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

Media type: E-Article
Title: Validity and Reproducibility of the ADNEX MR Scoring System in the Diagnosis of Sonographically Indeterminate Adnexal Masses
Contributor: Basha, Mohammad Abd Alkhalik; Abdelrahman, Hossam M.; Metwally, Maha Ibrahime; Alayouty, Nader Ali; Mohey, Nesreen; Zaitoun, Mohamed M.A.; Almassry, Hosam Nabil; Yousef, Hala Y.; El Sammak, Ahmed A.; Aly, Sameh Abdelaziz; Algazzar, Hesham Youssef; Farag, Mohamed Abd El‐Aziz Mohamed; Mosallam, Walid; Abo Shanab, Waleed S.; Ibrahim, Safaa A.; Mohamed, Ekramy A.; Mohamed, Abd El Motaleb; Afifi, Amira Hamed Mohamed; Harb, Ola A.; Azmy, Taghreed M.
imprint: Wiley, 2021
Published in: Journal of Magnetic Resonance Imaging
Language: English
DOI: 10.1002/jmri.27285
ISSN: 1053-1807; 1522-2586
Origination:
Footnote:
Description: <jats:sec><jats:title>Background</jats:title><jats:p>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.</jats:p></jats:sec><jats:sec><jats:title>Purpose</jats:title><jats:p>To assess the validity and reproducibility of the ADNEX MR Scoring system in the diagnosis of sonographically indeterminate AM.</jats:p></jats:sec><jats:sec><jats:title>Study Type</jats:title><jats:p>A prospective multicenter study.</jats:p></jats:sec><jats:sec><jats:title>Population</jats:title><jats:p>In all, 531 women (mean age, 44 ± 11.2 years; range, 21–79 years) with 572 sonographically indeterminate AM.</jats:p></jats:sec><jats:sec><jats:title>Field Strength/Sequence</jats:title><jats:p><jats:styled-content style="fixed-case">1.5T</jats:styled-content>/precontrast <jats:styled-content style="fixed-case">T<jats:sub>1</jats:sub></jats:styled-content>‐weighted imaging (<jats:styled-content style="fixed-case">WI</jats:styled-content>) fast spin echo (<jats:styled-content style="fixed-case">FSE)</jats:styled-content> (in‐phase and out‐of‐phase, with and without fat suppression); <jats:styled-content style="fixed-case">T<jats:sub>2</jats:sub>‐WI FSE</jats:styled-content>; <jats:styled-content style="fixed-case">diffusion‐WI</jats:styled-content> single‐shot echo planner with b‐values of 0 and 1000 s/mm<jats:sup>2</jats:sup>; and dynamic contrast‐enhanced perfusion <jats:styled-content style="fixed-case">T<jats:sub>1</jats:sub>‐WI</jats:styled-content> liver acquisition with volume acceleration (<jats:styled-content style="fixed-case">LAVA)</jats:styled-content>.</jats:p></jats:sec><jats:sec><jats:title>Assessment</jats:title><jats:p>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.</jats:p></jats:sec><jats:sec><jats:title>Statistical Tests</jats:title><jats:p>Four‐fold table test, kappa statistics (κ), and receiver operating characteristic (ROC) curve.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>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).</jats:p></jats:sec><jats:sec><jats:title>Data Conclusion</jats:title><jats:p>The current study supports the high validity and reproducibility of the ADNEX MR Scoring system for the diagnosis of sonographically indeterminate AM.</jats:p></jats:sec><jats:sec><jats:title>Level of Evidence</jats:title><jats:p>1</jats:p></jats:sec><jats:sec><jats:title>Technical Efficacy Stage</jats:title><jats:p>2</jats:p></jats:sec>

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