Abstract

Eighteen to 35% of adnexal masses remain non-classified following ultrasonography, leading to unnecessary surgeries and inappropriate management. This finding led to the conclusion that ultrasonography was insufficient to accurately assess adnexal masses and that a standardized MRI criteria could improve these patients’ management. The aim of this work is to present the different steps from the identification of the clinical issue to the daily use of a score and its inclusion in the latest international guidelines. The different steps were the following: (1) preliminary work to formalize the issue, (2) physiopathological analysis and finding dynamic parameters relevant to increase MRI performances, (3) construction and internal validation of a score to predict the nature of the lesion, (4) external multicentric validation (the EURAD study) of the score named O-RADS MRI, and (5) communication and education work to spread its use and inclusion in guidelines. Future steps will include studies at patients’ levels and a cost-efficiency analysis.

Critical relevance statement We present translating radiological research into a clinical application based on a step-by-step structured and systematic approach methodology to validate MR imaging for the characterization of adnexal mass with the ultimate step of incorporation in the latest worldwide guidelines of the O-RADS MRI reporting system that allows to distinguish benign from malignant ovarian masses with a sensitivity and specificity higher than 90%.

Key points

• The initial diagnostic test accuracy studies show the limitation of a preoperative assessment of adnexal masses using solely ultrasonography.

• The technical developments (DCE/DWI) were investigated with the value of dynamic MRI to accurately predict the nature of benign or malignant lesions to improve management.

• The first developing score named ADNEX MR Score was constructed using multiple easily assessed criteria on MRI to classify indeterminate adnexal lesions following ultrasonography.

• The multicentric adnexal study externally validated the score creating the O-RADS MR score and leading to its inclusion for daily use in international guidelines.

Details

Title
O-RADS MRI to classify adnexal tumors: from clinical problem to daily use
Author
Dabi, Yohann 1 ; Rockall, Andrea 2 ; Sadowski, Elisabeth 3 ; Touboul, Cyril 4 ; Razakamanantsoa, Leo 5 ; Thomassin-Naggara, Isabelle 5   VIAFID ORCID Logo  ; Poncelet, E.; Jalaguier-Coudray, A.; Guerra, A.; Fournier, L. S.; Stojanovic, S.; Millet, I.; Bharwani, N.; Juhan, V.; Cunha, T. M.; Masselli, G.; Balleyguier, C.; Malhaire, C.; Perrot, N.; Bazot, M.; Taourel, P.; Darai, E.; Rockall, A. G.

1  APHP, Sorbonne Université, Hôpital Tenon, Service de Gynecologie Et Obstétrique, Paris, France; Institut Universitaire de Cancérologie, Sorbonne Université, Hôpital Tenon, Paris, France 
2  Imperial College London, Department of Surgery and Cancer, Faculty of Medicine, London, UK (GRID:grid.7445.2) (ISNI:0000 0001 2113 8111); Imperial College Healthcare NHS Trust, Department of Radiology, London, UK (GRID:grid.417895.6) (ISNI:0000 0001 0693 2181) 
3  University of Michigan, Department of Radiology, Madison, USA (GRID:grid.214458.e) (ISNI:0000 0004 1936 7347) 
4  APHP, Sorbonne Université, Hôpital Tenon, Service de Gynecologie Et Obstétrique, Paris, France (GRID:grid.214458.e); Institut Universitaire de Cancérologie, Sorbonne Université, Hôpital Tenon, Paris, France (GRID:grid.214458.e) 
5  Institut Universitaire de Cancérologie, Sorbonne Université, Hôpital Tenon, Paris, France (GRID:grid.214458.e); APHP, Sorbonne Université, Hôpital Tenon, Service de Radiologie, Paris, France (GRID:grid.214458.e) 
Pages
29
Publication year
2024
Publication date
Dec 2024
Publisher
Springer Nature B.V.
e-ISSN
18694101
Source type
Scholarly Journal
Language of publication
English
DOI
https://doi.org/10.1186/s13244-023-01598-0
ProQuest document ID
2921366622
Copyright
© The Author(s) 2024. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.