OC05.05: Integrating contrast‐enhanced ultrasound to ovarian‐adnexal reporting and data system ultrasound scoring for the characterisation of adnexal lesions with solid components: time‐intensity curves or subjective assessment?

This study aims to compare the diagnostic accuracy of time-intensity curve (TIC) analysis and subjective visual assessment in contrast-enhanced ultrasound (CEUS), both integrated within the Ovarian-Adnexal Reporting and Data System (O-RADS) US risk stratification system, for characterising adnexal lesions with solid components. In this prospective, multicentre study conducted from September 2021 to December 2022, women with suspected adnexal lesions were enrolled. All participants underwent preoperative CEUS examinations. Histopathological findings were used as the gold standard for diagnosis. Lesions were classified according to the O-RADS US system. Enhancement of solid tissue compared to the outer myometrium was evaluated using both TIC analysis and subjective visual assessment. The diagnostic performance of these methods was assessed using receiver operating characteristic (ROC) curve analysis. The study analysed 180 lesions in 175 women, categorising 80 as malignant and 100 as benign. Incorporating CEUS with O-RADS US, assessed through both TIC analysis and subjective visual assessment, showed significantly improved diagnostic performance over O-RADS US alone, with an area under the curve (AUC) of 0.85 compared to 0.78. No significant difference was observed between the performance of TIC analysis and subjective visual assessment in the enhancement evaluation of solid tissue by CEUS for adnexal malignancy categorization (P = 0.83). Subjective visual assessment of solid tissue enhancement in adnexal lesions showed comparable accuracy to TIC analysis when used alongside CEUS in conjunction with the O-RADS US score for detecting adnexal malignancy.