Preoperative assessment of sonographically indeterminate ovarian mass: diagnostic validation of ovarian –adnexal reporting and data system (O-RADS MRI)

Fathy, Alaa Wagih; Henein, Merna Medhat Farag; El-Shweel, Mohamed A. El Ghany; Abd El-Rahim, Ahmed Rabea; Mohemed, Manar Mohamed Sayed

doi:10.21608/mjmr.2025.397530.1999

Preoperative assessment of sonographically indeterminate ovarian mass: diagnostic validation of ovarian –adnexal reporting and data system (O-RADS MRI)

Articles in Press

Document Type : Original Article

Authors

¹ radiology department, faculty of medicine, minia university

² Radiodiagnosis Department, Faculty of Medicine, Minia university, Egypt,

³ Department of radiology, faculty of medicine, Minia university

⁴ Professor of gynecology and obstetrics, Faculty of medicine, Minia university, Egypt

⁵ Radiology Department , Faculty of Medicine, Minia University, Egypt

10.21608/mjmr.2025.397530.1999

Abstract

Background:Ovarian cancer is the fifth highest cause of cancer-related death among women. The utilization of a reliable imaging modality is essential for differentiating between benign and malignant ovarian neoplasms.The Ovarian-Adnexal Reporting and Data System (O-RADS) seeks to provide standardized interpretations to diminish ambiguity in ultrasound results, hence improving the precision of ovarian malignancy risk evaluation.The O-RADS MRI score accurately differentiates between indeterminate benign and malignant ovarian tumors.

The target of this study was to evaluate the reliability of the Ovarian-Adnexal Reporting Data System Magnetic Resonance Imaging (O-RADS MRI) scale in identifying sonographically indeterminate ovarian masses.

Results: Our findings support the use of the O-RADS MRI score for assessing ovarian masses, especially those classified as indeterminate by ultrasonod. All benign lesions demonstrated DCE Type 1 (100%). Conversely, malignant tumors exhibited more varied and pronounced enhancement profiles as six lesions (37.5%) exhibited Type 2 enhancement curve, whereas ten lesions (62.5%) had Type 3 enhancement curve. Among malignant variations, serous cystadenocarcinoma demonstrated Type 2 in 2 cases (33.3%) and Type 3 in 4 cases (40%). Clear cell carcinoma was associated with one occurrence of Type 2 (16.7%) and two cases showed Type 3 (20%).Granulosa cell tumor,endometrioid carcinoma and metastases each one of them demonstrated Type 2 (16.7%) and Type 3 curve (10–20%).Immature teratoma was only linked to Type 2.

Conclusion:The O-RADS MRI score demonstrates remarkable accuracy and validity in distinguishing malignant from benign ovarian lesions.Utilizing this score in clinical settings may facilitate a patient-focused strategy for sonographically ambiguous masses,thereby preventing excessive surgical interventions.

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