Innovative optimization of greater omentum imaging report and data system for enhanced risk stratification of omental lesions

Abstract

Abstract Background In 2020, we introduced the Greater Omentum Imaging-Reporting and Data System (GOI-RADS), a novel classification system related to peritoneal lesions. However, its clinical application remained unvalidated. Objective This study aimed to validate GOI-RADS, optimize its parameters for a new grading system, and explore its clinical usefulness. Methods A retrospective-prospective study was conducted to validate and refine the GOI-RADS system. The study consisted of two phases: a retrospective validation phase and a prospective application phase. The first phase included patients with peritoneal lesions from 2019 to 2021, classified by GOI-RADS and verified against pathology. Contrast-enhanced ultrasound (CEUS) and real-time elastography (RTE) data were collected for developing a new grading system. Odds ratios optimized parameters. The second phase (2021–2024) assessed diagnostic consistency among sonographers and performance of grading systems. Results Among 215 patients with peritoneal lesions, the actual malignancy rates for GOI-RADS 2 (40.00%) and GOI-RADS 3 (61.22%) were much higher than predicted (5.56% and 37.25%). Combining CEUS and RTE parameters showed varying sensitivity and specificity: RTE + GOI-RADS (95.35%, 55.56%) and CEUS + GOI-RADS (96.51%, 44.44%). However, the grading system based on multiple ultrasound parameters, specifically when incorporating RTE, CEUS parameters, and GOI-RADS (Multi-GOIRADS), exhibited the highest diagnostic sensitivity and specificity of 88.37% and 83.33%, respectively. Its simplified version, sMulti-GOIRADS, had sensitivity of 73.26% and specificity of 94.44%. In the prospective study involving three sonographers of different qualifications, the use of sMulti-GOIRADS was found to be the most time-efficient and showed excellent diagnostic consistency among them. In contrast, Multi-GOIRADS required more time for scoring but offered superior diagnostic performance, particularly among senior sonographers (88.35% and 91.43%). Conclusions This study proposes a multiparametric ultrasound-based imaging-reporting and data system for risk stratification of omental malignancy, Multi-GOIRADS, and presents an optimized and simplified version, sMulti-GOIRADS, which demonstrates excellent diagnostic consistency and performance in clinical applications.

Keywords

• The greater omentum
• Omental score
• Contrast-enhanced ultrasound
• Greater omentum Imaging-Reporting and data system
• Real-time elastography