The predictive value of nomogram for adnexal cystic-solid masses based on O-RADS US, clinical and laboratory indicators

Abstract Background Ovarian cancer remains a leading cause of death among women, largely due to its asymptomatic early stages and high mortality when diagnosed late. Early detection significantly improves survival rates, and the Ovarian-Adnexal Reporting and Data System Ultrasound (O-RADS US) is cur...

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Main Authors: Chunchun Jin, Meifang Deng, Yanling Bei, Chan Zhang, Shiya Wang, Shun Yang, Lvhuan Qiu, Xiuyan Liu, Qiuxiang Chen
Format: Article
Language:English
Published: BMC 2024-11-01
Series:BMC Medical Imaging
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Online Access:https://doi.org/10.1186/s12880-024-01497-w
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author Chunchun Jin
Meifang Deng
Yanling Bei
Chan Zhang
Shiya Wang
Shun Yang
Lvhuan Qiu
Xiuyan Liu
Qiuxiang Chen
author_facet Chunchun Jin
Meifang Deng
Yanling Bei
Chan Zhang
Shiya Wang
Shun Yang
Lvhuan Qiu
Xiuyan Liu
Qiuxiang Chen
author_sort Chunchun Jin
collection DOAJ
description Abstract Background Ovarian cancer remains a leading cause of death among women, largely due to its asymptomatic early stages and high mortality when diagnosed late. Early detection significantly improves survival rates, and the Ovarian-Adnexal Reporting and Data System Ultrasound (O-RADS US) is currently the most commonly used method, but has limitations in specificity and accuracy. While O-RADS US has standardized reporting, its sensitivity can lead to the misdiagnosis of benign masses as malignant, resulting in overtreatment. This study aimed to construct a nomogram model based on the O-RADS US and clinical and laboratory indicators to predict the malignancy risk of adnexal cystic-solid masses. Methods This retrospective study collected data from patients with adnexal cystic-solid masses who underwent ultrasonography and were pathologically confirmed between January 2021 and December 2023 at the First Affiliated Hospital of Shenzhen University. They were categorized into benign and malignant groups according to pathological findings. Least absolute shrinkage and selection operator (LASSO) regression analysis was used to select the most relevant predictors of ovarian cancer. A nomogram model was constructed, and its diagnostic performance was calculated. We bootstrapped the data 500 times to perform internal verification, drew a calibration curve to verify the prediction ability, and performed a decision curve analysis to assess clinical usefulness. Results A total of 399 patients with adnexal cystic-solid masses were included in this study: 327 in the benign group and 72 in the malignant group. Five predictors associated with the risk of malignancy of adnexal cystic-solid masses were selected using LASSO regression: O-RADS, acoustic shadowing, postmenopausal status, CA125, and HE4. The area under the curve, sensitivity, specificity, accuracy, positive and negative predictive values of the nomogram were 0.909, 83.3%, 82.9%, 83.0%, 51.7%, and 95.8%, respectively. The calibration curve of the nomogram showed good consistency between the predicted and actual probabilities, and the decision curve showed good clinical usefulness. Conclusion The nomogram model based on O-RADS US and clinical and laboratory indicators can be used to predict the risk of malignancy in adnexal cystic-solid masses, with high predictive performance, good calibration, and clinical usefulness.
