MRI of Sonographically Indeterminate Adnexal Masses

Adusumilli, Saroja; Hussain, Hero K.; Caoili, Elaine M.; Weadock, William J.; Murray, John P.; Johnson, Timothy D.; Chen, Qixuan; Desjardins, Benoı̂t

doi:10.2214/ajr.05.0905

Cited by 134 publications

(87 citation statements)

References 27 publications

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“…The majority of sonographically (US) indeterminate masses are not rare and exotic lesions but common adnexal lesions [8,9] such as mature teratomas (dermoid tumours) with minimal fat or other atypical features, haemorrhagic lesions in which adherent blood clot may mimic mural vegetations and solid fibrous masses (ovarian fibroma/thecoma and uterine leiomyomata) whose solid nature raises concerns for malignancy. Thus most indeterminate adnexal masses are actually complex benign lesions.…”

Section: Introductionmentioning

confidence: 99%

ESUR guidelines for MR imaging of the sonographically indeterminate adnexal mass: an algorithmic approach

Forstner²,

et al. 2009

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ESUR guidelines for MR imaging of the sonographically indeterminate adnexal mass: an algorithmic approach Abstract A significant proportion of adnexal masses detected by sonography are indeterminate. Either their organ of origin is uncertain or it is unclear whether their nature is benign or malignant. MR imaging of the sonographically indeterminate adnexal mass can resolve most of these uncertainties. Most indeterminate masses result from common benign conditions and women with such masses can avoid unnecessary or inappropriate surgery. For the minority of women whose masses are malignant, use of MR imaging rather than a 'wait and watch' strategy of repeat ultrasound (US) results in a more timely diagnosis. There are simple diagnostic steps in the MR imaging assessment which direct an algorithmic and problem-solving approach based on signal characteristics and morphology. MR imaging should provide a more timely diagnosis and, thereby, guide the management of the patient with reduced costs of investigation and treatment.

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Section: Introductionmentioning

confidence: 99%

ESUR guidelines for MR imaging of the sonographically indeterminate adnexal mass: an algorithmic approach

Forstner²,

et al. 2009

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“…In the future, magnetic resonance imaging and positron emission tomography may have a role in the evaluation of adnexal masses (32,33) .…”

Section: Dimensionalmentioning

confidence: 99%

Clinical Significance of Thrombocytosis and CA125 as Predictor of Malignancy in Gynecological Pelvic Mass

Salamit¹

2018

Int.J.Curr.Res.Aca.Rev.

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Article InfoWe attempted to determine the increasing of platelet counts (> 450.000 /microliter) and Cancer Antigen 125 (CA125) serum level (> 35 U/mL) as useful tools for predicting and confirming malignancy in gynaecological pelvic mass. A prospective unmatched hospital based case-control study carried out about One hundred & ten women were enrolled in our study, divided into two group 60 women were control group (free of gynaecological pelvic mass) which were considered as -eligible entrants‖ into the study. Other group include 50 women above 15 years old with gynaecological pelvic mass were all candidate for laparotomy and using different diagnostic methods like clinical examination, imaging techniques (U/S, CT scan and MRI) and laboratory test (platelet count, CA125 and Histopathology). The data of those were subjected to statistical analysis (sensitivity, specificity, accuracy, NPV and PPV) which calculated to considered if it is statistically significant or not. Serum CA125 and blood platelets count were tested for validity when used as a test to predict a diagnosis of malignancy in gynaecological pelvic mass differentiating it from benign gynaecological pelvic mass. Both tests showed a very high validity in diagnosis (ROC area >0.95), with serum CA125 showing a marginally higher validity (ROC area larger by 0.017 only). Both ROC areas were significantly higher than the 0.5 area associated with an equivocal test. Platelets counts had a perfect cut-off value of ≥385.000 All study subjects with a blood platelets count equal or greater than 385.000 were malignant, while everybody below this cut-off value was healthy. For serum CA125 testing negative at the highest sensitivity (100% sensitive) cut-off value of (≥27.1( would excluded a possible diagnosis of malignancy in favor of being healthy with 100% confidence. The optimum cut-off value is ≥41.7, which is also the 100% specific and thus 100% diagnostic cut-off value. Both blood platelet count (≥ 385 X 10 3 microlitter) & serum level of CA125 (≥ 41.7 U/mL) are useful predictor tools to confirm malignancy in gynecological pelvic mass.

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“…In most case contrast enhanced MRI allows differentiation between benign and malignant ovarian cystic lesions [6]. For sonologically indeterminate lesions, MRI reportedly has a sensitivity and specificity of about 100% and 94% respectively [7]. Due to its high cost and limited availability it's often used as a problem solving tool in indeterminate lesions.…”

Section: Magnetic Resonance Imaging (Mri)mentioning

confidence: 99%

An Algorithm Based Approach To Ovarian Neoplasms

Mathew¹

2016

IJARS

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Introduction: Cancer of the ovaries is the 2 nd most common gynaecological malignancy and has the highest mortality rate among all gynaecological malignancies with an overall 5 year survival rate of 46%. A large number of the lesions are incidentally detected, for which imaging plays a vital role in treatment planning by characterizing these masses. Identifying benign lesions accurately may obviate unnecessary surgery, where as indeterminate or malignant lesions will require surgery with or without radio/chemotherapy. Aim:To inform the readers the imaging patterns of common and rarely encountered ovarian neoplasms and to provide an algorithm based approach to these ovarian lesions, which will not only aid in the management of these conditions but also obviate unnecessary investigations and surgeries. Materials and Methods:This was a prospective study conducted over a period of one year from January 2014 to January 2015 at the Department of Radiology, Father Muller Medical College, Mangalore, India. Data were collected from 82 patients who presented with ovarian cystic lesions on ultrasound and were either followed up by USG or underwent further evaluation by CT. Diagnosis was confirmed by histopathology. Statistical analysis involved percentage frequency.

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MRI of Sonographically Indeterminate Adnexal Masses

Abstract: Sonographically indeterminate adnexal masses of uncertain origin and solid or complex cystic content benefit from further evaluation with MRI, which is highly accurate for identifying the origin of a mass and characterizing its tissue content, obviating surgery.

Cited by 134 publications

References 27 publications

ESUR guidelines for MR imaging of the sonographically indeterminate adnexal mass: an algorithmic approach

ESUR guidelines for MR imaging of the sonographically indeterminate adnexal mass: an algorithmic approach

Clinical Significance of Thrombocytosis and CA125 as Predictor of Malignancy in Gynecological Pelvic Mass

An Algorithm Based Approach To Ovarian Neoplasms

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