ACR Appropriateness Criteria® Clinically Suspected Adnexal Mass, No Acute Symptoms

Imaging:, Expert Panel on Women’s; Atri, Mostafa; Alabousi, Abdullah; Reinhold, Caroline; Akin, Esma A.; Benson, Carol B.; Bhosale, Priyadarshani R.; Kang, Stella K.; Lakhman, Yulia; Nicola, Refky; Pandharipande, Pari V.; Patel, Maitray D.; Salazar, Gloria M.; Shipp, Thomas; Simpson, Lynn L.; Sussman, Betsy L; Uyeda, Jennifer W.; Wall, Darci J.; Whitcomb, Bradford P.; Zelop, Carolyn M.; Glanc, Phyllis

doi:10.1016/j.jacr.2019.02.011

Cited by 43 publications

(34 citation statements)

References 56 publications

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“…The heterogeneous nature of mucinous carcinoma, often coexisting with benign and borderline mucinous elements, suggests that mucinous carcinoma develops in a stepwise fashion from and color or power Doppler techniques, as the imaging modality of choice in patients with signs and symptoms suggestive of an adnexal mass (26). US is useful in determining the anatomic origin of the adnexal mass.…”

Section: Mucinous Carcinomamentioning

confidence: 99%

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Mucinous Neoplasms of the Ovary: Radiologic-Pathologic Correlation

Marko¹,

Marko²,

Pachigolla³

et al. 2019

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Section: Mucinous Carcinomamentioning

confidence: 99%

“…CT is not recommended in initial evaluation of a suspected adnexal mass (26). In the setting of an indeterminate complex cystic mass, CT may be useful in confirming the diagnosis of a mature cystic teratoma by demonstrating inter- nal macroscopic fat and coarse calcifications/ teeth (36).…”

Section: Detection and Characterizationmentioning

confidence: 99%

Mucinous Neoplasms of the Ovary: Radiologic-Pathologic Correlation

Marko¹,

Marko²,

Pachigolla³

et al. 2019

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“…CA 125 results were limited and CA125, ROMA, and OVA-1 were not routinely ordered for the patients selected. Studies have demonstrated that a generalist's expertise in subjective assessment with ultrasound findings may offer a better "diagnostic certainty" in differentiating between benign and malignant masses compared to tumor markers and algorithms [2,[11][12][13]. Although tumor markers are widely used, many researchers have also proved that women with ovarian cancer can have a normal CA 125 level [2,5].…”

Section: Discussionmentioning

confidence: 99%

“…With the reliance of laboratory testing and imaging, as well as increasing obesity levels limiting pelvic exams, there is a declining trend of accurately diagnosing patients solely based on physical exams [7]. Despite technological developments in analyzing adnexal masses, studies have shown that subjective assessments performed by experienced physicians have high sensitivities and specificities and are superior to other available classification systems or algorithms [5,[8][9][10][11][12].…”

Section: Introductionmentioning

confidence: 99%

Accuracy in Referrals to Gynecologic Oncologists Based on Clinical Presentation for Ovarian Mass

et al. 2020

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Ovarian cancer is one of the most lethal gynecological cancers in women due to late diagnosis. Despite technological advancements, experienced physicians have high sensitivities and specificities in subjective assessments when combining ultrasound findings and clinical history in analyzing adnexal masses. This study aims to demonstrate general obstetricians and gynecologists’ (OB/GYN) appropriateness in gynecologic oncologist referrals for malignant ovarian masses based on history and physical (H&P), imaging, and available tumor markers. Three board certified OB/GYNs were given 148 cases and determined whether or not they would refer them to a gynecologic oncologist. Results showed that OB/GYNs were 81–85% accurate in diagnosing patients with a benign or malignant disease. Among the malignant cases, reviewers had a high sensitivity ranging from 74–81% in appropriately referring a malignancy. In our study, OB/GYNs referred between 23–32% of ovarian masses to a gynecologic oncologist with only 9.5% of cases found to be malignant. Despite the high referral rates, generalists showed a high degree of sensitivity in accurately referring malignant diseases based solely on clinical experience and imaging studies, which could improve survival rates with early intervention by gynecologic oncologists.

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“…Incidental adnexal masses are commonly detected in daily medical practice due to the frequent lack of clinical manifestation. 1 Approximately 9% to 10% of women undergoing ultrasound have ovarian lesions. 2 Although most commonly used, ultrasound has some limitations including the small field of view, low resolution and interference by obesity or by gaseous bowel loops.…”

Section: Introductionmentioning

confidence: 99%

Adnexal masses characterized on 3 tesla magnetic resonance imaging – added value of diffusion techniques

Dimova

Zlatareva

Bakalova

et al. 2020

Radiology and Oncology

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BackgroundTo assess different types of adnexal masses as identified by 3T MRI and to discuss the added value of diffusion techniques compared with conventional sequences.Patients and methods174 women age between 13 and 87 underwent an MRI examination of the pelvis for a period of three years. Patients were examined in two radiology departments – 135 of them on 3 Tesla MRI Siemens Verio and 39 on 3 Tesla MRI Philips Ingenia. At least one adnexal mass was diagnosed in 98 patients and they are subject to this study. Some of them were reviewed retrospectively. Data from patients’ history, physical examination and laboratory tests were reviewed as well.Results124 ovarian masses in 98 females’ group of average age 47.2 years were detected. Following the MRI criteria, 59.2% of the cases were considered benign, 30.6% malignant and 10.2% borderline. Out of all masses 58.1% were classified as cystic, 12.9% as solid and 29% as mixed. Оf histologically proven tumors 74.4% were benign and 25.6% were malignant. All of the malignant tumors had restricted diffusion. 64 out of all patients underwent contrast enhancement. (34 there were a subject of contraindications). 39 (61%) of the masses showed contrast enhancement.ConclusionsClassifying adnexal masses is essential for the preoperative management of the patients. 3T MRI protocols, in particular diffusion techniques, increase significantly the accuracy of the diagnostic assessment.

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ACR Appropriateness Criteria® Clinically Suspected Adnexal Mass, No Acute Symptoms

Cited by 43 publications

References 56 publications

Mucinous Neoplasms of the Ovary: Radiologic-Pathologic Correlation

Mucinous Neoplasms of the Ovary: Radiologic-Pathologic Correlation

Accuracy in Referrals to Gynecologic Oncologists Based on Clinical Presentation for Ovarian Mass

Adnexal masses characterized on 3 tesla magnetic resonance imaging – added value of diffusion techniques

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