ROLE OF FUNCTIONAL MRI AND O-RADS MRI RISK SCORE IN EVALUATION OF INDETERMINATE OVARIAN MASSES

Abstract

Background- Ovarian masses are a common finding in routine clinical practice. MRI shows great accuracy in the detection and discrimination of ovarian/adnexal masses, but conventional MRI sequences sometimes fail to characterize indeterminate ovarian masses. Functional MRI techniques, such as DWI and DCE-MRI provides further information based on tissue cellularity and internal architecture of ovarian tumors respectively. To Aims- evaluate the various conventional and DCE-MRI characteristics of ovarian masses, to estimate their ADC values and to assess the performance of the O-RADS MRI risk score. The study was conducted in the Department of Materials and methodsRadio-diagnosis, TMCH over a period of one year, on 50 patients diagnosed with indeterminate or suspicious ovarian mass in US examination. MRI was performed on a 1.5-T MR imaging unit. The findings were correlated with results of HPE. Results- The diagnostic accuracy of O-RADS MRI risk score was 93.2%, sensitivity 94.74%, and specificity 93.67%. Among the DCE-MR parameters, MRE% showed higher specificity (80%) and Tmax showed higher sensitivity (97.5%). Malignant masses showed higher MRE% and less time to peak compared to benign masses. ADC cut-off of <1.0x10-3 for the solid component of the masses has produced a sensitivity of 90.24%, specificity of 77.78% and accuracy of 88.5%. Conclusion- Based on the results of our study, we conclude that in cases of indeterminate ovarian masses, functional MRI should be the investigation of choice. Further, applying the O-RADS MRI risk score in clinical practice standardizes reporting and allows for a customized patient-centred strategy.