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DIAGNOSTIC VALUE OF ACR O-RADS MRI v.2024 IN DIFFERENTIATING BENIGN AND MALIGNANT ADNEXAL MASSES
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Abstract
Background: The Ovarian-Adnexal Reporting and Data System for MRI (O-RADS MRI, version 2024) developed by the American College of Radiology (ACR) provides a standardized framework for risk stratification of adnexal masses. While validated internationally, its application in Vietnam remains limited. Purpose: To evaluate the correlation between O-RADS MRI categories and histopathological outcomes of ovarian tumors, and to identify MRI features predictive of malignancy. Materials and Methods: This retrospective study included 63 ovarian lesions from 57 patients who underwent preoperative pelvic MRI with histopathological confirmation between January 2023 and July 2025. Results: Eighteen of 63 lesions (28.6%) were malignant, including invasive ovarian carcinoma (n=11), ovarian metastasis from gastric carcinoma (n=1) and borderline tumors (n=6). The presence of strongly enhancing solid tissue was the strongest predictor of malignancy (OR = 35.6; 95% CI: 4.15–304.7; p=0.001). An O-RADS MRI cutoff of ≥4 achieved a sensitivity of 78% and specificity of 93%, with an AUC of 0.884. Malignancy rates increased across O-RADS categories: 2 (0%), 3 (14.3%), 4 (75%), and 5 (80%). Conclusion: O-RADS MRI demonstrates high diagnostic accuracy in differentiating benign from malignant adnexal masses. The assessment of enhancing solid tissue is particularly valuable for predicting malignancy and guiding management.
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Keywords
O-RADS MRI; Adnexal mass; Ovarian cancer; Malignancy prediction.
References
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