ArticleFrontiers in pediatrics2026
Age-stratified diagnostic performance of the ovarian-adnexal reporting and data system for adnexal masses: a focus on school-age children, early, and middle adolescents.
Article in Frontiers in pediatrics, 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
Objective: To evaluate the age-stratified diagnostic performance of the Ovarian-Adnexal Reporting and Data System (O-RADS) for distinguishing malignant adnexal masses in school-age children, early adolescents, and middle adolescents. Methods: This retrospective study included 501 pediatric patients with adnexal masses. All masses were classified according to the O-RADS ultrasound lexicon. Diagnostic performance was assessed across three age groups: school-age children, early adolescents, and middle adolescents. Results: Among 501 masses, 72 were in school-age children, 163 in early adolescents, and 266 in middle adolescents. In school-age children, sensitivity and negative predictive value (NPV) were both 100.0%, specificity 93.6%, and area under the curve (AUC) 0.968; in early adolescents, sensitivity 95.8%, specificity 88.5%, and AUC 0.922; in middle adolescents, sensitivity decreased to 88.2%, specificity to 85.6%, and AUC to 0.869. Positive predictive value (PPV) declined from 71.4% in school-age children to 29.4% in middle adolescents. A significant difference in AUC was observed between middle adolescents and school-age children ( Conclusion: The O-RADS ultrasound demonstrated favorable diagnostic performance in school-age children and early adolescents. The declining performance in middle adolescents, particularly the marked drop in PPV and significant decrease in AUC, underscores the need for age-specific considerations when applying O-RADS in pediatric populations.
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