Comparisons Of Different Ultrasound Classification Models In The Evaluation Of Ovarian Masses

Objective:To compare the diagnostic performance of Ovarian-adnexal Reporting and Data System(O-RADS),Assessment of Different Neoplasias in the Adnex(ADNEX),Gynecologic Imaging Reporting and Data System(GI-RADS),International Ovarian Tumor Analysis(IOTA)Logistic Regression model 2(LR2),Simple Rules Risk model(SRRisk)in differentiating benign and malignant ovarian tumors by junior doctors.Methods:Retrospective analysis of ultrasonography data of 690 cases with adnexl mass confirmed pathologically.O-RADS,ADNEX,GI-RADS,LR2 and SRRisk were applied to assess and classify the ovarian masses by a junior doctor.O-RADS >class 3;GI-RADS > class 3;SRRisk > grade 3;ADNEX takes 10%;ADNEX ≥10%;LR2 is cut off at 10%,LR2 ≥ 10% was considered as malignant.The sensitivity,specificity,accuracy,negative predictive value and positive predictive value of these five methods were calculated.Then comparing the AUC,sensitivity,specificity and accuracy of the five methods.Results:1.Of a total of 690 cases met the standard,including 506 benign tumors(73.33%);There were 184 malignant tumors(26.67%),82 of which were borderline tumors).2.The diagnostic efficacy of O-RADS,ADNEX,GI-RADS,LR2,SRRisk:The AUC of O-RADS,ADNEX,GI-RADS,LR2,SRRisk were 0.909(95%CI:0.885-0.929),0.887(95%CI: 0.861-0.910),0.904(95%CI: 0.879-0.925),0.853(95%CI: 0.824-0.878),0.885(95%CI: 0.824-0.878);Youden Index were 0.818,0.774,0.808,0.706,0.770;sensitivity were 93.48%,85.87%,91.85%,80.43%,87.50%;specificity were 88.34%,91.50%,88.93%,90.12%,89.53%;accuracy were 89.71%,90.00%,89.71%,87.54%,88.99%;the positive predictive value were 78.61%,75.11%,74.75%,75.23%,74.46%;the negative predictive values were 97.39%,94.68%,96.77%,92.68% and 95.17%.3.Comparison of diagnostic performance of O-RADS,ADNEX,GI-RADS,LR2 and SRRISK: There was no significant difference in AUC between O-RADS,ADNEX,GI-RADS and SRRisk(all P>0.005),but AUC of O-RADS,ADNEX model and GI-RADS was higher than that of LR2(P value was 0.001,0.001,<0.001).The sensitivity of O-RADS,GI-RADS and SRRisk were similar(all P>0.005).O-RADS had higher sensitivity than that of ADNEX model and LR2(P<0.001).GI-RADS had higher sensitivity than LR2(P<0.001).The specificity and accuracy of the five methods were similar(all P>0.005).The consistency between O-RADS,ADNEX,GI-RADS and SRRisk is high(Kappa value>0.75).O-RADS,ADNEX and GI-RADS showed a high consistency between qualitative diagnosis and pathological results of ovarian tumors(Kappa value>0.75).Conclusions:1.O-RADS,ADNEX model,GI-RADS and SRRISK have high diagnostic efficiency.2.The consistency between O-RADS,ADNEX,GI-RADS and SRRisk is good.The diagnostic efficiency of O-RADS is comparable to that of ADNEX;GI-RADS and SRRisk,better than LR2.3.O-RADS,ADNEX,GI-RADS,SRRisk and LR2 can have higher diagnostic efficiency when used by a junior ultrasound physician and have its quality.O-RADS has its own advantages:its description of adnexal tumors is more standardized,and it provides relevant management programs for all risk categories.O-RADS can become a widely used classification system.