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Liu D, Lyu G, Lai H, Li L, Gan Y, Yang S. Can the ultrasound microcystic pattern accurately predict borderline ovarian tumors? J Ovarian Res 2023; 16:162. [PMID: 37563718 PMCID: PMC10416400 DOI: 10.1186/s13048-023-01253-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 08/04/2023] [Indexed: 08/12/2023] Open
Abstract
OBJECTIVE To investigate whether the ultrasound microcystic pattern (MCP) can accurately predict borderline ovarian tumors (BOTs). METHODS A retrospective collection of 393 patients who met the inclusion criteria was used as the study population. Indicators that could well identify BOT in different pathological types of tumors were derived by multivariate unordered logistic regression analysis. Finally, the correlation between ultrasound MCP and pathological features was analyzed. RESULTS (1) MCP was present in 55 of 393 ovarian tumors, including 34 BOTs (34/68, 50.0%), 16 malignant tumors (16/88, 18.2%), and 5 benign tumors (5/237, 2.1%). (2) Univariate screening showed significant differences (P < 0.05) in patient age, CA-125 level, ascites, > 10 cyst locules, a solid component, blood flow, and MCP among BOTs, benign ovarian tumors, and malignant ovarian tumors. (3) Multivariate unordered logistic regression analysis showed that the blood flow, > 10 cyst locules, and MCP were significant factors in identifying BOTs (P < 0.05). (4) The pathology of ovarian tumors with MCP showed "bubble"- or "fork"- like loose tissue structures. CONCLUSION MCP can be observed in different pathological types of ovarian tumors and can be used as a novel sonographic marker to differentiate between BOTs, benign tumors and malignant tumors. MCP may arise as a result of anechoic cystic fluid filling the loose tissue gap.
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Affiliation(s)
- Danyi Liu
- Department of Ultrasound, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian, China
| | - Guorong Lyu
- Department of Ultrasound, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian, China.
- Department of Ultrasound, Collaborative Innovation Center for Maternal and Infant Health Service Application Technology, Quanzhou Medical College, No.2, Anji Road, Quanzhou, Fujian, China.
| | - Hongwei Lai
- Department of Ultrasound, Fujian Provincial Maternity and Children's Hospital, Fuzhou, Fujian, China
| | - Liya Li
- Department of Ultrasound, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian, China
| | - Yaduan Gan
- Department of Ultrasound, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, Fujian, China
| | - Shuping Yang
- Department of Ultrasound, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, Fujian, China
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Gong LP, Li XY, Wu YN, Dong S, Zhang S, Feng YN, Lv YE, Guo XJ, Peng YQ, Du XS, Tian JW, Sun CX, Sun LT. Nomogram based on the O-RADS for predicting the malignancy risk of adnexal masses with complex ultrasound morphology. J Ovarian Res 2023; 16:57. [PMID: 36945000 PMCID: PMC10029304 DOI: 10.1186/s13048-023-01133-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 03/09/2023] [Indexed: 03/23/2023] Open
Abstract
OBJECTIVE The accurate preoperative differentiation of benign and malignant adnexal masses, especially those with complex ultrasound morphology, remains a great challenge for junior sonographers. The purpose of this study was to develop and validate a nomogram based on the Ovarian-Adnexal Reporting and Data System (O-RADS) for predicting the malignancy risk of adnexal masses with complex ultrasound morphology. METHODS A total of 243 patients with data on adnexal masses with complex ultrasound morphology from January 2019 to December 2020 were selected to establish the training cohort, while 106 patients with data from January 2021 to December 2021 served as the validation cohort. Univariate and multivariate analyses were used to determine independent risk factors for malignant tumors in the training cohort. Subsequently, a predictive nomogram model was developed and validated in the validation cohort. The calibration, discrimination, and clinical net benefit of the nomogram model were assessed separately by calibration curves, receiver operating characteristic (ROC) curves, and decision curve analysis (DCA). Finally, we compared this model to the O-RADS. RESULTS The O-RADS category, an elevated CA125 level, acoustic shadowing and a papillary projection with color Doppler flow were the independent predictors and were incorporated into the nomogram model. The area under the ROC curve (AUC) of the nomogram model was 0.958 (95% CI, 0.932-0.984) in the training cohort. The specificity and sensitivity were 0.939 and 0.893, respectively. This nomogram also showed good discrimination in the validation cohort (AUC = 0.940, 95% CI, 0.899-0.981), with a sensitivity of 0.915 and specificity of 0.797. In addition, the nomogram model showed good calibration efficiency in both the training and validation cohorts. DCA indicated that the nomogram was clinically useful. Furthermore, the nomogram model had higher AUC and net benefit than the O-RADS. CONCLUSION The nomogram based on the O-RADS showed a good predictive ability for the malignancy risk of adnexal masses with complex ultrasound morphology and could provide help for junior sonographers.
