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European Radiology
Published in: European Radiology 6/2011

01-06-2011 | Urogenital

Indeterminate adnexal masses at ultrasound: effect of MRI imaging findings on diagnostic thinking and therapeutic decisions

Authors: Bianka Chilla, Nik Hauser, Gad Singer, Mafalda Trippel, Johannes M. Froehlich, Rahel A. Kubik-Huch

Published in: European Radiology | Issue 6/2011

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Abstract

Objective

To determine the impact of MRI including DWI on therapeutic decision-making and costs in the work-up of patients with a indeterminate adnexal mass on ultrasound.

Methods

Thirty-eight patients with indeterminate ovarian lesions scheduled for surgery were included in this prospective study. In a questionnaire, the surgeon characterised the lesions based on a morphological score and determined the surgical procedure. The assessment was re-evaluated knowing MR findings and correlated with the final diagnosis. A cost-benefit analysis of MRI was performed. The impact of including DWI in the MR protocol was assessed.

Results

MRI provided major diagnostic information in 11/38 cases (28.9%) resulting in abstention from surgery in 5 cases; moderate additional information was recorded in 10/38 (26.3%) patients. Overall a net cost saving (3’676 EUR) was achieved. DWI did not show a significant difference between benign and malignant lesions. Teratomas yielded significantly lower mean ADC values (0.597 × 10-3 mm2/s) compared with all other adnexal lesions (1.812 × 10-3 mm2/s); the mean ADC values in endometrioma (1.387 × 10-3 mm2/s) were significantly lower than in other cystic lesions (2.372 × 10-3 mm2/s).

Conclusion

Inclusion of MRI in the diagnostic algorithm of the indeterminate adnexal mass allows better differentiation of ovarian lesions resulting in a change of therapeutic decision-making with net cost savings.
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Metadata
Title
Indeterminate adnexal masses at ultrasound: effect of MRI imaging findings on diagnostic thinking and therapeutic decisions
Authors
Bianka Chilla
Nik Hauser
Gad Singer
Mafalda Trippel
Johannes M. Froehlich
Rahel A. Kubik-Huch
Publication date
01-06-2011
Publisher
Springer-Verlag
Published in
European Radiology / Issue 6/2011
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-010-2018-x

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