Diagnostic performance of CEUS combined with O-RADS ultrasound risk stratification for adnexal masses: A systematic review and meta-analysis

Background and study aims A number of studies have reported that contrast-enhanced ultrasound (CEUS) imaging might be used for the early diagnosis of adnexal masses. A meta-analysis was performed to evaluate the diagnostic accuracy of CEUS combined with Ovarian−Adnexal Reporting and Data System (O-RADS) ultrasound risk stratification for adnexal masses. Patients and methods Related articles was retrieved from PubMed, Web of Science, Embase and the Cochrane Library in strict accordance with established standards, and data (including true positive, false positive, false negative and true negative value) was extracted from the original articles. The Quality Assessment of Diagnostic Accuracy Studies 2 was used to evaluate the quality of articles and the possibility of bias. STATA 12.0 Software were used to perform statistical analysis. Results Five articles included 598 patients were analyzed in this meta-analysis. The pooled sensitivity and specificity of CEUS combined with O-RADS for the diagnosis of adnexal masses were 0.95 (95% confidence interval [CI]: 0.91-0.98), and 0.86 (95% CI: 0.79-0.91). Moreover, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio (DOR), and the area under the curve (AUC) were 6.81 (95% CI: 4.61-10.08), 0.05 (95% CI: 0.03-0.11), 111.30 (95% CI: 65.32-189.65) and 0.97 (95% CI: 0.95-0.98), respectively. The pooled AUC and DOR for the detection of CEUS combined with O-RADS were superior to O-RADS US. Conclusions Our findings revealed that O-RADS combined with CEUS can improve the diagnostic accuracy of ovarian adnexal masses.