O-RADS MRI scoring system: key points for correct application in inexperienced hands
Abstract Objectives To evaluate the efficacy of the O-RADS MRI criteria in the stratification of risk of malignancy of solid or sonographically indeterminate ovarian masses and assess the interobserver agreement of this classification between experienced and inexperienced radiologists. Methods This...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2024-04-01
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| Series: | Insights into Imaging |
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| Online Access: | https://doi.org/10.1186/s13244-024-01670-3 |
| _version_ | 1797209264355278848 |
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| author | Lledó Cabedo Carmen Sebastià Meritxell Munmany Pere Fusté Lydia Gaba Adela Saco Adela Rodriguez Blanca Paño Carlos Nicolau |
| author_facet | Lledó Cabedo Carmen Sebastià Meritxell Munmany Pere Fusté Lydia Gaba Adela Saco Adela Rodriguez Blanca Paño Carlos Nicolau |
| author_sort | Lledó Cabedo |
| collection | DOAJ |
| description | Abstract Objectives To evaluate the efficacy of the O-RADS MRI criteria in the stratification of risk of malignancy of solid or sonographically indeterminate ovarian masses and assess the interobserver agreement of this classification between experienced and inexperienced radiologists. Methods This single-centre retrospective study included patients from 2019 to 2022 with sonographically indeterminate or solid ovarian masses who underwent MRI with a specific protocol for characterisation according to O-RADS MRI specifications. Each study was evaluated using O-RADS lexicon by two radiologists, one with 17 years of experience in gynaecological radiology and another with 4 years of experience in general radiology. Findings were classified as benign, borderline, or malignant according to histology or stability over time. Diagnostic performance and interobserver agreement were assessed. Results A total of 183 patients with US indeterminate or solid adnexal masses were included. Fifty-seven (31%) did not have ovarian masses, classified as O-RADS 1. The diagnostic performance for scores 2–5 was excellent with a sensitivity, specificity, PPV, and NPV of 97.4%, 100%, 96.2%, and 100%, respectively by the experienced radiologist and 96.1%, 92.0%, 93.9%, and 94.8% by the inexperienced radiologist. Interobserver concordance was very high (Kappa index 0.92). Almost all the misclassified cases were due to misinterpretation of the classification similar to reports in the literature. Conclusion The diagnostic performance of O-RADS MRI determined by either experienced or inexperienced radiologists is excellent, facilitating decision-making with high diagnostic accuracy and high reproducibility. Knowledge of this classification and use of assessment tools could avoid frequent errors due to misinterpretation. Critical relevance statement Up to 31% of ovarian masses are considered indeterminate by transvaginal US and 32% of solid lesions considered malignant by transvaginal US are benign. The O-RADs MRI accurately classifies these masses, even when used by inexperienced radiologists, thereby avoiding incorrect surgical approaches. Key points • O-RADS MRI accurately classifies indeterminate and solid ovarian masses by ultrasound. • There is excellent interobserver agreement between experienced and non-experienced radiologists. • O-RADS MRI is a helpful tool to assess clinical decision-making in ovarian tumours. Graphical Abstract |
| first_indexed | 2024-04-24T09:51:56Z |
| format | Article |
| id | doaj.art-2b9bce2bb69f40a8bdea3c9ca369d796 |
| institution | Directory Open Access Journal |
| issn | 1869-4101 |
| language | English |
| last_indexed | 2024-04-24T09:51:56Z |
| publishDate | 2024-04-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Insights into Imaging |
