External validation of ADNEX MR SCORING system: a single-centre retrospective study.

Area of Science:

• Radiology
• Oncology
• Gynecologic Imaging

Background:

• Adnexal masses require accurate characterization to guide management.
• Ultrasonography can be indeterminate for adnexal masses, necessitating further imaging.
• Magnetic Resonance Imaging (MRI) offers detailed anatomical and textural information.

Purpose of the Study:

• To assess the diagnostic performance of the ADNEX MR SCORING system.
• To evaluate the accuracy of MRI in characterizing indeterminate adnexal masses.
• To determine the system's effectiveness in differentiating benign from malignant lesions.

Main Methods:

• Retrospective analysis of 778 adnexal masses in 663 women undergoing MRI.
• Independent review of MRI images by two radiologists using the ADNEX MR SCORING system (scores 1-5).
• Receiver operating characteristic (ROC) analysis to evaluate diagnostic performance; masses scored 4+ considered malignant.

Main Results:

• High malignancy rates observed for scores 4 and 5 (62.6%-87.4%).
• Areas under the ROC curves were excellent (0.923-0.929) for differentiating benign and malignant masses.
• Overall diagnostic accuracy was high (90.1%-90.2%), with sensitivity (84.6%-85.6%) and specificity (91.7%-91.9%).

Conclusions:

• The ADNEX MR SCORING system demonstrates high accuracy in distinguishing benign from malignant adnexal masses via MRI.
• The system's accuracy may be reduced for tumors with borderline malignancy or low malignant potential.
• Further refinement may be needed for specific tumor subtypes.