Integrating Contrast-enhanced US to O-RADS US for Classification of Adnexal Lesions with Solid Components: Time-intensity Curve Analysis versus Visual Assessment.
Manli Wu, Ying Wang, Manting Su, Ruili Wang, Xiaofeng Sun, Rui Zhang, Liang Mu, Li Xiao, Hong Wen, Tingting Liu, Xiaotao Meng, Licong Huang, Xinling Zhang
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Abstract
Purpose To compare the diagnostic performance of time-intensity curve (TIC) analysis and subjective visual assessment of contrast-enhanced US (CEUS) when integrated with the Ovarian-Adnexal Reporting and Data System (O-RADS) US risk stratification system for characterizing adnexal lesions with solid components. Materials and Methods In this prospective multicenter study conducted from September 2021 to December 2022, female individuals with suspected adnexal lesions containing solid components detected at routine US were enrolled. All participants underwent preoperative CEUS examinations. Histopathologic findings were used as the reference standard for diagnosis. Lesions were classified according to the O-RADS US system. Enhancement of solid tissue compared with the outer myometrium was evaluated using both TIC analysis and subjective visual assessment. The diagnostic performance of O-RADS alone and each CEUS assessment method when integrated with the O-RADS US system was assessed and compared using receiver operating characteristic curve analysis. Results A total of 180 lesions (80 malignant and 100 benign histopathologic outcomes) in 175 participants (median age, 47 years [IQR, 33-56]) were analyzed. Incorporating CEUS (assessed through both TIC analysis and subjective visual assessment) with O-RADS US showed significantly improved diagnostic performance over O-RADS US alone, with an area under the receiver operating characteristic curve (AUC) of 0.86 (95% CI: 0.80, 0.91) compared with 0.78 (95% CI: 0.71, 0.84). No evidence of a difference was observed between the AUCs of TIC analysis and subjective visual assessment in the enhancement evaluation of solid tissue with CEUS for adnexal malignancy categorization (P = .83). Conclusion Subjective visual assessment and TIC analysis of CEUS features when integrated with the O-RADS US scoring system showed comparable diagnostic performance in assigning adnexal malignancy risk. Keywords: Adnexal Lesions, Contrast-enhanced US, O-RADS, Time-intensity Curve Analysis Supplemental material is available for this article. © RSNA, 2024.
将对比增强 US 与 O-RADS US 相结合,对有实性成分的附件病变进行分类:时间强度曲线分析与目测评估。
目的 比较对比增强造影剂 US(CEUS)的时间强度曲线(TIC)分析和主观视觉评估与卵巢-附件报告和数据系统(O-RADS)US 风险分层系统整合后对含有实性成分的附件病变的诊断性能。材料与方法 在这项于 2021 年 9 月至 2022 年 12 月进行的前瞻性多中心研究中,纳入了常规 US 检测到疑似附件病变(含实性成分)的女性患者。所有参与者均接受了术前 CEUS 检查。组织病理学检查结果作为诊断的参考标准。根据 O-RADS US 系统对病变进行分类。与子宫外层肌层相比,实性组织的增强情况通过 TIC 分析和主观视觉评估进行评估。使用接收器操作特征曲线分析法评估和比较了单独使用 O-RADS 和将每种 CEUS 评估方法与 O-RADS US 系统整合后的诊断性能。结果 对 175 名参与者(中位年龄 47 岁 [IQR,33-56])的 180 个病变(80 个恶性和 100 个良性组织病理学结果)进行了分析。将 CEUS(通过 TIC 分析和主观目测评估)与 O-RADS US 结合使用,诊断效果明显优于单独使用 O-RADS US,接收器操作特征曲线下面积 (AUC) 为 0.86(95% CI:0.80, 0.91),而 O-RADS US 为 0.78(95% CI:0.71, 0.84)。在使用 CEUS 对实体组织进行增强评估以进行附件恶性肿瘤分类时,未观察到 TIC 分析和主观视觉评估的 AUC 之间存在差异(P = 0.83)。结论 CEUS特征的主观视觉评估和TIC分析与O-RADS US评分系统相结合,在评估附件恶性肿瘤风险方面显示出相当的诊断性能。关键词附件病变 对比增强 US O-RADS 时间强度曲线分析 本文有补充材料。© RSNA, 2024.
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