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| 1 | Reliability of ultrasound ovarian-adnexal reporting and data system amongst less experienced readers before and after training显示文摘BACKGROUND The 2018 ovarian-adnexal reporting and data system(O-RADS)guidelines are aimed at providing a system for consistent reports and risk stratification for ovarian lesions found on ultrasound.It provides key characteristics and findings for lesions,a lexicon of descriptors to communicate findings,and risk characterization and associated follow-up recommendation guidelines.However,the ORADS guidelines have not been validated in North American institutions or amongst less experienced readers.AIM To evaluate the diagnostic accuracy and inter-reader reliability of ultrasound ORADS risk stratification amongst less experienced readers in a North American institution with and without pre-test training.METHODS A single-center retrospective study was performed using 100 ovarian/adnexal lesions of varying O-RADS scores.Of these cases,50 were allotted to a training cohort and 50 to a testing cohort via a non-randomized group selection process in order to approximately equal distribution of O-RADS categories both within and between groups.Reference standard O-RADS scores were established through consensus of three fellowship-trained body imaging radiologists.Three PGY-4 residents were independently evaluated for diagnostic accuracy and inter-reader reliability with and without pre-test O-RADS training.Sensitivity,specificity,positive predictive value,negative predictive value(NPV),and area under the curve(AUC)were used to measure accuracy.Fleiss kappa and weighted quadratic(pairwise)kappa values were used to measure inter-reader reliability.Statistical significance was P<0.05.RESULTS Mean patient age was 40±16 years with lesions ranging from 1.2 to 22.5 cm.Readers demonstrated excellent specificities(85%-100%pre-training and 91%-100%post-training)and NPVs(89%-100%pre-training and 91-100%post-training)across the O-RADS categories.Sensitivities were variable(55%-100%pre-training and 64%-100%post-training)with malignant ORADS 4 and 5 Lesions pre-training and post-training AUC values of 0.87-0.95 and 0.94-098,respectively(P<0.001).Nineteen of 22(86%)misclassified cases in pre-training were related to mischaracterization of dermoid features or wall/septation morphology.Fifteen of 17(88%)of posttraining misclassified cases were related to one of these two errors.Fleiss kappa inter-reader reliability was‘good’and pairwise inter-reader reliability was‘very good’with pre-training and post-training assessment(k=0.76 and 0.77;and k=0.77-0.87 and 0.85-0.89,respectively).CONCLUSION Less experienced readers in North America achieved excellent specificities and AUC values with very good pairwise inter-reader reliability.They may be subject to misclassification of potentially malignant lesions,and specific training around dermoid features and smooth vs irregular inner wall/septation morphology may improve sensitivity. | Prayash Katlariwala Mitchell P Wilson Yeli Pi Baljot S Chahal Roger Croutze Deelan Patel Vimal Patel Gavin Low | 2022 | World Journal of Radiology2022，14，9： | 2 |
| 2 | Autoantibodies to glutamate receptor GIuR3 in Rasmussen's encephalitis 显示文摘 | Rogers SW Andrews PI Gahring LC | 1994 | Science1994，265，5172： | 1 |
| 3 | Fusobacterium nucleatum supports the growth of Porphyromonas gingivalis in oxygenated and carbon-dioxide-depleted environments显示文摘 | Diaz PI Zilm PS Rogers AH | 2002 | Microbiology2002，148，2： | 1 |
| 4 | Multiple aspects of homocysteine neurotoxicity,glutamate excitotoxicity,kinase hyperactivation and DNA damage显示文摘 | Ho PI Ortiz D Rogers E | 2002 | J Neurosci Res2002，70，5： | 1 |
| 5 | Multiple aspects of homocysteine neurotoxicity: glutamate excitotoxicity, kinase hyperactivation and DNA damage 显示文摘 | Ho PI Ortiz D Rogers E | 2002 | J Neurosic Res2002，70，： | 1 |
| 6 | Multiple aspects of homocysteine neurotoxicity: glutamate excitotoxicity, kinase hyperactlvation and DNA damage 显示文摘 | Ho PI Ortiz D Rogers E | 2002 | J Neurosci Res2002，70，： | 1 |
| 7 | Autoantibodies to glutamate receptor GluR3 in Rasmussen's encephalitis显示文摘 | Andrews PI Gahring LC | 1994 | Science1994，265，5172： | 1 |
| 8 | Intrapericardial paclitaxel delivery inhibits neointimal proliferation and promotes arterial enlargement after porcine coronary overstretch显示文摘 | Hou D Rogers PI Toleikis PM | 2000 | Circulation2000，102，： | 1 |
| 9 | Multiple aspects of homocysteine neurotoxicity glutamate excitotoxicity, kinase hyperactivation and DNA damage 显示文摘 | Ho PI Ortiz D Rogers E | 2002 | Neurosci Res2002，70，5： | 1 |
| 10 | Multiple aspects of homocysteine neurotoxicity:glutamate excitotoxicity,kinase hyperactivation and DNA damage 显示文摘 | Ho PI Ortiz D Rogers E | 2002 | J Neurosci Res2002，70，5： | 1 |
| 11 | Autoantibodies to glutamate receptor GluR3 in Rasmussen's encephalitis显示文摘 | Rogers SW Andrews PI Gahring LC | 1994 | Science1994，265，： | 1 |
| 12 | Autoantibodies to glutamate receptor GluR3 in Rasmussen's encephalitis显示文摘 | Rogers SW Andrews PI Gahring LC | 1994 | Science1994，265，5172： | 1 |
| 13 | Multiple aspects of homocysteine neurotoxicity:glutamate excitotoxicity,kinase hyperactivation and DNA damage显示文摘 | Ho PI Ortiz D Rogers E | 2002 | J Neurosci Res2002，70，5： | 1 |
| 14 | Multiple aspects of homocysteine neurotoxicity: glutamate excitotoxicity, kinase hyperactivation and DNA damage 显示文摘 | Ho PI Ortiz D Rogers E | 2002 | J Neurosci Res2002，70，5： | 1 |
| 15 | Bisphosphonates: pharmacology, mechanisms of action and clinical uses 显示文摘 | Russell RG Croucher PI Rogers MJ | 1999 | Osteoporos Int1999，9，2： | 1 |
| 16 | Bisphosphonates: pharmacology, mechanisms of action and clinical uses 显示文摘 | Russell RG Croucher PI Rogers MJ | 1999 | Osteoporos Int1999，92，： | 1 |
| 17 | Bisphosphonates: pharmacology, mechanisms of action and clinical uses显示文摘 | Russell RG Croucher PI Rogers MJ | 1999 | Osteoporos Int1999，9，： | 1 |
| 18 | Multipleaspects of homocysteine neurotoxicity:Glutamate excitotoxicity,kinase hyperac-tion and DNA damage显示文摘 | Ho PI Ortiz D Rogers E | 2002 | J Neurosci Res2002，70，5： | 1 |
| 19 | Autoantibodies to chronic localized encephalitis显示文摘 | Roger SW Andrews PI Gahring LC | 1994 | Science1994，265，： | 1 |
| 20 | Multiple aspects of homocysteineneuro- toxicity : glutamate excitotoxicity, kinase hyperactivation andDNA damage 显示文摘 | Ho PI Ortiz D Rogers E | 2002 | J Neurosci Res2002，70，： | 1 |
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