Ovarian-Adnexal Reporting and Data System in describing and classifying adnexal masses: inter-reviewer agreement

doi:10.3877/cma.j.issn.1672-6448.2022.11.007

Abstract

Abstract:

Objective

To evaluate the inter-reviewer agreement (IRA) of the American College of Radiology (ACR) Ovarian-Adnexal Reporting and Data System (O-RADS) in describing and classifying adnexal masses (AMs) among different physicians.

Methods

This retrospective study included 392 AMs (353 benign, 39 malignant) collected at the Maternal and Child Health Hospital of Hubei Province between January 2019 and December 2019. Two sonographers who were blind to the history and pathology analyzed all ultrasound images, and then recorded the descriptors and the O-RADS classifications, independently. The Fleiss kappa (κ) test was applied to evaluate the IRA of O-RADS descriptive terms and scoring results.

Results

For the two sonographers, the IRA of descriptive terms for ascites or peritoneal nodules was very good (κ=0.940, P＜0.001), that for AMs category and morphology of inner wall or external contour was good (κ=0.762 and 0.712, P＜0.001 and=0.048, respectively), that for vascularity was fair (κ=0.510, P＜0.001), and that for papillary projection was poor (κ=0.362, P＜0.001). The IRA of the O-RADS classification was good (κ=0.742, P＜0.001).

Conclusion

The ACR O-RADS classification has good diagnostic consistency among different physicians, and it can be used as an objective method for the diagnosis of AMs and is of great value for standardizing ultrasound report and reducing the interpretation error among different physicians.

Key words: Reporting and data system, Ovarian-adnexal, Adnexal masses, Medical ultrosound

Cai Xu, Zongjing Huang, Tao Zhang, Sheng Zhao, Xinwu Cui. Ovarian-Adnexal Reporting and Data System in describing and classifying adnexal masses: inter-reviewer agreement[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2022, 19(11): 1193-1197.

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URL: https://chaosheng.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1672-6448.2022.11.007

https://chaosheng.cma-cmc.com.cn/EN/Y2022/V19/I11/1193

Figures/Tables 5

References 10

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O-RADS分类	恶性风险值	术语
0	检查未完成
1	正常卵巢	卵泡、黄体
2	几乎可以肯定为良性（＜1%）	单房囊肿无实性成分	内壁光滑，＜10 cm
		典型良性病变	典型的出血性囊肿、皮样囊肿、子宫内膜异位囊肿，＜10 cm
		典型良性病变	单纯卵巢旁囊肿、典型腹膜包涵囊肿、典型输卵管积水，任意大小
3	低风险（≥1%，＜10%）	单房囊肿无实性成分	内壁光滑（单纯性或非单纯性），≥10 cm
		单房囊肿无实性成分	内壁不规则增厚，厚径＜3 mm，任意大小
		典型良性病变	典型出血性囊肿、皮样囊肿、子宫内膜异位囊肿≥10 cm
		多房囊肿无实性成分	内壁光滑，＜10 cm，血流评分=1~3分
		实质性病变	外缘光滑，任意大小，血流评分=1分
4	中等风险（≥10%，＜50%）	单房囊肿有实性成分	任意大小，乳头状突起0~3个，任意血流评分
		多房囊肿无实性成分	（1）内壁光滑，≥10 cm，血流评分=1~3分；（2）任意大小，内壁光滑，血流评分=4分；（3）内壁或隔膜不规则，任意大小、任意血流评分
		多房囊肿有实性成分	任意大小，血流评分=1~2分
		实质性病变	外缘光滑，任意大小，血流评分=2~3分
5	高风险（≥50%）	单房囊肿有实性成分	乳头状突起≥4个，任意大小、任意血流评分
		多房囊肿有实性成分	任意大小，血流评分=3~4分
		实质性病变	（1）外缘规则，任意大小，血流评分=4分；（2）不规则，任意大小、任意血流评分
		腹水或腹膜结节	排除生理性或者O-RADS 2类

O-RADS分类	恶性风险值	术语
0	检查未完成
1	正常卵巢	卵泡、黄体
2	几乎可以肯定为良性（＜1%）	单房囊肿无实性成分	内壁光滑，＜10 cm
		典型良性病变	典型的出血性囊肿、皮样囊肿、子宫内膜异位囊肿，＜10 cm
		典型良性病变	单纯卵巢旁囊肿、典型腹膜包涵囊肿、典型输卵管积水，任意大小
3	低风险（≥1%，＜10%）	单房囊肿无实性成分	内壁光滑（单纯性或非单纯性），≥10 cm
		单房囊肿无实性成分	内壁不规则增厚，厚径＜3 mm，任意大小
		典型良性病变	典型出血性囊肿、皮样囊肿、子宫内膜异位囊肿≥10 cm
		多房囊肿无实性成分	内壁光滑，＜10 cm，血流评分=1~3分
		实质性病变	外缘光滑，任意大小，血流评分=1分
4	中等风险（≥10%，＜50%）	单房囊肿有实性成分	任意大小，乳头状突起0~3个，任意血流评分
		多房囊肿无实性成分	（1）内壁光滑，≥10 cm，血流评分=1~3分；（2）任意大小，内壁光滑，血流评分=4分；（3）内壁或隔膜不规则，任意大小、任意血流评分
		多房囊肿有实性成分	任意大小，血流评分=1~2分
		实质性病变	外缘光滑，任意大小，血流评分=2~3分
5	高风险（≥50%）	单房囊肿有实性成分	乳头状突起≥4个，任意大小、任意血流评分
		多房囊肿有实性成分	任意大小，血流评分=3~4分
		实质性病变	（1）外缘规则，任意大小，血流评分=4分；（2）不规则，任意大小、任意血流评分
		腹水或腹膜结节	排除生理性或者O-RADS 2类

甲医师	乙医师				合计
甲医师	2类	3类	4类	5类	合计
2类	249	4	6	0	259
3类	9	46	4	1	60
4类	5	4	29	11	49
5类	1	0	7	16	24
合计	264	54	46	28	392

甲医师	乙医师				合计
甲医师	2类	3类	4类	5类	合计
2类	249	4	6	0	259
3类	9	46	4	1	60
4类	5	4	29	11	49
5类	1	0	7	16	24
合计	264	54	46	28	392

[1]	Cai Xu, Yuan Zhou, Sheng Zhao, Xinwu Cui. Value of ovarian-adnexal reporting and data system in differential diagnosis of benign and malignant adnexal masses [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(01): 51-56.
[2]	Zhi Wang, Kana Wang, Ling Min, Fan Yang, Xiaorong Qi, Ying Zheng. Clinical analysis of 14 cases of laparoendoscopic single-site surgery with adnexal masses in pregnancy [J]. Chinese Journal of Laparoscopic Surgery(Electronic Edition), 2021, 14(05): 304-308.

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