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Abstract

Background Ultrasound is the initial modality employed to investigate adnexal lesions due to its high sensitivity and specificity in excluding malignancy when classic benign characteristics are observed. Nevertheless, the positive predictive value (PPV) of cancer can vary from 7% to 50% when a lesion has indeterminate imaging features in the US, and the PPV for cancer can range from 29% up to more than 50% when a lesion exhibits characteristics that are concerned for malignancy. (2). MRI has the capacity to enhance the PPV from cancer to 71%, with a negative predictive value of 98%. (3). The MRI's ability to provide a more precise examination for sonographically indeterminate lesions drops the probability of suspect and, as a result, the variety of operations conducted for benign diagnoses in asymptomatic women. (4). The O-RADS Ovarian-Adnexal Imaging-Reporting-Data SystemMRI risk score has an opportunity to enhance the accuracy of lesion characterization depicted in US, enhance interdisciplinary communication, and facilitate the most effective control of adnexal lesions through consistent implementation. (6). Aim and objectives: The objective of the present study is to evaluate the accuracy and inter-reader agreement of the ORADS MR risk stratification system in the evaluation of adnexal lesions. Patients and Methods A retrospective study was performed in the Department of Radiodiagnosis at Ain Shams University Hospitals following approval from the Research Ethical Committee. 150 patients with 170 adnexal masses reported on post-contrast MRI Each patient underwent dynamic post-contrast MRI. Image interpretation was done by two readers independently. The readers assigned each adnexal lesion with the standard O-RADS lexicon. The final diagnosis for every cases was determined by histology or clinical follow-up. Results Our results showed almost perfect agreement as regards the O-RADS classification system. The minor discrepancies came from difficulty in the interpretation of certain cases leading to discrepancies as regards O-RADS 2 and 3 classifications. Additionally, there can be misinterpretation as regards the categorization of dynamic enhancement curve as type 2 or 3 leading to discrepancies between O-RADS4 and 5. Fortunately, as regards any misdiagnosis between O-RADS 2 and 3, it can be sorted out by follow-up. Conclusion MRI is capable of delivering a more precise diagnosis for sonographically indeterminate ovarian lesions..

Article Type

Original Study

Subject Area

Radiology

IRB Number

FMASU R241/2022

Creative Commons License

Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License
This work is licensed under a Creative Commons Attribution-NonCommercial-Share Alike 4.0 International License.

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