ArticleAbdominal radiology (New York)2026
Follow-up MRI recommendations for adnexal lesions on pelvic ultrasound: frequency, associations and outcomes.
Article in Abdominal radiology (New York), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeTo assess the frequency and outcomes of follow-up MRI recommendations for adnexal lesions on pelvic US interpreted by US experts versus non-US expert abdominal radiologists.
methodsIn this IRB-approved, HIPAA-compliant retrospective cohort study, all pelvic US reports in adult women between 2018-2023 at a tertiary academic center were screened using a validated NLP algorithm for follow-up MRI recommendations for incidental adnexal lesions. MRI recommendation rates, compliance with the recommendation, and impact of MRI on management (malignancy risk upgrade/no change/downgrade and final outcomes) were compared between US expert and non-US expert abdominal radiologists.
resultsOf 19,335 pelvic US in 14,328 patients (15,609, 80.7% read by US experts, 3726, 19.3% by non-US expert abdominal radiologists), 458 (2.3%) had follow-up MRI recommendations. US experts made fewer recommendations (248, 1.5% vs 210, 5.6%; p < 0.001) and had higher compliance rate (157, 63.3% vs 108, 51.4%; p = 0.01). MRI caused risk downgrade, no change, and upgrade in 191 (72.1%), 62 (23.4%), and 12 (4.5%) respectively; without significant difference between US experts and non-US experts (113, 72%, 39, 24.8%, 5, 3.2% vs 78, 72.2%, 23, 21.3%, 7, 6.5%; p = 0.96). Of 191 lesions with risk-downgrade, 124 underwent surgery (n = 60) or follow-up (n = 64) without any cancers; 67 had no further follow-up. Of 12 lesions with risk-upgrade on MRI, 6 (50%) were malignant, 4 (33.3%) benign, 2 (16.7%) borderline. Of 193 cases where MRI was not performed, 60 were resected (53, 88.3% benign, 3, 5.0% borderline, 4, 6.7% malignant).
conclusionUS experts made fewer follow-up MRI recommendations, with no difference in the impact of MRI on risk-assessment between US experts and non-US expert radiologists. MRI resulted in malignancy risk-downgrade in most lesions and can potentially avoid unnecessary surgeries.
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