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Affiliation(s)
- Li-Ping Gong
- Department of Ultrasound, Zhejiang Provincial People's Hospital, Hangzhou, 310014, Zhejiang Province, China
| | - Xiao-Ying Li
- Department of Ultrasound, Zhejiang Provincial People's Hospital, Hangzhou, 310014, Zhejiang Province, China
| | - Ying-Nan Wu
- Department of Ultrasound, Zhejiang Provincial People's Hospital, Hangzhou, 310014, Zhejiang Province, China
| | - Shuang Dong
- Department of Ultrasound, Zhejiang Provincial People's Hospital, Hangzhou, 310014, Zhejiang Province, China
| | - Shuang Zhang
- Department of Ultrasound, The Second Affiliated Hospital of Harbin Medical University, Harbin, 150001, Heilongjiang Province, China
| | - Ya-Nan Feng
- Department of Ultrasound, Zhejiang Provincial People's Hospital, Hangzhou, 310014, Zhejiang Province, China
| | - Ya-Er Lv
- Department of Ultrasound, Zhejiang Provincial People's Hospital, Hangzhou, 310014, Zhejiang Province, China
| | - Xi-Juan Guo
- Department of Ultrasound, Shijiazhuang Obstetrics and Gynecology Hospital, Shijiazhuang, 050011, Hebei Province, China
| | - Yan-Qing Peng
- Department of Ultrasound, Zhejiang Provincial People's Hospital, Hangzhou, 310014, Zhejiang Province, China
| | - Xiao-Shan Du
- Department of Ultrasound, The Second Affiliated Hospital of Harbin Medical University, Harbin, 150001, Heilongjiang Province, China
| | - Jia-Wei Tian
- Department of Ultrasound, The Second Affiliated Hospital of Harbin Medical University, Harbin, 150001, Heilongjiang Province, China
| | - Cong-Xin Sun
- Department of Ultrasound, Shijiazhuang Obstetrics and Gynecology Hospital, Shijiazhuang, 050011, Hebei Province, China.
| | - Li-Tao Sun
- Department of Ultrasound, Zhejiang Provincial People's Hospital, Hangzhou, 310014, Zhejiang Province, China.
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Wang M, Li Y, Xu T, Shi C, Jiang L, Liu K. Clinical Analysis of 17 Cases of Borderline Ovarian Tumors During Pregnancy. Front Oncol 2022; 12:934751. [PMID: 35912239 PMCID: PMC9326021 DOI: 10.3389/fonc.2022.934751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 06/15/2022] [Indexed: 11/30/2022] Open
Abstract
Objective The study retrospectively analyzed the clinical characteristics and prognosis of 17 cases of pregnancy complicated by borderline ovarian tumors to provide help for clinical workers. Materials and Methods The clinicopathological data of 17 patients with ovarian borderline tumors during pregnancy at the Shengjing Hospital of China Medical University from January 2015 to June 2021 were collected and analyzed retrospectively. The average age of the patients was 31.82 years (25–45 years), the average number of pregnancies was 2.06 times (1–6 times), and the average number of births was 0.41 times (0–1 time). Results Among the 17 patients, 4 were diagnosed in the first trimester, 2 in the second trimester, and 11 in the third trimester. Most of the first symptoms were cysts, cyst enlargement, or cyst rupture. Among them, 3 cases (1 in the first trimester and 2 in the second trimester) continued pregnancy after a conservative operation, 9 cases underwent cesarean section and a conservative operation simultaneously, and the mother and child had a good outcome. Two cases underwent conservative operations and induced abortion, and 1 case underwent an ectopic pregnancy operation at the same time. The prognosis of the patients was good without recurrence. Conclusion Preoperative diagnosis of borderline ovarian tumors in pregnancy is delayed, and imaging and tumor markers are not specific. The coincidence rate between intraoperative frozen pathology and postoperative paraffin pathology was not high. Borderline tumors are mainly treated by surgery, and the prognosis for mothers and infants is good.
