Abstract
BACKGROUND: Contrast-enhanced ultrasound (CEUS) and Ovarian-Adnexal Reporting and Data System ultrasound classification (O-RADS US) have been applied in the diagnosis and risk stratification of ovarian and adnexal masses. This study aimed to evaluate the diagnostic value and risk stratification efficacy of CEUS and O-RADS US for ovarian and adnexal masses. METHODS: A systematic review and meta-analysis of studies in the PubMed, Embase, Web of Science, and the Cochrane Library databased published until October 2024 was conducted. The Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) was used for quality assessment. The Deeks funnel plot asymmetry test was used for the publication bias. The summary sensitivity, specificity, diagnostic odds ratio (DOR), and summary receiver operating characteristic (SROC) curve were used for the evaluation of diagnostic performance. The bivariate mixed-effects model in STATA 17.0 software (StataCorp) was used for the meta-analysis. RESULTS: This meta-analysis included a total of 21 studies, comprising 5,433 patients. CEUS was evaluated in seven studies, while O-RADS US was assessed in 15 studies, with one study using both methods for evaluation. The quality assessment revealed that bias risk and concerns regarding applicability were generally related to patient selection. The pooled sensitivity and specificity of CEUS were 93% [95% confidence interval (CI): 87-96%] and 91% (95% CI: 82-95%), respectively. For O-RADS US, the pooled sensitivity and specificity were 94% (95% CI: 87-98%) and 81% (95% CI: 72-88%), respectively. CONCLUSIONS: CEUS and O-RADS US both exhibit high sensitivity in differentiating ovarian or adnexal masses, with CEUS also demonstrating very high specificity.