Saerah Iffat Zafar, Syeda Tatheer Fatima.
Risk Stratification of Adnexal Masses Using MRI Ovarian-Adnexal Reporting and Data System (O-RADS) in Comparison to Sonographic Evaluation.
J Islamic Int Med Coll Jan ;18(4):234-8.

Objective: To assess the improvement in MRI categorization of adnexal lesions in females by adoption of standardized ovarian and adnexal reporting and data system (O-RADS) for differentiation between benign and malignant masses, in comparison to sonographic findings. Study Design: Descriptive cross-sectional study. Place and Duration of Study: Radiology department of CMH Abbottabad for a period of 12 months from 01 September 2021 to 31 August 2022. Materials and Methods: A total of 26 adult female patients with pelvic masses referred to CMH Abbottabad between September 2021 to August 2022 for MRI pelvis were included in the study with the prerequisite of prior ultrasound examination. Signal characteristics of adnexal masses, presence of septae, papillary projections, degree of enhancement, diffusion restriction, and ancillary findings were identified. Grading of the lesions was performed according to O-RADS following the American College of Radiologists (ACR) criteria- from 1-5 in order of potential of malignancy; findings were compared with sonographic results. Clinico-lab correlation and management outcomes of these patients were followed for final diagnosis. Results: Out of 26 patients included in the study, majority were benign on MRI - 84.6% (n=22/26), falling in ORADS 2/3 categories. Only 2 out of 11 complex cysts (18.2%) turned out to be definitely malignant (O-RADS 5) on MRI, while rest were benign (O-RADS 3) showing varying stages of bleed (9 out of 11 at 81.8%). All sonographically malignant lesions -15.3% of adnexal masses (n=4/26) were confirmed on MRI (O-RADS 5) and histopathology. Conclusion: Risk stratification scoring through MRI O-RADS aids in accurate differentiation of malignant from benign lesions, particularly in sonographically indeterminate lesions, aiding gynaecologists in timely management and referral of these patients.

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