ArticleTranslational cancer research2026
The role of apparent diffusion coefficient histogram analysis in improving O-RADS magnetic resonance imaging classification of adnexal lesions: a retrospective diagnostic accuracy study.
Article in Translational cancer research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Ovarian cancer is the fourth leading cause of death among neoplastic diseases in women. The Ovarian-Adnexal Reporting Data System (O-RADS) magnetic resonance imaging (MRI) scoring is a five-point risk stratification system that combines morphological features with diffusion and perfusion features, which allows categorization of adnexal masses. This study aimed to evaluate the value of apparent diffusion coefficient (ADC) histogram analysis and serum carbohydrate antigen 125 (CA-125) levels to improve the performance of the O-RADS MRI score in classification of adnexal lesions. Methods: The retrospective study included 196 patients with 235 adnexal lesions. Exclusion criteria included lack of histopathological results, prior treatment for adnexal lesions, poor image quality, and absence of ADC maps or contrast-enhanced (CE) magnetic resonance (MR) images. The MRI protocol included T1-weighted imaging (T1WI), T2-weighted imaging (T2WI), diffusion weighted imaging (DWI), and CE sequences, with ADC histogram parameters extracted using FireVoxel software. Histological results of surgically excised specimens served as the reference standard. Clinical information, ADC histogram parameters and O-RADS MRI scores were compared between benign and malignant lesions. Predictive factors for malignancy were identified through univariate and multivariate analyses, while diagnostic performance of the multivariate model, O-RADS score, and their combination was assessed using receiver operating characteristic (ROC) curve analysis. Results: Significant differences in ADC histogram parameters were observed between benign and malignant lesions, except for the ADC maximum value (ADC Conclusions: The ADC histogram analysis may improve the diagnostic performance of the O-RADS MRI score in preoperative classification of adnexal lesions.
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