Evaluation of adnexal masses with ultrasonographic parameters and magnetic resonance imaging

Adnexal masses (AMs) are commonly seen gynecological problems. Most of the AMs of women in reproductive period are physiologic. A rare but lethal cause of AMs is ovarian cancer. It is important to distinguish benign and malignant AMs. In this study, two scoring systems named "Evaluation of Different Neoplasms in Adnexa (ADNEX)" model and "Ovarian-Adnexal Reporting Data System MR (O-RADS MR)" were examined in terms of diagnostic performance in distinguishing benign or malignant AMs.

Patients undergone surgery due to AMs were involved in this retrospective study. ADNEX risk model scores and MRI results of patients were re-evaluated for calculating O-RADS MRI scores.

284 patients enrolled in this study. ADNEX risk model had a 93.8% (95% CI: 90.9-96.7%) of area under the ROC curve (AUC) for malignancy risk (p < 0.001). O-RADS risk model had a 95.7% (95% CI: 92.8-98.6) of AUC (p < 0.001). When cut-off value was set as 42%, sensitivity and specificity of ADNEX risk model were 87% and 88.6, respectively. Sensitivity and specificity of O-RADS MRI risk scoring system were 93.8% and 93.2 when cut-off value was set as ≥ 4, respectively. AUC values of ADNEX risk model and O-RADS MRI scores were not significantly different in terms of differentiating between benign and malignant cases (p = 0.218).

ADNEX risk model and O-RADS MRI score are successful in terms of identifying benign and malign cases for evaluation of AMs. There was no significant difference in the ability of these two methods to distinguish benign and malignant cases.