E-ISSN 1305-3612
Abdominal Radiology - Original Article
Accuracy of the ADNEX MR scoring system based on a simplified MRI protocol for the assessment of adnexal masses
1 Department of Obstetrics and Gynecology, State University of Campinas- Unicamp, Campinas Faculty of Medical Sciences, São Paulo, Brazil.; Section of Imaginology, Sumaré State Hospital, Sumaré, São Paulo,, Brazil  
2 Department of Obstetrics and Gynecology, State University of Campinas-Unicamp, Campinas Faculty of Medical Sciences, São Paulo, Brazil..  
3 Section of Imaginology, Sumaré State Hospital, Sumaré, São Paulo, Brazil.  
4 Department of Radiology, Federal University of Rio de Janeiro National Faculty of Medicine, Rio de Janeiro, RJ, Brazil.  
Diagn Interv Radiol ; : -
DOI: 10.5152/dir.2018.17378
Abstract

Purpose:  To evaluate the ADNEX MR Scoring System for the prediction of adnexal mass malignancy, using a simplified MR protocol.

 

Methods: Two hundred patients with 237 adnexal masses prospectively underwent magnetic resonance imaging (MRI; February 2014–February 2016) and were followed until February 2017. Two radiologists calculated ADNEX MR scores using a MR protocol with a simplified dynamic study, not a high temporal resolution study, as originally proposed. Sensitivity, specificity, positive and negative predictive values and likelihood ratios, and the area under the receiver operating characteristic curve were calculated (cut-off for malignancy, score ≥ 4). The reference standard was histopathological diagnosis or imaging findings during >12 months follow-up.

 

Results: Seventy-nine of 237 (33.3%) lesions were malignant. The ADNEX MR scoring system, using a simplified MR protocol, showed 94.9% (95% confidence interval [CI], 87.5–98.6%) sensitivity and 97.5% (95% CI, 93.6–99.3%) specificity in malignancy prediction; it was thus highly accurate, like the original system. The level of interobserver agreement on simplified scoring was high (κ=0.91).

 

Conclusion: In a tertiary cancer centre, the ADNEX MR Scoring System, even based on a simplified MR protocol, performed well in the prediction of adnexal masses malignant. It may enable the standardisation of MRI reporting on adnexal masses, thereby improving communication between radiologists and gynaecologists.

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