Validity and Reproducibility of the ADNEX MR Scoring System in the Diagnosis of Sonographically Indeterminate Adnexal Masses.

Autor: Basha MAA; Department of Radio-Diagnosis, Faculty of Human Medicine, Zagazig University, Zagazig, Egypt., Abdelrahman HM; Department of Radio-Diagnosis, Faculty of Human Medicine, Zagazig University, Zagazig, Egypt., Metwally MI; Department of Radio-Diagnosis, Faculty of Human Medicine, Zagazig University, Zagazig, Egypt., Alayouty NA; Department of Radio-Diagnosis, Faculty of Human Medicine, Zagazig University, Zagazig, Egypt., Mohey N; Department of Radio-Diagnosis, Faculty of Human Medicine, Zagazig University, Zagazig, Egypt., Zaitoun MMA; Department of Radio-Diagnosis, Faculty of Human Medicine, Zagazig University, Zagazig, Egypt., Almassry HN; Department of Radio-Diagnosis, Faculty of Human Medicine, Zagazig University, Zagazig, Egypt., Yousef HY; Department of Radio-Diagnosis, Faculty of Human Medicine, Zagazig University, Zagazig, Egypt., El Sammak AA; Department of Radio-Diagnosis, Faculty of Human Medicine, Zagazig University, Zagazig, Egypt., Aly SA; Department of Radio-Diagnosis, Faculty of Human Medicine, Benha University, Benha, Egypt., Algazzar HY; Department of Radio-Diagnosis, Faculty of Human Medicine, Benha University, Benha, Egypt., Farag MAEM; Department of Radio-Diagnosis, Faculty of Human Medicine, Al Azhar University, Cairo, Egypt., Mosallam W; Department of Radio-Diagnosis, Faculty of Human Medicine, Suez Canal University, Ismailia, Egypt., Abo Shanab WS; Department of Radio-Diagnosis, Faculty of Human Medicine, Port Said University, Port Said, Egypt., Ibrahim SA; Department of Obstetrics & Gynecology, Faculty of Human Medicine, Zagazig University, Zagazig, Egypt., Mohamed EA; Department of Obstetrics & Gynecology, Faculty of Human Medicine, Zagazig University, Zagazig, Egypt., Mohamed AEM; Department of Clinical Oncology, Faculty of Human Medicine, Zagazig University, Zagazig, Egypt., Afifi AHM; Department of Clinical Pathology, Faculty of Human Medicine, Zagazig University, Zagazig, Egypt., Harb OA; Department of Pathology, Faculty of Human Medicine, Zagazig University, Zagazig, Egypt., Azmy TM; Department of Radio-Diagnosis, Faculty of Human Medicine, Zagazig University, Zagazig, Egypt.
Jazyk: angličtina
Zdroj: Journal of magnetic resonance imaging : JMRI [J Magn Reson Imaging] 2021 Jan; Vol. 53 (1), pp. 292-304. Date of Electronic Publication: 2020 Jul 26.
DOI: 10.1002/jmri.27285
Abstrakt: Background: The diagnosis of sonographically indeterminate adnexal masses (AM) signifies a major challenge in clinical practice. Early detection and characterization have increased the need for accurate imaging evaluation before treatment.
Purpose: To assess the validity and reproducibility of the ADNEX MR Scoring system in the diagnosis of sonographically indeterminate AM.
Study Type: A prospective multicenter study.
Population: In all, 531 women (mean age, 44 ± 11.2 years; range, 21-79 years) with 572 sonographically indeterminate AM.
Field Strength/sequence: 1.5T/precontrast T 1 -weighted imaging (WI) fast spin echo (FSE) (in-phase and out-of-phase, with and without fat suppression); T 2 -WI FSE; diffusion-WI single-shot echo planner with b-values of 0 and 1000 s/mm 2 ; and dynamic contrast-enhanced perfusion T 1 -WI liver acquisition with volume acceleration (LAVA).
Assessment: All MRI examinations were evaluated by three radiologists, and the AM were categorized into five scores based on the ADNEX MR Scoring system. Score 1: no AM; 2: benign AM; 3: probably benign AM; 4: indeterminate AM; 5: probably malignant AM. Histopathology and imaging follow-up were used as the standard references for evaluating the validity of the ADNEX MR Scoring system for detecting ovarian malignancy.
Statistical Tests: Four-fold table test, kappa statistics (κ), and receiver operating characteristic (ROC) curve.
Results: In all, 136 (23.8%) AM were malignant, and 436 (76.2%) were benign. Of the 350 AM classified as score 2, one (0.3%) was malignant; of the 62 AM classified as score 3, six (9.7%) were malignant; of the 73 AM classified as score 4, 43 (58.9%) were malignant; and of the 87 AM categorized as score 5, 86 (98.9%) were malignant. The best cutoff value for predicting malignant AM was score >3 with sensitivity and specificity of 92.9% and 94.9%, respectively. The interreader agreement of the ADNEX MR Scoring was very good (κ = 0.861).
Data Conclusion: The current study supports the high validity and reproducibility of the ADNEX MR Scoring system for the diagnosis of sonographically indeterminate AM.
Level of Evidence: 1 TECHNICAL EFFICACY STAGE: 2.
(© 2020 International Society for Magnetic Resonance in Medicine.)
Databáze: MEDLINE
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