ESUR recommendations for MR imaging of the sonographically indeterminate adnexal mass: An update
Open accessAbstract
An update of the 2010 published ESUR recommendations of MRI of the sonographically indeterminate adnexal mass integrating functional techniques is provided. An algorithmic approach using sagittal T2 and a set of transaxial T1 and T2WI allows categorization of adnexal masses in one of the following three types according to its predominant signal characteristics. T1 'bright' masses due to fat or blood content can be simply and effectively determined using a combination of T1W, T2W and FST1W imaging. When there is concern for a solid component within such a mass, it requires additional assessment as for a complex cystic or cystic-solid mass. For low T2 solid adnexal masses, DWI is now recommended. Such masses with low DWI signal on high b value image (e.g. > b 1000 s/mm2) can be regarded as benign. Any other solid adnexal mass, displaying intermediate or high DWI signal, requires further assessment by contrast-enhanced (CE)T1W imaging, ideally with DCE MR, where a type 3 curve is highly predictive of malignancy. For complex cystic or cystic-solid masses, both DWI and CET1W—preferably DCE MRI—is recommended. Characteristic enhancement curves of solid components can discriminate between lesions that are highly likely malignant and highly likely benign. • MRI is a useful complementary imaging technique for assessing sonographically indeterminate masses. • Categorization allows confident diagnosis in the majority of adnexal masses. • Type 3 contrast enhancement curve is a strong indicator of malignancy. • In sonographically indeterminate masses, complementary MRI assists in triaging patient management.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Kawahara et al. (2021) published a formula that estimates R2 values by incorporating CEA and tumor diameters as independent predictive factors for discriminating endometriosis ovarian cancer from ovarian endometrioma.
“Kawahara et al. (2021) published a formula that estimates R2 values by incorporating CEA and tumor diameters as independent predictive factors for discriminating endometriosis ovarian cancer, from ovarian endometrioma [20,51].”
From Malignancy in Abdominal Wall Endometriosis: Is There a Way to Avoid It? A Systematic Review (2024) · cites this paper as [51]
The Complex cystic or cystic-solid masses and New developments sections discuss MRI findings and an MRI scoring system, but neither describes a formula estimating R2 from CEA and tumour diameter. Searches for Kawahara, CEA, tumour diameter and R2 found no passage addressing the claimed formula. Page numbers were not available in our copy. (LLM, conf=0.78)
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Timmerman, D., Ameye, L., Fischerová, D., Epstein, E., Melis, G. B., Guerriero, S., Holsbeke, C. V., Savelli, L., Fruscio, R., Lissoni, A. A., et al. (2010) · BMJ · doi:10.1136/bmj.c6839 · Cited by 486 · see citing works
Effect of Surgeon Specialty on Processes of Care and Outcomes for Ovarian Cancer Patients
Earle, C. C., Schrag, D., Neville, B. A., Yabroff, K. R., Topor, M. A., Fahey, A., Trimble, E. L., Bodurka, D. C., Bristow, R. E., Carney, M. E., et al. (2006) · JNCI Journal of the National Cancer Institute · doi:10.1093/jnci/djj019 · Cited by 415 · see citing works
Surgery by consultant gynecologic oncologists improves survival in patients with ovarian carcinoma
Engelen, M. J. A., Kos, H. E., Willemse, P. H. B., Aalders, J. G., de Vries, E. G. E., Schaapveld, M., Otter, R., & van der Zee, A. G. J. (2005) · Cancer · doi:10.1002/cncr.21616 · Cited by 305 · see citing works
Complex Adnexal Masses: Detection and Characterization with MR Imaging—Multivariate Analysis
Hricak, H., Chen, M., Coakley, F. V., Kinkel, K., Yu, K. K., Sica, G. T., Bacchetti, P., & Powell, C. B. (2000) · Radiology · doi:10.1148/radiology.214.1.r00ja3939 · Cited by 295 · see citing works
Self-citationVernooij, F., Heintz, P. M., Witteveen, E. O., et al. (2007) · Gynecologic Oncology · doi:10.1016/j.ygyno.2007.02.030 · Cited by 280 · see citing works
MRI, CT, and PET/CT for Ovarian Cancer Detection and Adnexal Lesion Characterization
Iyer, V. R., & Lee, S. I. (2010) · American Journal of Roentgenology · doi:10.2214/ajr.09.3522 · Cited by 264 · see citing works
