EP23.04: Comparison of transabdominal and transvaginal contrast‐enhanced ultrasound (US) to ovarian‐adnexal reporting and data system US in assessing adnexal masses

To compare the performance of adding value of transabdominal and transvaginal contrast-enhanced ultrasound (US) to ovarian-adnexal reporting and data system US (O-RADS US) in differential diagnosis of adnexal masses. A total of 180 adnexal masses with solid components in 175 women were enrolled in study between September 2021 and November 2022. All patients underwent routine Doppler US examinations and contrast-enhanced US examinations. All patients were scheduled for surgery and pathological results served as the reference standard. Routine Doppler US, contrast-enhanced US images and video were reviewed by a subspecialty radiologist. The O-RADS US was downgraded or upgraded according to the contrast-enhanced US characteristics of the masses. The diagnostic accuracy was assessed using ROC curve analysis. The area under the ROC curve AUC was calculated to compare the diagnostic performance of adding value of transabdominal and transvaginal contrast-enhanced US to O-RADS US. The diagnostic performance of adding transabdominal and transvaginal contrast-enhanced US to O-RADS US were both significantly higher than that of O-RADS US alone (AUC: 0.83 vs 0.76, P = 0.018; AUC: 0.92 vs 0.81, P = 0.013). Combing transvaginal contrast-enhanced US and O-RADS US was superior to that of combing transabdominal contrast-enhanced US and O-RADS US in the differential diagnosis of adnexal masses (P = 0.047). When the maximal diameter of adnexal masses ≤ 40 mm, combing transabdominal contrast-enhanced US and O-RADS US presented the lowest diagnostic performance, with an AUC of 0.73. Transvaginal contrast-enhanced US was superior to that of transabdominal contrast-enhanced US in assessing adnexal masses with solid components. When the maximal diameter of adnexal masses ≤ 40 mm transvaginal contrast-enhanced US examination was recommended.