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Adnexal Lesion Imaging: Past, Present, and Future.
Elizabeth A Sadowski1, Andrea Rockall1, Isabelle Thomassin-Naggara1
1From the Departments of Radiology (E.A.S.) and Obstetrics and Gynecology (E.A.S., L.M.B., S.K.W.), University of Wisconsin School of Medicine and Public Health, 600 Highland Ave, E3/372, Madison, WI 53792-3252; Division of Surgery and Cancer, Imperial College London, Hammersmith Campus, London, UK (A.R.); Department of Radiology, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Hôpital Tenon, Paris, France (I.T.N.); Department of Radiology, Stanford University School of Medicine, Stanford, Calif (P.J.); Department of Imaging Sciences, University of Rochester, Rochester, NY (A.G.); Department of Radiology, Brigham and Women's Hospital, Boston, Mass (A.B.S., Y.G.); Augmented Imaging Precision Health Laboratory (AIPHL), Research Institute of the McGill University Health Centre, and Department of Radiology, McGill University, Montreal, Canada (C.R.); and Montreal Imaging Experts, Montreal, Canada (C.R.).
Imaging plays a crucial role in managing adnexal lesions, reducing unnecessary surgeries for benign conditions. Advanced systems like O-RADS improve ovarian cancer risk assessment and patient care.
Area of Science:
- Radiology
- Gynecologic Imaging
- Oncology
Background:
- Imaging is integral to adnexal lesion management, guiding conservative follow-up for benign findings.
- Historically, imaging has reduced surgical rates for benign adnexal lesions since the 1970s.
- Ovarian-Adnexal Reporting and Data System (O-RADS) enhances cancer risk stratification.
Purpose of the Study:
- To review the evolution of adnexal lesion treatment influenced by imaging.
- To present current data on US, CT, and MRI for assessing ovarian cancer likelihood.
- To discuss future directions in adnexal imaging for early ovarian cancer detection.
Main Methods:
- Review of imaging modalities including ultrasound (US), computed tomography (CT), and magnetic resonance imaging (MRI).
- Analysis of data-driven O-RADS scoring systems for standardized risk assessment.
- Evaluation of imaging's impact on surgical intervention rates for adnexal lesions.
Main Results:
- Imaging advancements have decreased the rate of surgery for benign adnexal lesions.
- O-RADS systems provide standardized lexicons and cancer risk scores.
- US serves as the primary imaging modality, with MRI offering higher specificity when needed.
Conclusions:
- Imaging significantly impacts the management of adnexal lesions, improving diagnostic accuracy.
- Standardized reporting systems like O-RADS are crucial for optimizing patient care and reducing interventions.
- Continued advancements in adnexal imaging are vital for the early detection of ovarian cancer.
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