Adnexal Masses: Development and Preliminary Validation of an MR Imaging Scoring System
Thomassin‐Naggara, I., Aubert, É., Rockall, A., et al. (2013) · Radiology · doi:10.1148/radiol.13121161 · Cited by 222 · see citing works
Self-citationKaijser, J., Sayasneh, A., Hoorde, K. V., Ghaem‐Maghami, S., Bourne, T., Timmerman, D., & CALSTER, B. V. (2013) · Human Reproduction Update · doi:10.1093/humupd/dmt059 · Cited by 219 · see citing works
Thomassin‐Naggara, I., Bazot, M., Daraï, É., et al. (2008) · Radiology · doi:10.1148/radiol.2481071120 · Cited by 202 · see citing works
Self-citationThomassin‐Naggara, I., Toussaint, I., Perrot, N., et al. (2010) · Radiology · doi:10.1148/radiol.10100751 · Cited by 193 · see citing works
Self-citationContribution of diffusion-weighted MR imaging for predicting benignity of complex adnexal masses
Thomassin‐Naggara, I., Daraï, É., Cuénod, C. A., et al. (2009) · European Radiology · doi:10.1007/s00330-009-1299-4 · Cited by 190 · see citing works
Self-citationThomassin‐Naggara, I., Daraï, É., Cuénod, C. A., et al. (2008) · Journal of Magnetic Resonance Imaging · doi:10.1002/jmri.21377 · Cited by 175 · see citing works
Self-citationNakayama, T., Yoshimitsu, K., Irie, H., Aibe, H., Tajima, T., Nishie, A., Asayama, Y., Matake, K., Kakihara, D., Matsuura, S., et al. (2005) · Journal of Magnetic Resonance Imaging · doi:10.1002/jmri.20369 · Cited by 168 · see citing works
Ovarian cancer in endometriosis: molecular biology, pathology, and clinical management
Mandai, M., Yamaguchi, K. D., Matsumura, N., Baba, T., & Konishi, I. (2009) · International Journal of Clinical Oncology · doi:10.1007/s10147-009-0935-y · Cited by 162 · see citing works
Fujii, S., Kakite, S., Nishihara, K., Kanasaki, Y., Harada, T., Kigawa, J., Kaminou, T., & Ogawa, T. (2008) · Journal of Magnetic Resonance Imaging · doi:10.1002/jmri.21575 · Cited by 159 · see citing works
Role of diffusion-weighted imaging in the diagnosis of gynecological diseases
Namimoto, T., Awai, K., Nakaura, T., Yanaga, Y., Hirai, T., & Yamashita, Y. (2008) · European Radiology · doi:10.1007/s00330-008-1185-5 · Cited by 148 · see citing works
PET/MRI and PET/CT in advanced gynaecological tumours: initial experience and comparison
Queiroz, M. A., Huch, R., Hauser, N., et al. (2015) · European Radiology · doi:10.1007/s00330-015-3657-8 · Cited by 124 · see citing works
Spencer, J. A. D., Forstner, R., Cunha, T. M., et al. (2009) · European Radiology · doi:10.1007/s00330-009-1584-2 · Cited by 112 · see citing works
Self-citationKatayama, M., Masui, T., Kobayashi, S., Ito, T., Sakahara, H., Nozaki, A., & Kabasawa, H. (2002) · Journal of Computer Assisted Tomography · doi:10.1097/00004728-200203000-00015 · Cited by 103 · see citing works
Bernardin, L., Dilks, P., Liyanage, S. H., et al. (2011) · European Radiology · doi:10.1007/s00330-011-2331-z · Cited by 95 · see citing works
Thomassin‐Naggara, I., Balvay, D., Aubert, É., et al. (2011) · European Radiology · doi:10.1007/s00330-011-2329-6 · Cited by 94 · see citing works
Self-citationClinically oriented three‐step strategy for assessment of adnexal pathology
Ameye, L., Timmerman, D., Valentin, L., Paladini, D., Zhang, J., Holsbeke, C. V., Lissoni, A. A., Savelli, L., Veldman, J., Testa, A. C., et al. (2012) · Ultrasound in Obstetrics and Gynecology · doi:10.1002/uog.11177 · Cited by 88 · see citing works
Kierans, A. S., Bennett, G. L., Mussi, T. C., Babb, J. S., Rusinek, H., Melamed, J., & Rosenkrantz, A. B. (2012) · Journal of Magnetic Resonance Imaging · doi:10.1002/jmri.23794 · Cited by 71 · see citing works
CALSTER, B. V., Timmerman, D., Valentin, L., McIndoe, A., Ghaem‐Maghami, S., Testa, A. C., Vergote, I. B., & Bourne, T. (2012) · BJOG An International Journal of Obstetrics & Gynaecology · doi:10.1111/j.1471-0528.2012.03297.x · Cited by 62 · see citing works
Thomassin‐Naggara, I., Daraï, É., Nassar-Slaba, J., et al. (2007) · Journal of Computer Assisted Tomography · doi:10.1097/01.rct.0000237810.88251.9e · Cited by 60 · see citing works
Self-citationMagnetic resonance imaging features of ovarian fibroma, fibrothecoma, and thecoma
Chung, B. M., Park, S. B., Lee, J. B., et al. (2014) · Abdominal Imaging · doi:10.1007/s00261-014-0257-z · Cited by 60 · see citing works
Can quantitative dynamic contrast-enhanced MRI independently characterize an ovarian mass?
