias in the adne Xa(ADNEX)model for the diagnosis of adnexal tumors by junior doctors.Methods:The data of 634 patients with adnexal tumors confirmed by pathology were analyzed retrospectively,judging by junior doctors according to GI-RADS,LR2 model and ADNEX model.According to GI-RADS,3 ways were defined to judge tumors,named GR1,GR2 and GR3.GR1 classified GI-RADS 1-3 as benign,GI-RADS 4a-5 as malignant;GR2 classified GI-RADS 1-4a as benign,GI-RADS4b-5 as malignant;GR3 classified GI-RADS 1-4b as benign,GI-RADS 5 as malignant.Taking LR2=10% and ADNEX=10% as critical points.Taking pathology as diagnostic gold standard,the diagnostic efficacy of GI-RADS,LR2 model and ADNEX model was analyzed and compared.Results:1.The diagnostic efficacy of GI-RADS: when using GR1,GR2,GR3,the sensitivity was 90.15%,71.97%,48.48%,the specificity was 87.65%,95.82%,98.80%,the positive predictive value was 65.75%,81.90%,91.43%,the negative predictive value was 97.13%,92.86%,87.94%,the accuracy rates were 88.17%,90.85%,88.33%,and the Youden Index was 0.778,0.678,0.473,respectively.The diagnostic efficacy of GR1 was better than that of GR2 and GR3.The area under the receiver operating characteristic(ROC)curve was 0.924(95%CI: 0.900-0.943).2.The diagnostic efficacy of LR2 model: the sensitivity was 83.33%,the specificity was 90.84%,the positive predictive value was 70.51%,the negative predictive value was 95.40%,the accuracy rate was 89.27%,the Youden Index was0.742,and the area under the ROC curve was 0.915(95%CI: 0.891-0.936).3.The diagnostic efficacy of the ADNEX model: the sensitivity was 84.85%,the specificity was 85.86%,the positive predictive value was 61.20%,the negative predictive value was 95.57%,the accuracy rate was 85.65%,the Youden Index was0.707,and the area under the ROC curve was 0.933(95%CI: 0.911-0.951).4.Comparison of diagnostic effectiveness among GI-RADS,LR2 model and ADNEX model: The diagnostic efficacy of GI-RADS and LR2 model,GI-RADS and ADNEX model was comparable(P>0.05).The specificity of LR2 was significantly higher than that of ADNEX model.The difference was statistically significant(P<0.05).There was no difference in sensitivity,accuracy rate and the area under the ROC curve between LR2 model and ADNEX model(all P>0.05).GI-RADS,LR2 model and ADNEX model had high consistency between qualitative diagnosis and pathological diagnosis of adnexal tumors.5.When differentiating adnexal tumors of different pathological types(benign,borderline,stage Ⅰ ovarian cancer,stage Ⅱ-Ⅳ ovarian cancer and metastatic cancer),ADNEX model had the best diagnostic value in distinguishing benign tumor and stage Ⅱ-Ⅳ ovarian cancer(AUC=0.990,95%CI: 0.978-0.997),but the worst diagnostic value in distinguishing stage Ⅰ ovarian cancer and metastatic tumor(AUC=0.689,95%CI: 0.538-0.816),as well as distinguishing stage Ⅰ ovarian cancer and borderline tumor(AUC=0.735,95%CI: 0.620-0.830).Conclusions:1.GR1 is considered to be the most accurate of the three ways for GI-RADS to distinguish benign and malignant of adnexal tumors.2.ADNEX model shows its good value when differentiating different pathological types by junior doctors.But when evaluating between stageⅠ ovarian cancer and metastatic tumor,or between stage Ⅰ ovarian cancer and borderline tumor,it has limited value.3.When diagnosis of benign and malignant adnexal tumors by junior doctors,the diagnostic efficacy of GI-RADS,LR2 model and ADNEX model is excellent and comparable.Because of its convenience,GI-RADS is preferred to screen for adnexal malignant tumors.While ADNEX model could be used to distinguish different types of adnexal tumors.