Tuesday, 21 October 2025

Rodríguez C, Vegas S, Del Olmo M, Quintana P, Sancho J, Pablos MJ, Alcázar JL, Pelayo I. ECO-SCORE: Development of a New Ultrasound Score for the Study of Cystic and Solid-Cystic Adnexal Masses Based on Imaging Characteristics

Biomedicines. 2025

"ECO-SCORE sets a new standard in ultrasound diagnosis of malignant adnexal masses" Dr. Irene Pelayo-Delgado & Paula Quintana-Zapata

Summary:

The accurate diagnosis of adnexal masses is a critical challenge in gynecological practice. Current ultrasound-based models, such as the ADNEX model, IOTA Simple Rules, and O-RADS, have demonstrated good diagnostic performance but are limited by the inclusion of demographic factors and solid confounding lesions. This study aimed to develop and validate a novel ultrasound score (ECO-SCORE) for cystic and solid-cystic lesions based solely on imaging characteristics to improve diagnostic accuracy and applicability in clinical practice. Methods: We conducted a retrospective study on 330 women diagnosed with adnexal masses, including 251 benign and 79 malignant cases. Ultrasound features were analyzed using logistic regression to identify key predictors of malignancy. A new scoring model was developed, excluding demographic or tumor-marker data. Diagnostic performance metrics, including sensitivity, specificity, AUC, and odds ratios, were calculated and compared to existing models using a testing set (20% of the data). Results: The ECO-SCORE achieved an AUC of 97.08%, outperforming ADNEX model (87.5%), IOTA Simple Rules (85.7%), and O-RADS (87.5%). Sensitivity and specificity were 92.98% and 88.88%, respectively, with an odds ratio of 106. Key predictors included irregular contour, absence of acoustic shadows, vascularization within solid areas, and vascularization of papillae. Conclusions: The ECO-SCORE demonstrated superior diagnostic accuracy compared to established models, highlighting its potential as a reliable tool for assessing adnexal masses using ultrasound features exclusively. Further multicenter validation is needed to confirm its robustness across different clinical settings.

Why do you highlight this publication?

ECO-SCORE is a model for predicting the malignancy of adnexal masses based exclusively on ultrasound characteristics (including irregular contour, absence of acoustic shadows, vascularization within solid areas, and vascularization of papillae). It offers a highly accurate, image-based approach to diagnosing adnexal masses. In the near future, we plan to include this ECO-SCORE as a diagnostic solution within the MISSION 2030 program. Its simplicity and accuracy make it a promising tool for clinical practice.