title: External validation of the MR imaging scoring system for the management of adnexal masses.
abstract: OBJECTIVE
  To investigate the prognostic value of ADNEX Magnetic Resonance Imaging Scoring in the preoperative management of adnexal masses.
  
  
  METHODS
  We performed a retrospective study on patients who underwent surgery for an adnexal mass, with prior exploration by Magnetic Resonance Imaging (MRI), at the Gynecology Department of the Poissy Teaching Hospital between May 2012 and August 2014. MRI data were retrospectively read by radiologists, without knowledge of the histology, and classified according to the criteria of the ADNEX MR score. The radiological presumption of benign or malignant mass was compared with the final histological diagnosis. We calculated the sensitivity, specificity, positive and negative likelihood ratios and ROC curve of the ADNEX MR score with their 95% confidence intervals (95%CI).
  
  
  RESULTS
  One-hundred-and-forty-eight patients were included in the study of which 24 had malignant or borderline ovarian tumors. The proportion of malignant or borderline ovarian tumors in each class of the ADNEX MR score in our study was: ADNEX I: 0% (95%CI, 0-8); ADNEX II: 1.7% (95%CI, 0.04-8.9); ADNEX III: 7.7% (95%CI, 0.2-36); ADNEX IV: 57.1% (95%CI, 34.2-78.8) and ADNEX V: 100% (95%CI, 69.2-100). Thus, for an ADNEX MR score greater than or equal to 4, the sensitivity was 91.7% (95%CI, 73-99) and the specificity 92.7% (95%CI, 86.7-96.6) for the diagnosis of a malignant or borderline ovarian tumor. The area under the ROC curve was 0.92 (95% CI%, 0.86-0.98).
  
  
  CONCLUSIONS
  MRI, coupled with the use of the ADNEX MR scoring system, can accurately classify adnexal masses into low-risk (ADNEX MR score <4) or high-risk (ADNEX MR score ≥4) group, thereby allowing for appropriate preoperative counseling and planning for surgery.
authors: Department of Gynecology and Obstetrics, CHI Poissy-St-Germain, 10, rue du Champ Gaillard, 78300 Poissy, France.
authors: Mireille
authors: M
authors: Ruiz
authors: Department of Radiology, CHI Poissy-St-Germain, 10, rue du Champ Gaillard, 78300 Poissy, France.
authors: Pénélope
authors: P
authors: Labauge
authors: Department of Pathology, CHI Poissy-St-Germain, 10, rue du champ Gaillard, 78300 Poissy, France.
authors: Anne
authors: A
authors: Louboutin
authors: Department of Radiology, CHI Poissy-St-Germain, 10, rue du Champ Gaillard, 78300 Poissy, France.
authors: Olivier
authors: O
authors: Limot
authors: Department of Gynecology and Obstetrics, CHI Poissy-St-Germain, 10, rue du Champ Gaillard, 78300 Poissy, France; EA 7285 Risques Cliniques et Sécurité en Santé des Femmes, Université Versailles-Saint-Quentin-en-Yvelines, 78000 Versailles, France.
authors: Arnaud
authors: A
authors: Fauconnier
authors: Department of Gynecology and Obstetrics, CHI Poissy-St-Germain, 10, rue du Champ Gaillard, 78300 Poissy, France; EA 7285 Risques Cliniques et Sécurité en Santé des Femmes, Université Versailles-Saint-Quentin-en-Yvelines, 78000 Versailles, France. Electronic address: cyrillehuchon@yahoo.fr.
authors: Cyrille
authors: C
authors: Huchon
mesh_terms: D000291:Adnexal Diseases / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D010051:Ovarian Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
keywords: Diagnosis; MRI; Ovarian cancer; Sensitivity; Specificity