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Lai HW, Lyu GR, Kang Z, Li LY, Zhang Y, Huang YJ. Comparison of O-RADS, GI-RADS, and ADNEX for Diagnosis of Adnexal Masses: An External Validation Study Conducted by Junior Sonologists. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2022; 41:1497-1507. [PMID: 34549454 DOI: 10.1002/jum.15834] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Revised: 08/09/2021] [Accepted: 08/15/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To externally validate the Ovarian-adnexal Reporting and Data System (O-RADS) and evaluate its performance in differentiating benign from malignant adnexal masses (AMs) compared with the Gynecologic Imaging Reporting and Data System (GI-RADS) and Assessment of Different NEoplasias in the adneXa (ADNEX). METHODS A retrospective analysis was performed on 734 cases from the Second Affiliated Hospital of Fujian Medical University. All patients underwent transvaginal or transabdominal ultrasound examination. Pathological diagnoses were obtained for all the included AMs. O-RADS, GI-RADS, and ADNEX were used to evaluate AMs by two sonologists, and the diagnostic efficacy of the three systems was analyzed and compared using pathology as the gold standard. We used the kappa index to evaluate the inter-reviewer agreement (IRA). RESULTS A total of 734 AMs, including 564 benign masses, 69 borderline masses, and 101 malignant masses were included in this study. O-RADS (0.88) and GI-RADS (0.90) had lower sensitivity than ADNEX (0.95) (P < .05), and the PPV of O-RADS (0.98) was higher than that of ADNEX (0.96) (P < .05). These three systems showed good IRA. CONCLUSION O-RADS, GI-RADS, and ADNEX showed little difference in diagnostic performance among resident sonologists. These three systems have their own characteristics and can be selected according to the type of center, access to patients' clinical data, or personal comfort.
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Affiliation(s)
- Hong-Wei Lai
- Department of Ultrasound, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Guo-Rong Lyu
- Department of Ultrasound, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
- Quanzhou Medical College, Quanzhou, China
| | - Zhuo Kang
- Department of Ultrasound, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Li-Ya Li
- Department of Ultrasound, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Ying Zhang
- Department of Ultrasound, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Yi-Jun Huang
- Department of Ultrasound, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
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Clinical Analysis of 137 Cases of Ovarian Tumors in Pregnancy. JOURNAL OF ONCOLOGY 2022; 2022:1907322. [PMID: 35664560 PMCID: PMC9159870 DOI: 10.1155/2022/1907322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 03/17/2022] [Accepted: 03/18/2022] [Indexed: 11/18/2022]
Abstract
Ovarian tumors do not really typically occur in association with pregnant; however, once they do, the treatment is critical. It is important to note that around 6% of ovarian tumors in pregnancies are cancerous. The problems induced by ovarian tumors in pregnancy particularly necessitate rapid medical intervention and are much more frequent than cancer. Medication choices and survival of ovary tumor patients could be influenced by varied diagnoses of ovarian masses. So, we present an upgraded logistic regression (ULR) approach in this paper. Initially, the collection of 137 patient datasets was employed in screening test to identify the ovarian tumor as benign-tumor and malignant-tumor by using contrast-enhanced ultrasonography (CEU) method. Then, the screening test images are preprocessed using wavelet transform (WT) approach. The preprocessed data are extracted by using local binary pattern (LBP) and laws' texture energy (LTE) techniques. Finally, the clinical analysis of the ovarian tumor can be obtained by the proposed ULR approach. The performances were examined and compared with existing approaches to achieve the proposed approach with greatest correctness. The findings are depicted by utilizing the MATLAB tool.
