Tuesday, December 1 | 3:00 p.m. to 4:00 p.m. | T7-SSOB02-7 | Room S404
In this presentation, attendees will find out how well MRI identifies endometriosis-associated ovarian malignancy.
Women with endometriosis are prone to both atypical benign lesions and specific ovarian cancers, which can make adnexal masses hard to assess.
Researchers led by Catherine Wang, MD, from the University of Montreal led the study of 143 women with endometriosis who underwent pelvic MRI for an indeterminate adnexal mass. These included lesions rated O-RADS 3, 4, or 5 exams on ultrasound. The women then had surgery with pathological analysis. Two radiologists independently assessed morphological and functional MRI features and assigned O-RADS MRI scores.
The final cohort had 143 patients with a median age of 45 years and 182 adnexal masses. Of these, 65.9% were benign, 14.8% were borderline, and 19.2% were invasive tumors. Among borderline tumors, 48.1% were of the seromucinous subtype. Among invasive tumors, 62.8% were clear cell or endometrioid cystadenocarcinomas.
The team identified the following factors linked to malignancy: solid tissue, size over 4.5 cm, multilocularity, loss of T2 shading, an abnormal ovarian pedicle, menopausal status, and deep pelvic endometriosis (all p < 0.01).
An O-RADS MRI score of four or higher correctly classified 155 of 182 masses, for an accuracy of 86.8%, sensitivity of 95.1%, and specificity of 82.5%. Invasive tumors differed from borderline tumors in their solid tissue, with obtuse angles (odds ratio [OR] 5.8), irregular borders (OR, 4.0), and fewer than four solid nodules (OR, 7.0). Every tumor with an apparent diffusion coefficient value of 0.7 or lower in solid tissue proved to be invasive.
The results show how MRI provides robust risk stratification for these masses, with the researchers highlighting that MRI supports consistent reporting and appropriate surgical referral while helping reduce unnecessary aggressive interventions.
Attend this session to find out more.