| spelling | doaj.art-2b9bce2bb69f40a8bdea3c9ca369d7962024-04-14T11:18:32ZengSpringerOpenInsights into Imaging1869-41012024-04-0115111510.1186/s13244-024-01670-3O-RADS MRI scoring system: key points for correct application in inexperienced handsLledó Cabedo0Carmen Sebastià1Meritxell Munmany2Pere Fusté3Lydia Gaba4Adela Saco5Adela Rodriguez6Blanca Paño7Carlos Nicolau8Department of Radiology, Hospital Clínic de BarcelonaDepartment of Radiology, Hospital Clínic de BarcelonaDepartment of Gynaecology and Obstetrics, Hospital Clínic de BarcelonaDepartment of Gynaecology and Obstetrics, Hospital Clínic de BarcelonaDepartment of Oncology, Hospital Clínic de BarcelonaDepartment of Pathology, Hospital Clínic de BarcelonaDepartment of Oncology, Hospital Clínic de BarcelonaDepartment of Radiology, Hospital Clínic de BarcelonaDepartment of Radiology, Hospital Clínic de BarcelonaAbstract Objectives To evaluate the efficacy of the O-RADS MRI criteria in the stratification of risk of malignancy of solid or sonographically indeterminate ovarian masses and assess the interobserver agreement of this classification between experienced and inexperienced radiologists. Methods This single-centre retrospective study included patients from 2019 to 2022 with sonographically indeterminate or solid ovarian masses who underwent MRI with a specific protocol for characterisation according to O-RADS MRI specifications. Each study was evaluated using O-RADS lexicon by two radiologists, one with 17 years of experience in gynaecological radiology and another with 4 years of experience in general radiology. Findings were classified as benign, borderline, or malignant according to histology or stability over time. Diagnostic performance and interobserver agreement were assessed. Results A total of 183 patients with US indeterminate or solid adnexal masses were included. Fifty-seven (31%) did not have ovarian masses, classified as O-RADS 1. The diagnostic performance for scores 2–5 was excellent with a sensitivity, specificity, PPV, and NPV of 97.4%, 100%, 96.2%, and 100%, respectively by the experienced radiologist and 96.1%, 92.0%, 93.9%, and 94.8% by the inexperienced radiologist. Interobserver concordance was very high (Kappa index 0.92). Almost all the misclassified cases were due to misinterpretation of the classification similar to reports in the literature. Conclusion The diagnostic performance of O-RADS MRI determined by either experienced or inexperienced radiologists is excellent, facilitating decision-making with high diagnostic accuracy and high reproducibility. Knowledge of this classification and use of assessment tools could avoid frequent errors due to misinterpretation. Critical relevance statement Up to 31% of ovarian masses are considered indeterminate by transvaginal US and 32% of solid lesions considered malignant by transvaginal US are benign. The O-RADs MRI accurately classifies these masses, even when used by inexperienced radiologists, thereby avoiding incorrect surgical approaches. Key points • O-RADS MRI accurately classifies indeterminate and solid ovarian masses by ultrasound. • There is excellent interobserver agreement between experienced and non-experienced radiologists. • O-RADS MRI is a helpful tool to assess clinical decision-making in ovarian tumours. Graphical Abstracthttps://doi.org/10.1186/s13244-024-01670-3CancerMRIOvary |
| spellingShingle | Lledó Cabedo Carmen Sebastià Meritxell Munmany Pere Fusté Lydia Gaba Adela Saco Adela Rodriguez Blanca Paño Carlos Nicolau O-RADS MRI scoring system: key points for correct application in inexperienced hands Insights into Imaging Cancer MRI Ovary |
| title | O-RADS MRI scoring system: key points for correct application in inexperienced hands |
| title_full | O-RADS MRI scoring system: key points for correct application in inexperienced hands |
| title_fullStr | O-RADS MRI scoring system: key points for correct application in inexperienced hands |
| title_full_unstemmed | O-RADS MRI scoring system: key points for correct application in inexperienced hands |
| title_short | O-RADS MRI scoring system: key points for correct application in inexperienced hands |
| title_sort | o rads mri scoring system key points for correct application in inexperienced hands |
| topic | Cancer MRI Ovary |
| url | https://doi.org/10.1186/s13244-024-01670-3 |
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