{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T11:35:08Z","timestamp":1789472108634,"version":"build-2803163510"},"reference-count":25,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,1,10]],"date-time":"2025-01-10T00:00:00Z","timestamp":1736467200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Ultrasound Medicine"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Acoustic shadowing is an important benign ultrasound (US) feature for adnexal masses (AMs). To validate the diagnostic performance and interobserver agreement of the 2019 version and 2022 version of Ovarian\u2010Adnexal Reporting and Data System Ultrasound (O\u2010RADS US) and ascertain whether adding acoustic shadowing to O\u2010RADS US v2019 as a benign ultrasound feature can enhance its diagnostic efficacy among junior radiologist.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective study included consecutive women with suspected adnexal masses who underwent ultrasound examinations between September 2022 and January 2024. One junior doctor (Reader 1, 2\u2009years of experience) classified each AM according to the O\u2010RADS US v2019 and the v2022. Lesions were reclassified according to the US features of acoustic shadowing based on the O\u2010RADS US v2019: the O\u2010RADS category was downgraded by one level with acoustic shadowing and remained unchanged without acoustic shadowing for categories 2\u20135. Receiver operating characteristic (ROC) curve analysis was used to evaluate the diagnostic performance of the two versions of O\u2010RADS and the modified O\u2010RADS model. Two independent junior radiologists (Reader 1 and Reader 2 with 3\u2009years of experience) then classified the 200 AMs randomly selected for a test\u2013retest analysis. Kappa (<jats:italic>\u043a<\/jats:italic>) statistics were used to assess the interobserver agreement.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall, 1015 women (range, 16\u201386\u2009years) with 1061 AMs were evaluated. Of the lesions, 864 (81.4%) were benign and 197 (18.6%) were malignant. The area under the ROC curve (AUC) for O\u2010RADS v2019 and v2022 were 0.920 (95% confidence interval [CI]: 0.902, 0.936, <jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001) and 0.924 (95% CI: 0.906, 0.939, <jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001), respectively. The modified model based on O\u2010RADS v2019 incorporating acoustic shadowing as a benign US feature showed an improved AUC of 0.934 (95% CI: 0.917, 0.948, <jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001). A significant difference was observed between the AUCs of the modified O\u2010RADS and two versions of O\u2010RADS models (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.005). The inclusion of acoustic shadowing increased specificity by 5.4% in predicting malignant adnexal masses, compared with the O\u2010RADS US v2019 with a specificity of 76.2%. Using the modified O\u2010RADS category 4 as the optimal cut\u2010off value for predicting malignancy showed a sensitivity, specificity, positive predictive value, and negative predictive value were 94.4% (95% CI: 90.2%, 97.2%), 81.6% (95% CI: 78.8%, 84.1%), 53.9% (95% CI: 50.3%, 57.5%), and 98.5% (95% CI: 97.3%, 99.1%), respectively. The inter\u2010observer agreement in the O\u2010RADS category between these two junior radiologists was good (<jats:italic>\u03ba<\/jats:italic>\u2009=\u20090.74, <jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>We validated the excellent performance of the Ovarian\u2010Adnexal Reporting and Data system Ultrasound for diagnosing adnexal masses, and the inclusion of acoustic shadowing increased specificity by 5.4% in predicting malignant adnexal masses, compared with the O\u2010RADS US v2019 with the specificity of 76.2%.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jum.16644","type":"journal-article","created":{"date-parts":[[2025,1,10]],"date-time":"2025-01-10T12:44:56Z","timestamp":1736513096000},"page":"845-855","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Diagnostic Performance of O\u2010<scp>RADS US<\/scp> (Version 2019 and Version 2022) Incorporating Acoustic Shadowing by Junior Radiologists"],"prefix":"10.1002","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-4584-6390","authenticated-orcid":false,"given":"CuiYi","family":"Wu","sequence":"first","affiliation":[{"name":"Department of Ultrasonic Medicine, Fetal Medical Centre The First Affiliated Hospital of Sun Yat\u2010sen University  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0354-3396","authenticated-orcid":false,"given":"LiHong","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Ultrasonic Medicine, Fetal Medical Centre The First Affiliated Hospital of Sun Yat\u2010sen University  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"JianHong","family":"Shang","sequence":"additional","affiliation":[{"name":"Department of Ultrasonic Medicine, Fetal Medical Centre The First Affiliated Hospital of Sun Yat\u2010sen University  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"HongNing","family":"Xie","sequence":"additional","affiliation":[{"name":"Department of Ultrasonic Medicine, Fetal Medical Centre The First Affiliated Hospital of Sun Yat\u2010sen University  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruan","family":"Peng","sequence":"additional","affiliation":[{"name":"Department of Ultrasonic Medicine, Fetal Medical Centre The First Affiliated Hospital of Sun Yat\u2010sen University  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,1,10]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21820"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/ijgc-2021-002565"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(08)70005-6"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.5603\/GP.a2017.0116"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12880-023-01153-9"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.5365"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.9012"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.24777"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacr.2018.07.004"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2019191150"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers14133151"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00261-022-03580-8"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00432-023-05108-z"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2021.04.031"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.230685"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ultrasmedbio.2019.04.001"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/jum.16100"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.09.3562"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2016.01.007"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.211868"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/jum.15834"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2020200437"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.g5920"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics13172785"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.4329\/wjr.v14.i9.319"}],"container-title":["Journal 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