MRI identifies malignant ovarian cancer

  • Thomassin-Naggara I & al.
  • JAMA Netw Open
  • 3 Jan 2020

  • curated by Deepa Koli
  • Univadis Clinical Summaries
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Takeaway

  • A 5-point ovarian-adnexal reporting data system magnetic resonance imaging (O-RADS MRI) score shows high specificity and sensitivity for malignancy in women with sonographically indeterminate adnexal masses.

Why this matters

  • This score will allow an individualized patient-centric approach for sonographically indeterminate adnexal masses.

Study design

  • A routine pelvic MRI was performed in 1130 consecutive patients with sonographically indeterminate adnexal mass.
  • Funding: Société d’Imagerie de la Femme; others.

Key results

  • 18.0% of patients showed ≥1 malignant adnexal or nonadnexal pelvic mass.
  • No invasive cancer was assigned a score of 2.
  • Among experienced vs junior readers, a score of 4/5 suggested a malignant mass with a:
    • Sensitivity of 0.93 (95% CI, 0.89-0.96) vs 0.92 (95% CI, 0.87-0.95), respectively.
    • Specificity of 0.91 (95% CI, 0.89-0.93) vs 0.90 (95% CI, 0.88-0.91), respectively.
  • The interrater agreement of the score between experienced and junior readers was substantial (κ=0.784; 95% CI, 0.743-0.824).
  • The origin of each pelvic mass was correctly categorized as adnexal with a sensitivity of 0.99 (95% CI, 0.98-0.99) and a specificity of 0.78 (95% CI, 0.71-0.85).

Limitations

  • Observational design.