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Timor-Tritsch IE, Monteagudo A, Popiolek DA, Duncan KM, Goldstein SR. Reaffirming microcystic ultrasound appearance of borderline ovarian tumors using three-dimensional 'silhouette' rendering. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2022; 59:700-704. [PMID: 35195307 DOI: 10.1002/uog.24883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 01/04/2022] [Accepted: 02/14/2022] [Indexed: 06/14/2023]
Affiliation(s)
- I E Timor-Tritsch
- Department of Obstetrics and Gynecology, New York University School of Medicine, New York, NY, USA
| | - A Monteagudo
- Icahn School of Medicine, Carnegie Imaging for Women, New York, NY, USA
| | - D A Popiolek
- Department of Pathology, New York University School of Medicine, New York, NY, USA
| | - K M Duncan
- Department of Obstetrics and Gynecology, New York University School of Medicine, New York, NY, USA
| | - S R Goldstein
- Department of Obstetrics and Gynecology, New York University School of Medicine, New York, NY, USA
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Qian L, Du Q, Jiang M, Yuan F, Chen H, Feng W. Comparison of the Diagnostic Performances of Ultrasound-Based Models for Predicting Malignancy in Patients With Adnexal Masses. Front Oncol 2021; 11:673722. [PMID: 34141619 PMCID: PMC8204044 DOI: 10.3389/fonc.2021.673722] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Accepted: 05/07/2021] [Indexed: 11/29/2022] Open
Abstract
Aim This study aimed to compare different ultrasound-based International Ovarian Tumor Analysis (IOTA) prediction models, namely, the Simple Rules (SRs) the Assessment of Different NEoplasias in the adneXa (ADNEX) models, and the Risk of Malignancy Index (RMI), for the pre-operative diagnosis of adnexal mass. Methods This single-centre diagnostic accuracy study involved 486 patients. All ultrasound examinations were analyzed and the prediction models were applied. Pathology was the clinical reference standard. The diagnostic performances of prediction models were measured by evaluating receiver-operating characteristic curves, sensitivities, specificities, positive and negative predictive values, positive and negative likelihood ratios, and diagnostic odds ratios. Results To discriminate benign and malignant tumors, areas under the ROC curves (AUCs) for ADNEX models were 0.94 (95% CI: 0.92–0.96) with CA125 and 0.94 (95% CI: 0.91–0.96) without CA125, which were significantly higher than the AUCs for RMI I-III: 0.87 (95% CI: 0.83–0.90), 0.83 (95% CI: 0.80–0.86), and 0.82 (95% CI: 0.78–0.86), (all P < 0.0001). At a cut-off of 10%, the ADNEX model with CA125 had the highest sensitivity (0.93; 95% CI: 0.87–0.97) compared with the other models. The SRs model achieved a sensitivity of 0.93 (95% CI: 0.86–0.97) and a specificity of 0.86 (95% CI: 0.82–0.89) when inconclusive diagnoses (11.7%) were classified as malignant. Conclusion ADNEX and SRs models were excellent at characterising adnexal masses which were superior to the RMI in Chinese patients.
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Affiliation(s)
- Le Qian
- Department of Obstetrics and Gynecology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Qinwen Du
- Department of Obstetrics and Gynecology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Meijiao Jiang
- Department of Obstetrics and Gynecology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Fei Yuan
- Department of Pathology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Hui Chen
- Department of Obstetrics and Gynecology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Weiwei Feng
- Department of Obstetrics and Gynecology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
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