Accuracy of magnetic resonance imaging in ovarian tumor: a systematic quantitative review

Medeiros, Lídia Rosi; Freitas, Luciana Bueno de; Rosa, Daniela Dornelles; Silva, Fábio R.; Silva, Loraine S.; Birtencourt, Lisiane T.; Edelweiss, Maria Isabel Albano; Rosa, Maria Inês da

doi:10.1016/j.ajog.2010.08.031

Cited by 47 publications

(24 citation statements)

References 33 publications

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“…25 In a recently published large systematic quantitative review of the use of the MRI in the discrimination of invasive and borderline tumors from benign ovarian lesions, a sensitivity of 0.92 and a specificity of 0.85 have been reported for this imaging technique. 26 Owing to its remarkably high reported sensitivity, it seems possible that MRI in combination with expert sonography and the RMI could potentially further ameliorate the diagnostic accuracy in the assessment of an adnexal mass. Prospective evaluation of triage systems including MRI is warranted to possibly reduce surgical interventions.…”

Section: Discussionmentioning

confidence: 99%

Preoperative Multimodal Strategies for Risk Assessment of Adnexal Masses

Radosa

Camara²,

Vorwergk³

et al. 2011

International Journal of Gynecological Cancer

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Section: Discussionmentioning

confidence: 99%

Preoperative Multimodal Strategies for Risk Assessment of Adnexal Masses

Radosa

Camara²,

Vorwergk³

et al. 2011

International Journal of Gynecological Cancer

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“…Although MRI is considerably more expensive than US, it plays an important role in the preoperative discrimination of indeterminate adnexal masses found on US. Risk stratification with ADNEX MR scoring system could improve overall cost optimization, as unnecessary surgery can be avoided in low-risk patients (with scores ≤3), and high-risk patients (with scores ≥4) can be referred for urgent laparotomy in specialized oncologic centers (12,21). Four borderline tumors (cystic masses without solid tissue) were assigned a score of 3, reflecting some difficulty with the use of the system.…”

Section: Total Of Lesions 164mentioning

confidence: 99%

Accuracy of the ADNEX MR scoring system based on a simplified MRI protocol for the assessment of adnexal masses

Pereira

Sarian

Yoshida

et al. 2018

Diagn Interv Radiol

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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...

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“…13,14 Furthermore, we assessed the included studies with reference to the Oxford Centre for Evidence-Based Medicine Levels of Evidence Classification rubric. 15 Only studies with Oxford Evidence levels 1 to 3 were considered to be of high quality, whereas those with levels 4 and 5 were excluded.…”

Section: Quality Assessmentmentioning

confidence: 99%