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) mm(2)/s) compared with all other adnexal lesions (1.812 × 10(-3) mm(2)/s); the mean ADC values in endometrioma (1.387 × 10(-3) mm(2)/s) were significantly lower than in other cystic lesions (2.372 × 10(-3) mm(2)/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.
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) mm(2)/s) compared with all other adnexal lesions (1.812 × 10(-3) mm(2)/s); the mean ADC values in endometrioma (1.387 × 10(-3) mm(2)/s) were significantly lower than in other cystic lesions (2.372 × 10(-3) mm(2)/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.
Authors: A B Kurtz; J V Tsimikas; C M Tempany; U M Hamper; P H Arger; R L Bree; R J Wechsler; I R Francis; J E Kuhlman; E S Siegelman; D G Mitchell; S G Silverman; D L Brown; S Sheth; B G Coleman; J H Ellis; R J Kurman; D J Caudry; B J McNeil Journal: Radiology Date: 1999-07 Impact factor: 11.105
Authors: H Hricak; C B Powell; K K Yu; E Washington; L L Subak; J L Stern; M G Cisternas; R L Arenson Journal: Radiology Date: 1996-02 Impact factor: 11.105
Authors: Johannes M Froehlich; Thierry Metens; Bianka Chilla; Nik Hauser; Markus Klarhoefer; Rahel A Kubik-Huch Journal: Insights Imaging Date: 2012-09-26
Authors: I Thomassin-Naggara; D Balvay; A Rockall; M F Carette; M Ballester; E Darai; M Bazot Journal: Biomed Res Int Date: 2015-08-27 Impact factor: 3.411
Authors: Pietro Valerio Foti; Giancarlo Attinà; Saveria Spadola; Rosario Caltabiano; Renato Farina; Stefano Palmucci; Giuseppe Zarbo; Rosario Zarbo; Maria D'Arrigo; Pietro Milone; Giovanni Carlo Ettorre Journal: Insights Imaging Date: 2015-12-16