Adnexal masses: what is the role of ultrasonographic imaging?

Coccia, Maria Elisabetta; Rizzello, Francesca; Romanelli, Chiara; Capezzuoli, Tommaso

doi:10.1007/s00404-014-3327-0

Cited by 22 publications

(19 citation statements)

References 65 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…1 This tenet applies particularly to obstetric and gynecologic patients for whom a skillfully performed and well-interpreted ultrasound image usually obviates the need to proceed to additional more costly and complex cross-sectional imaging techniques. [1][2][3] Yet still today, many women with pelvic pain, masses, or flank pain first undergo computed tomography (CT) scans and those with Müllerian duct anomalies typically have magnetic resonance images (MRIs). [1][2][3][4][5] Not uncommonly, CT or MRI of the pelvis often yield indeterminate and confusing findings that then require clarification by ultrasound imaging.…”

mentioning

confidence: 99%

“…[1][2][3] Yet still today, many women with pelvic pain, masses, or flank pain first undergo computed tomography (CT) scans and those with Müllerian duct anomalies typically have magnetic resonance images (MRIs). [1][2][3][4][5] Not uncommonly, CT or MRI of the pelvis often yield indeterminate and confusing findings that then require clarification by ultrasound imaging. The use of CT scans has tripled since 1993, and CT scans done in 2007 could result in as many as 29,000 future cancers in the United States, with the largest contribution to this risk arising from the CT of the pelvis and abdomen.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Consider ultrasound first for imaging the female pelvis

Benacerraf¹,

Abuhamad²,

Bromley³

et al. 2015

American Journal of Obstetrics and Gynecology

View full text Add to dashboard Cite

mentioning

confidence: 99%

mentioning

confidence: 99%

Consider ultrasound first for imaging the female pelvis

Benacerraf¹,

Abuhamad²,

Bromley³

et al. 2015

American Journal of Obstetrics and Gynecology

View full text Add to dashboard Cite

“…Pelvic ultrasound remains the mainstay of evaluation with up to 90% of adnexal masses being adequately characterized by ultrasound alone. 13,14 Ultrasound features strongly suggestive of malignancy include a solid component, presence of ascites, and thick septations. 13,15 Conversely unilocular, sololucent cysts with smooth edges and regular borders are suggestive of benign disease, with malignancy rates generally <1%.…”

mentioning

confidence: 99%

“…13,15,16 Pelvic ultrasound with color doppler flow can also be used to evaluate for benign cysts, torsion, ectopic pregnancy, and malignancy. 14,15,17 If the diagnosis of an adnexal mass remains uncertain after ultrasound a second imaging modality can be used to aid in determining the risk of malignancy. 18 If an ectopic pregnancy or other emergency condition is diagnosed by ultrasound then appropriate treatment should be provided.…”

mentioning

confidence: 99%

Adnexal Masses in the Premenopausal Patient

Hall

Randall²

2015

Clinical Obstetrics &Amp; Gynecology

View full text Add to dashboard Cite

Practitioners may frequently encounter adnexal masses in premenopausal women. Adnexal masses can represent a wide variety of etiologies, and therefore they can represent a diagnostic dilemma. When an adnexal mass is found the initial work up must focus on identifying acute pathology followed by determining the risk of a malignancy. Pelvic ultrasound remains the mainstay for evaluation of adnexal masses in premenopausal patients. If ultrasounds findings are indeterminate magnetic resonance imaging (MRI) is the next imaging modality of choice. The evaluation for malignancy should include serum marker screening. Aspiration of adnexal masses is generally avoided, due to the lack of therapeutic benefit and risk of seeding a tumor. When ultrasound findings are suggestive of benign disease, conservative management, including repeat imaging, should be considered. If the clinical suspicion for malignancy is high referral to a gynecologic oncologist is warranted. In other patients whom the evaluation of their adnexal mass remains unclear surgical excision with care not to disrupt the integrity of the mass should be performed for pathologic diagnosis.

show abstract

“…US is the first-line modality for the assessment of suspected adnexal masses, with very accurate results (5). However, US examination yields indeterminate findings in approximately 20% of adnexal masses (6)(7)(8).…”

mentioning

confidence: 99%

Untitled

2014

Diagn Interv Radiol

View full text Add to dashboard Cite

PURPOSEWe aimed to evaluate the ADNEX MR scoring system for the prediction of adnexal mass malignancy, using a simplified magnetic resonance imaging (MRI) protocol. METHODSIn this prospective study, 200 patients with 237 adnexal masses underwent MRI between February 2014 and February 2016 and were followed until February 2017. Two radiologists calculated ADNEX MR scores using an MRI protocol with a simplified dynamic study, not a high temporal resolution study, as originally proposed. Sensitivity, specificity, positive and negative predictive values, likelihood ratios, and the area under the receiver operating characteristic curve were calculated (cutoff for malignancy, score ≥ 4). The reference standard was histopathologic diagnosis or imaging findings during >12 months of follow-up. RESULTSOf 237 lesions, 79 (33.3%) were malignant. The ADNEX MR scoring system, using a simplified MRI protocol, showed 94.9% (95% confidence interval [CI], 87.5%-98.6%) sensitivity and 97.5% (95% CI, 93.6%-99.3%) specificity in malignancy prediction; it was thus highly accurate, like the original system. The level of interobserver agreement on simplified scoring was high (κ = 0.91). CONCLUSIONIn a tertiary cancer center, the ADNEX MR scoring system, even based on a simplified MRI protocol, performed well in the prediction of malignant adnexal masses. This scoring system may enable the standardization of MRI reporting on adnexal masses, thereby improving communication between radiologists and gynecologists.You may cite this article as: Pereira PN, Sarian LO, Yoshida A, et al. Accuracy of the ADNEX MR scoring system based on a simplified MRI protocol for the assessment of adnexal masses. Diagn Interv Radiol 2018; 24:63-71. A dnexal masses are frequent findings in pelvic and abdominal imaging studies, such as those conducted with ultrasonography (US), computed tomography (CT), and magnetic resonance imaging (MRI) (1). Preoperative evaluation of these lesions and determination of the risk of malignancy are critical to define treatment. A lesion with a low risk of malignancy can be followed or treated with minimally invasive surgery performed by a general gynecologist. When the risk of malignancy is significant, the patient should be referred to a tertiary center for treatment by a multidisciplinary team that includes an oncologic gynecologist (2, 3).Every year, about 240 000 women worldwide are diagnosed with ovarian cancer. The 5-year survival rate is less than 45%, and ovarian cancer is responsible for about 150 000 deaths annually. Thus, it is the seventh most common cancer and the eighth most common cause of cancer death among women (4).US is the first-line modality for the assessment of suspected adnexal masses, with very accurate results (5). However, US examination yields indeterminate findings in approximately 20% of adnexal masses (6-8). Exophytic and large tumors, fatty components, clots that mimic vegetation, and fibrous tumors have morphologic characteristics that are difficult to interpret with US. Other imaging methods (e...

show abstract

Adnexal masses: what is the role of ultrasonographic imaging?

Cited by 22 publications

References 65 publications

Consider ultrasound first for imaging the female pelvis

Consider ultrasound first for imaging the female pelvis

Adnexal Masses in the Premenopausal Patient

Untitled

Contact Info

Product

Resources

About