ESR Essentials: characterisation and staging of adnexal masses with MRI and CT-practice recommendations by ESUR.
Giacomo AvesaniCamilla PanicoStephanie NougaretRamona WoitekBenedetta GuiEvis SalaPublished in: European radiology (2024)
Ovarian masses encompass various conditions, from benign to highly malignant, and imaging plays a vital role in their diagnosis and management. Ultrasound, particularly transvaginal ultrasound, is the foremost diagnostic method for adnexal masses. Magnetic Resonance Imaging (MRI) is advised for more precise characterisation if ultrasound results are inconclusive. The ovarian-adnexal reporting and data system (O-RADS) MRI lexicon and scoring system provides a standardised method for describing, assessing, and categorising the risk of each ovarian mass. Determining a histological differential diagnosis of the mass may influence treatment decision-making and treatment planning. When ultrasound or MRI suggests the possibility of cancer, computed tomography (CT) is the preferred imaging technique for staging. It is essential to outline the extent of the malignancy, guide treatment decisions, and evaluate the feasibility of cytoreductive surgery. This article provides a comprehensive overview of the key imaging processes in evaluating and managing ovarian masses, from initial diagnosis to initial treatment. It also includes pertinent recommendations for properly performing and interpreting various imaging modalities. KEY POINTS: MRI is the modality of choice for indeterminate ovarian masses at ultrasound, and the O-RADS MRI lexicon and score enable unequivocal communication with clinicians. CT is the recommended modality for suspected ovarian masses to tailor treatment and surgery. Multidisciplinary meetings integrate information and help decide the most appropriate treatment for each patient.
Keyphrases
- contrast enhanced
- magnetic resonance imaging
- computed tomography
- magnetic resonance
- diffusion weighted imaging
- ultrasound guided
- high resolution
- contrast enhanced ultrasound
- image quality
- emergency department
- dual energy
- primary care
- palliative care
- positron emission tomography
- decision making
- pulmonary embolism
- acute coronary syndrome
- pet ct
- mass spectrometry
- coronary artery disease
- quality improvement
- health information
- fluorescence imaging
- clinical practice
- squamous cell
- smoking cessation
- metastatic renal cell carcinoma