Zhang HP, Zhu Q, Wu JJ, Yang AQ, Chen TT, Zhang J, Zhou YQ. Comparison of dagnostic performance between senior and junior radiologists using subjective assessment vs ovarian-adnexal reporting and data system. World J Clin Oncol 2026; 17(5): 119512 [DOI: 10.5306/wjco.v17.i5.119512]
Corresponding Author of This Article
Yu-Qing Zhou, MD, Professor, Department of Ultrasound in Obstetrics and Gynecology, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, No. 1111 Xianxia Road, Shanghai 200336, China. doczhou@qq.com
Research Domain of This Article
Womens Studies
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Retrospective Study
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May 24, 2026 (publication date) through May 23, 2026
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World Journal of Clinical Oncology
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2218-4333
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Zhang HP, Zhu Q, Wu JJ, Yang AQ, Chen TT, Zhang J, Zhou YQ. Comparison of dagnostic performance between senior and junior radiologists using subjective assessment vs ovarian-adnexal reporting and data system. World J Clin Oncol 2026; 17(5): 119512 [DOI: 10.5306/wjco.v17.i5.119512]
World J Clin Oncol. May 24, 2026; 17(5): 119512 Published online May 24, 2026. doi: 10.5306/wjco.v17.i5.119512
Comparison of dagnostic performance between senior and junior radiologists using subjective assessment vs ovarian-adnexal reporting and data system
Hui-Ping Zhang, Quan Zhu, Jing-Jing Wu, An-Qiang Yang, Tian-Tian Chen, Juan Zhang, Yu-Qing Zhou
Hui-Ping Zhang, Quan Zhu, Jing-Jing Wu, Tian-Tian Chen, Yu-Qing Zhou, Department of Ultrasound in Obstetrics and Gynecology, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200336, China
An-Qiang Yang, Department of Pathology, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200336, China
Juan Zhang, Department of Gynaecology and Obstetrics, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 201620, China
Co-corresponding authors: Juan Zhang and Yu-Qing Zhou.
Author contributions: Zhang HP, Zhang J, and Zhou YQ conceptualized and designed the study; Zhu Q and Wu JJ performed the ultrasound assessments; Yang AQ verified the pathological results; Chen TT collected clinical data and ultrasound images; Zhang HP, Zhang J, and Zhou YQ performed statistical analyses and interpreted the results; Zhang HP drafted the manuscript and all other authors revised the manuscript; and all authors have read and approved the final version of the manuscript. Zhang J and Zhou YQ contributed equally to this work as co-corresponding authors. They were responsible for study conception and design, data analysis and interpretation, critical revision of the manuscript for important intellectual content, and final approval of the version to be published.
Supported by Key Specialty of Changning District, Shanghai, China, No. 20231004; Key Science-Technology Project of Songjiang District Committee on Science and Technology, No. 2023SJKWGG042.
Institutional review board statement: This was a retrospective study approved by the Ethics Committee of our hospital (No. CNFBLLAR-2024-006).
Informed consent statement: Written informed consent was obtained from all patients prior to ultrasound examinations.
Conflict-of-interest statement: All authors declare that they have no conflict of interest to disclose.
Data sharing statement: The datasets used during the current study are available from the corresponding author on reasonable request.
Corresponding author: Yu-Qing Zhou, MD, Professor, Department of Ultrasound in Obstetrics and Gynecology, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, No. 1111 Xianxia Road, Shanghai 200336, China. doczhou@qq.com
Received: February 6, 2026 Revised: March 26, 2026 Accepted: April 13, 2026 Published online: May 24, 2026 Processing time: 103 Days and 0.3 Hours
Abstract
BACKGROUND
The diagnosis of ovarian-adnexal lesions is challenging due to the variability in radiologist experience, which may lead to inconsistent diagnostic outcomes. The ovarian-adnexal reporting and data system (O-RADS) aims to standardize ultrasound-based diagnosis; however, optimization of the clinical utility of O-RADS remains unclear.
AIM
To compare the diagnostic performance of subjective assessment and O-RADS between senior and junior radiologists in ovarian adnexal lesions.
METHODS
This was a retrospective study and included 364 patients with 414 ovarian-adnexal lesions (30 malignant and 384 benign), all confirmed by pathological examination. A senior radiologist and a junior radiologist independently diagnosed all lesions using subjective assessment and O-RADS, respectively. Diagnostic indices including sensitivity, specificity, and accuracy were compared, and the consistency of O-RADS classification between the two radiologists was analyzed.
RESULTS
For the senior radiologist, the accuracy of subjective assessment (96.6%, 400/414) was significantly higher than that of O-RADS (89.1%, 369/414); compared with subjective assessment, O-RADS significantly decreased specificity (97.9% vs 90.1%, χ2 = 20.812, P < 0.001) and accuracy (χ2 = 17.538, P < 0.001), while sensitivity showed no significant change (80.0% vs 76.7%, χ2 = 0.098, P = 0.754). For the junior radiologist, O-RADS significantly improved sensitivity compared with subjective assessment (76.7% vs 46.7%, χ2 = 5.711, P = 0.017), with no significant decreases in specificity (95.3% vs 97.1%, χ2 = 1.756, P = 0.185) or accuracy (94.0% vs 93.4%, χ2 = 0.082, P = 0.775). The O-RADS classification consistency between the senior and junior radiologist was moderate (Kappa = 0.475, P < 0.001).
CONCLUSION
Senior radiologists should prioritize subjective assessment to maximize diagnostic accuracy, while junior radiologists can significantly benefit from O-RADS to improve sensitivity in diagnosing malignant lesions.
Core Tip: For ovarian-adnexal lesion diagnosis, senior radiologists achieve higher accuracy with subjective assessment, while junior radiologists can significantly improve sensitivity in diagnosing malignant lesions using the ovarian-adnexal reporting and data system (O-RADS). Moderate O-RADS inter-radiologist consistency highlights the need for strengthened training to enhance diagnostic standardization, guiding personalized application of O-RADS based on radiologist experience.
