Diagnostic accuracy of a modified non-contrast O-RADS MRI scoring system: a retrospective study
Abstract
Objective: To develop a modified non-contrast O-RADS MRI scoring system and validate its diagnostic performance.
Materials and methods: The modified non-contrast O-RADS MRI scoring system was developed by incorporating the significant signs from the standard O-RADS MRI system. This study retrospectively enrolled the 176 adnexal masses in cohort A. MRI imaging features were compared between benign and malignant tumors within this cohort. The diagnostic performance of the two scoring models was assessed by estimating the area under the curve (AUC), net reclassification improvement (NRI), and integrated discrimination improvement (IDI). In addition, 352 adnexal lesions from cohorts B and C were included to further evaluate the diagnostic ability of the modified scoring system.
Results: In cohort A, the papillary projections exhibiting the sea anemone sign were highly indicative of borderline lesions ( p = 0.001). Diffusion restriction in solid components significantly distinguished benign from malignant masses ( p = 0.001). The apparent diffusion coefficient (ADC) value of cystic components yielded a cutoff of 1.74 ( p < 0.05). The DeLong test revealed no statistically significant difference in AUCs between the two systems in cohort A ( p > 0.05). The NRI and IDI for the modified non-contrast O-RADS MRI scoring system were −4.13% and −0.04, respectively (all p > 0.05). In cohorts B and C, the AUCs were 0.933 and 0.910.
Conclusion: The diagnostic efficacy of the modified non-contrast O-RADS MRI scoring system was comparable to that of the standard O-RADS MRI risk stratification system, facilitating the distinction between benign and malignant adnexal neoplasms.
Key Points: Question How can a modified non-contrast O-RADS MRI scoring system be developed, and can this scoring system accurately classify adnexal masses?
Findings The modified non-contrast O-RADS MRI system demonstrates excellent diagnostic performance and reliable risk stratification of adnexal masses by evaluating key imaging features.
Critical relevance statement The modified non-contrast O-RADS MRI scoring system contributes to the risk stratification of adnexal masses, particularly for patients who cannot undergo contrast agent administration. This system provides a reliable tool to optimize treatment strategies and improve patient outcomes.
Related
- Reply to Comment on Diagnostic Accuracy of a Sonographic Scoring System in Predicting the Malignant Potential of a Soft-tissue Swelling.
- CT-Referenced Diagnostic Performance and Complementary Error Patterns of Artificial Intelligence Versus a Single Emergency Physician in Chest Radiograph Interpretation: A Retrospective Paired Diagnostic Accuracy Study
- Diagnostic Accuracy of Preoperative Magnetic Resonance Imaging for Staging Endometrial Carcinoma: A Retrospective Single-Centre Study
- Diagnostic Accuracy of Multiparametric Ultrasound Versus Cross-Sectional Imaging for Differentiating Benign and Malignant Cervical Lymph Nodes: A Histopathology-Referenced Retrospective Study
- Enhancing diagnostic accuracy with core needle biopsy and immunohistochemistry in indeterminate thyroid nodules: a retrospective diagnostic accuracy study.
BibTeX
@article{ren2026diagnostic,
title = {{Diagnostic accuracy of a modified non-contrast O-RADS MRI scoring system: a retrospective study}},
author = {Yan Ren and Can Cui and Zhijing Zhang and Wei Liao and Chen Zhang and Yue Cheng and Wen Shen},
journal = {Insights into imaging},
year = {2026},
month = oct,
doi = {10.1186/s13244-026-02425-y},
url = {https://europepmc.org/article/PMC/PMC13675434},
note = {CC BY},
}
RIS
TY - JOUR
TI - Diagnostic accuracy of a modified non-contrast O-RADS MRI scoring system: a retrospective study
AU - Yan Ren
AU - Can Cui
AU - Zhijing Zhang
AU - Wei Liao
AU - Chen Zhang
AU - Yue Cheng
AU - Wen Shen
PY - 2026
DA - 2026/10/16
JO - Insights into imaging
DO - 10.1186/s13244-026-02425-y
UR - https://europepmc.org/article/PMC/PMC13675434
AB - Objective: To develop a modified non-contrast O-RADS MRI scoring system and validate its diagnostic performance. Materials and methods: The modified non-contrast O-RADS MRI scoring system was developed by incorporating the significant signs from the standard O-RADS MRI system. This study retrospectively enrolled the 176 adnexal masses in cohort A. MRI imaging features were compared between benign and malignant tumors within this cohort. The diagnostic performance of the two scoring models was assessed by estimating the area under the curve (AUC), net reclassification improvement (NRI), and integrated discrimination improvement (IDI). In addition, 352 adnexal lesions from cohorts B and C were included to further evaluate the diagnostic ability of the modified scoring system. Results: In cohort A, the papillary projections exhibiting the sea anemone sign were highly indicative of borderline lesions ( p = 0.001). Diffusion restriction in solid components significantly distinguished benign from malignant masses ( p = 0.001). The apparent diffusion coefficient (ADC) value of cystic components yielded a cutoff of 1.74 ( p < 0.05). The DeLong test revealed no statistically significant difference in AUCs between the two systems in cohort A ( p > 0.05). The NRI and IDI for the modified non-contrast O-RADS MRI scoring system were −4.13% and −0.04, respectively (all p > 0.05). In cohorts B and C, the AUCs were 0.933 and 0.910. Conclusion: The diagnostic efficacy of the modified non-contrast O-RADS MRI scoring system was comparable to that of the standard O-RADS MRI risk stratification system, facilitating the distinction between benign and malignant adnexal neoplasms. Key Points: Question How can a modified non-contrast O-RADS MRI scoring system be developed, and can this scoring system accurately classify adnexal masses? Findings The modified non-contrast O-RADS MRI system demonstrates excellent diagnostic performance and reliable risk stratification of adnexal masses by evaluating key imaging features. Critical relevance statement The modified non-contrast O-RADS MRI scoring system contributes to the risk stratification of adnexal masses, particularly for patients who cannot undergo contrast agent administration. This system provides a reliable tool to optimize treatment strategies and improve patient outcomes.
SN - 1869-4101
ER -