Skip to main content

ORIGINAL RESEARCH article

Front. Oncol.
Sec. Cancer Imaging and Image-directed Interventions
Volume 14 - 2024 | doi: 10.3389/fonc.2024.1369900

Clinical value of ACR O-RADS combined with CA125 in the risk stratification of adnexal masses

Provisionally accepted
Rui-Ke Pan Rui-Ke Pan 1Shu-Qin Zhang Shu-Qin Zhang 2*Xian-Ya Zhang Xian-Ya Zhang 3Tong Xu Tong Xu 3*Xin-Wu Cui Xin-Wu Cui 3Ran Li Ran Li 4*Ming Yu Ming Yu 2*Bo Zhang Bo Zhang 1*
  • 1 Department of Medical Ultrasound, Shanghai East Hospital of Clinical Medical College, Nanjing Medical University, Shanghai, China
  • 2 Department of Medical Ultrasound, The First People’s Hospital of Lianyungang, Lianyungang, Jiangsu Province, China
  • 3 Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
  • 4 Department of Medical Ultrasound, The First Affiliated Hospital of Xinxiang Medical University, Xinxiang, Henan Province, China

The final, formatted version of the article will be published soon.

    Purpose: To develop a combined diagnostic model integrating the sub-classification of the 2022 version of American College of Radiology (ACR) Ovarian-adnexal Reporting and Data System (O-RADS) with carbohydrate antigen 125 (CA125) and to validate whether the combined model can offer superior diagnostic efficacy than O-RADS alone in assessing adnexal malignancy risk. Methods: A retrospective analysis was performed on 593 patients with adnexal masses (AMs) and the pathological and clinical data were included. According to the large differences in malignancy risk indices for different image features in O-RADS category 4, the lesions were categorized into groups A and B. A new diagnostic criterion was developed. Lesions identified as a category of 1, 2, 3 and 4A with a CA125 level below 35 U/ml were classified as benign. Lesions identified as a category of 4A with a CA125 level more than or equal to 35 U/ml and lesions with a category of 4B and 5 were classified as malignant. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy and the area under the curve (AUC) of O-RADS(v2022), CA125 and the combined model in the diagnosis of AMs were calculated and compared.The sensitivity, specificity, PPV, NPV, accuracy and AUCs of the combined model were 92.4%, 96.5%, 80.2%, 98.8%, 94.1% and 0.945, respectively. The specificity, PPV, accuracy and AUC of the combined model were significantly higher than those of O-RADS alone (all P < 0.01). In addition, both models had acceptable sensitivity and NPV but there were no significant differences among them (P > 0.05).The combined model integrating O-RADS sub-classification with CA125 could improve the specificity and PPV in diagnosing malignant AMs. It could be a valuable tool in the clinical application of risk stratification of AMs.

    Keywords: O-RADS, CA125, Adnexal masses, ultrasound, malignancy risk

    Received: 13 Jan 2024; Accepted: 13 Aug 2024.

    Copyright: © 2024 Pan, Zhang, Zhang, Xu, Cui, Li, Yu and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Shu-Qin Zhang, Department of Medical Ultrasound, The First People’s Hospital of Lianyungang, Lianyungang, 222002, Jiangsu Province, China
    Tong Xu, Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei Province, China
    Ran Li, Department of Medical Ultrasound, The First Affiliated Hospital of Xinxiang Medical University, Xinxiang, 453100, Henan Province, China
    Ming Yu, Department of Medical Ultrasound, The First People’s Hospital of Lianyungang, Lianyungang, 222002, Jiangsu Province, China
    Bo Zhang, Department of Medical Ultrasound, Shanghai East Hospital of Clinical Medical College, Nanjing Medical University, Shanghai, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.