ArticleEuropean journal of radiology2023
Improving risk stratification of indeterminate adnexal masses on MRI: What imaging features help predict malignancy in O-RADS MRI 4 lesions?
Article in European journal of radiology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it, 13 citations in OpenAlex.
- Node-RADS: a systematic review and meta-analysis of diagnostic performance, category-wise malignancy rates, and inter-observer reliability.European radiology · 2025Pooled it
- Diagnostic accuracy of a modified non-contrast O-RADS MRI scoring system: a retrospective study.Insights into imaging · 2026Article
- Article
- Diagnostic value of multiparametric MRI combined with an interpretable machine learning model in the differentiation of benign and malignant ovarian-adnexal lesions classified as O-RADS 4.BMC medical imaging · 2025Article
- Review
- Differentiating struma ovarii from FIGO stage I malignant ovarian tumors in O-RADS MRI 5 lesions: a targeted cohort study.Abdominal radiology (New York) · 2025Article
- Diagnostic performance of a modified O-RADS classification system for adnexal lesions incorporating clinical features.Abdominal radiology (New York) · 2025Article
- Efficacy of a combination of O-RADS, CEUS, and CA125, in identification of ovary-adnexal malignant lesions.American journal of cancer research · 2025Article
- Developing a deep learning model for predicting ovarian cancer in Ovarian-Adnexal Reporting and Data System Ultrasound (O-RADS US) Category 4 lesions: A multicenter study.Journal of cancer research and clinical oncology · 2024Article
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 1 country.
Funding
Abstract
purposeOvarian-Adnexal Reporting and Data System (O-RADS) MRI uses a 5-point scale to establish malignancy risk in sonographically-indeterminate adnexal masses. The management of O-RADS MRI score 4 lesions is challenging, as the prevalence of malignancy is widely variable (5-90%). We assessed imaging features that may sub-stratify O-RADS MRI 4 lesions into malignant and benign subgroups.
methodRetrospective single-institution study of women with O-RADS MRI score of 4 adnexal masses between April 2021-August 2022. Imaging findings were assessed independently by 2 radiologists according to the O-RADS lexicon white paper. MRI and clinical findingswere compared between malignant and benign adnexal masses, and inter-reader agreement was calculated.
resultsSeventy-four women (median age 52 years, IQR 36-61) were included. On pathology, 41 (55.4%) adnexal masses were malignant. Patients with malignant masses were younger (p = 0.02) with higher CA-125 levels (p = 0.03). Size of solid tissue was greater in malignant masses (p = 0.01-0.04). Papillary projections and larger solid portion were more common in malignant lesions; irregular septations and predominantly solid composition were more frequent in benign lesions (p < 0.01). Solid tissue of malignant lesions was more often hyperintense on T2-weighted and diffusion-weighted imaging (p ≤ 0.03). Other imaging findings were not significantly different (p = 0.09-0.77). Inter-reader agreement was excellent-good for most features (ICC = 0. 662-0.950; k = 0. 650-0.860).
conclusionVarious MRI and clinical features differed between malignant and benign O-RADS MRI score 4 adnexal masses. O-RADS MRI 4 lesions may be sub-stratified (high vs low risk) based on solid tissue characteristics and CA-125 levels.
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