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

• Published in: Diagnostic and interventional radiology (Ankara, Turkey) Vol. 24; no. 2; pp. 63 - 71
• Main Authors: Pereira, Patrick N, Sarian, Luis O, Yoshida, Adriana, Araújo, Karla G, Barros, Ricardo H O, Baião, Ana C, Parente, Daniella B, Derchain, Sophie
• Format: Journal Article
• Language: English
• Published: Turkey Galenos Yayinevi Tic. Ltd 01.03.2018; Aves Yayincilik Ltd. STI; Turkish Society of Radiology; Galenos Publishing House
• Subjects: Abdominal Imaging; Adnexa Uteri - anatomy & histology; Adnexa Uteri - diagnostic imaging; Adnexa Uteri - pathology; Adnexal Diseases - diagnostic imaging; Adnexal Diseases - pathology; Adnexal Diseases - surgery; Adult; Aged; Confidence intervals; Diagnosis; Female; Follow-Up Studies; Health aspects; Humans; Lesions; Magnetic resonance imaging; Magnetic Resonance Imaging - methods; Mathematical analysis; Middle Aged; Minimally Invasive Surgical Procedures - standards; NMR; Nuclear magnetic resonance; Observer Variation; Ovarian cancer; Ovarian Neoplasms - diagnostic imaging; Ovarian Neoplasms - pathology; Ovarian Neoplasms - surgery; Predictions; Predictive Value of Tests; Prospective Studies; Sensitivity; Standardization; Temporal resolution; Tertiary Care Centers; Uterus
• ISSN: 1305-3612; 1305-3825; 1305-3612
• DOI: 10.5152/dir.2018.17378

We aimed to evaluate the ADNEX MR scoring system for the prediction of adnexal mass malignancy, using a simplified magnetic resonance imaging (MRI) protocol. In 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. Of 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). In 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.