Contrast-enhanced ultrasound quantitative parameters for predicting benign and malignant greater omentum lesions: an applied study

To explore the value of contrast-enhanced ultrasound (CEUS) quantitative parameters in differentiating benign and malignant diseases of the greater omentum and to establish a new CEUS Greater Omentum Imaging Reporting and Data System (CEUS-GOIRADS). We analyzed 15 CEUS parameters from 124 patients undergoing omental biopsy (2020–2024) to develop a noninvasive predictive model and assess its diagnostic value. Statistically significant parameters were further analyzed using receiver operating characteristic (ROC) curve cutoff values to determine odds ratios (ORs) for each group. A CEUS-OS was developed for each patient, and ROC curve analysis was performed to evaluate its efficacy in distinguishing between benign and malignant omental diseases. Among 124 patients meeting the inclusion criteria, 76 had malignant lesions and 48 had benign lesions. Multivariate analysis identified three out of 15 CEUS parameters—IMAX, Fs50, and WioAUC—as associated with malignant lesions of the greater omentum. The noninvasive predictive model demonstrated a sensitivity of 90.7% and specificity of 90.5% for diagnosing malignant omental lesions. Furthermore, the established CEUS-GOIRADS grading system showed a sensitivity of 94.7% and specificity of 89.6% for differentiating between benign and malignant omental diseases. Quantitative analysis of CEUS parameters provides effective indicators for determining the nature of greater omental lesions. This non-invasive imaging modality can reliably predict whether omental lesions are benign or malignant. The CEUS-GOIRADS demonstrates high sensitivity and specificity in differentiating benign from malignant omental diseases, suggesting its potential as a CEUS-GOIRADS valuable tool in the multi-step diagnostic evaluation of patients with various omental pathologies.