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spelling doaj-art-9a1bf2227e9b4e939dfc3fc5cd53bb402025-08-20T02:22:29ZengBMCBMC Medical Imaging1471-23422024-11-0124111310.1186/s12880-024-01497-wThe predictive value of nomogram for adnexal cystic-solid masses based on O-RADS US, clinical and laboratory indicatorsChunchun Jin0Meifang Deng1Yanling Bei2Chan Zhang3Shiya Wang4Shun Yang5Lvhuan Qiu6Xiuyan Liu7Qiuxiang Chen8Department of Ultrasound, Shenzhen Second People’s Hospital, The First Affiliated Hospital of Shenzhen University Health Science CenterDepartment of Ultrasound, Shenzhen Second People’s Hospital, The First Affiliated Hospital of Shenzhen University Health Science CenterDepartment of Ultrasound, Shenzhen Second People’s Hospital, The First Affiliated Hospital of Shenzhen University Health Science CenterDepartment of Ultrasound, Shenzhen Second People’s Hospital, The First Affiliated Hospital of Shenzhen University Health Science CenterDepartment of Ultrasound, Shenzhen Second People’s Hospital, The First Affiliated Hospital of Shenzhen University Health Science CenterDepartment of Ultrasound, Shenzhen Second People’s Hospital, The First Affiliated Hospital of Shenzhen University Health Science CenterDepartment of Ultrasound, Shenzhen Second People’s Hospital, The First Affiliated Hospital of Shenzhen University Health Science CenterDepartment of Ultrasound, Shenzhen Second People’s Hospital, The First Affiliated Hospital of Shenzhen University Health Science CenterDepartment of Ultrasound, Shenzhen Second People’s Hospital, The First Affiliated Hospital of Shenzhen University Health Science CenterAbstract Background Ovarian cancer remains a leading cause of death among women, largely due to its asymptomatic early stages and high mortality when diagnosed late. Early detection significantly improves survival rates, and the Ovarian-Adnexal Reporting and Data System Ultrasound (O-RADS US) is currently the most commonly used method, but has limitations in specificity and accuracy. While O-RADS US has standardized reporting, its sensitivity can lead to the misdiagnosis of benign masses as malignant, resulting in overtreatment. This study aimed to construct a nomogram model based on the O-RADS US and clinical and laboratory indicators to predict the malignancy risk of adnexal cystic-solid masses. Methods This retrospective study collected data from patients with adnexal cystic-solid masses who underwent ultrasonography and were pathologically confirmed between January 2021 and December 2023 at the First Affiliated Hospital of Shenzhen University. They were categorized into benign and malignant groups according to pathological findings. Least absolute shrinkage and selection operator (LASSO) regression analysis was used to select the most relevant predictors of ovarian cancer. A nomogram model was constructed, and its diagnostic performance was calculated. We bootstrapped the data 500 times to perform internal verification, drew a calibration curve to verify the prediction ability, and performed a decision curve analysis to assess clinical usefulness. Results A total of 399 patients with adnexal cystic-solid masses were included in this study: 327 in the benign group and 72 in the malignant group. Five predictors associated with the risk of malignancy of adnexal cystic-solid masses were selected using LASSO regression: O-RADS, acoustic shadowing, postmenopausal status, CA125, and HE4. The area under the curve, sensitivity, specificity, accuracy, positive and negative predictive values of the nomogram were 0.909, 83.3%, 82.9%, 83.0%, 51.7%, and 95.8%, respectively. The calibration curve of the nomogram showed good consistency between the predicted and actual probabilities, and the decision curve showed good clinical usefulness. Conclusion The nomogram model based on O-RADS US and clinical and laboratory indicators can be used to predict the risk of malignancy in adnexal cystic-solid masses, with high predictive performance, good calibration, and clinical usefulness.https://doi.org/10.1186/s12880-024-01497-wUltrasoundAdnexal massesOvarian-adnexal reporting and Data SystemO-RADSNomogramHE4
spellingShingle Chunchun Jin
Meifang Deng
Yanling Bei
Chan Zhang
Shiya Wang
Shun Yang
Lvhuan Qiu
Xiuyan Liu
Qiuxiang Chen
The predictive value of nomogram for adnexal cystic-solid masses based on O-RADS US, clinical and laboratory indicators
BMC Medical Imaging
Ultrasound
Adnexal masses
Ovarian-adnexal reporting and Data System
O-RADS
Nomogram
HE4
title The predictive value of nomogram for adnexal cystic-solid masses based on O-RADS US, clinical and laboratory indicators
title_full The predictive value of nomogram for adnexal cystic-solid masses based on O-RADS US, clinical and laboratory indicators
title_fullStr The predictive value of nomogram for adnexal cystic-solid masses based on O-RADS US, clinical and laboratory indicators
title_full_unstemmed The predictive value of nomogram for adnexal cystic-solid masses based on O-RADS US, clinical and laboratory indicators
title_short The predictive value of nomogram for adnexal cystic-solid masses based on O-RADS US, clinical and laboratory indicators
title_sort predictive value of nomogram for adnexal cystic solid masses based on o rads us clinical and laboratory indicators
topic Ultrasound
Adnexal masses
Ovarian-adnexal reporting and Data System
O-RADS
Nomogram
HE4
url https://doi.org/10.1186/s12880-024-01497-w
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