Dilks, P., Narayanan, P., Reznek, R. H., et al. (2010) · European Radiology · doi:10.1007/s00330-010-1795-6 · Cited by 55 · see citing works
Sclerosing stromal tumor of the ovary: radiologic findings
Matsubayashi, R. N., Matsuo, Y., Doi, J., et al. (1999) · European Radiology · doi:10.1007/s003300050844 · Cited by 54 · see citing works
Discriminative MRI features of fallopian tube masses
Ghattamaneni, S., Bhuskute, N. M., Weston, M. J., et al. (2009) · Clinical Radiology · doi:10.1016/j.crad.2009.03.007 · Cited by 27 · see citing works
Poncelet, É., Delpierre, C., Kerdraon, O., et al. (2013) · Clinical Radiology · doi:10.1016/j.crad.2013.03.029 · Cited by 27 · see citing works
Tang, Y. Z., Liyanage, S., Narayanan, P., et al. (2012) · European Radiology · doi:10.1007/s00330-012-2568-1 · Cited by 27 · see citing works
The usefulness of 18F-FDG-PET/CT in discriminating benign from malignant ovarian teratomas
Yokoyama, T., Takehara, K., Yamamoto, Y., et al. (2015) · International Journal of Clinical Oncology · doi:10.1007/s10147-015-0800-0 · Cited by 24 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Robinson, K. A., Menias, C. O., Chen, L., Schiappacasse, G., Shaaban, A. M., Caserta, M. P., Elsayes, K. M., VanBuren, W. M., & Bolan, C. W. (2020) · Abdominal Radiology · doi:10.1007/s00261-019-01914-7 · Cited by 67 · see citing works
Malignancy in Abdominal Wall Endometriosis: Is There a Way to Avoid It? A Systematic Review
Alaert, J., Lancelle, M., Timmermans, M., Tanos, P., Nisolle, M., & Karampelas, S. (2024) · Journal of Clinical Medicine · doi:10.3390/jcm13082282 · Cited by 9 · see citing works
“Kawahara et al. (2021) published a formula that estimates R2 values by incorporating CEA and tumor diameters as independent predictive factors for discriminating endometriosis ovarian cancer, from ovarian endometrioma [20,51].”
Background
- Authors
- Forstner, R., Thomassin-Naggara, I., Cunha, T. M., Kinkel, K., Masselli, G., Kubik-Huch, R., Spencer, J. A., & Rockall, A.
- Affiliations
- Paracelsus Medical University (AT)
- Instituto Português de Oncologia Francisco Gentil (PT)
- Hirslanden Clinique des Grangettes (CH)
- Sapienza University of Rome (IT)
- St James's University Hospital (GB)
- Royal Marsden NHS Foundation Trust (GB)
- Corresponding author
- Forstner, Rosemarie
- Venue
- European Radiology
- Published
- 2016-10-21
- Volume
- 27
- Issue
- 6
- Pages
- 2248-2257
- ISSN
- 0938-7994 (ISSN-L)
- 1432-1084
- PMC
- PMC5408043
- OpenAlex
- W2533216420
- Cited by
- 204
- References
- 32
- Citations by year
- 2026: 21 · 2025: 17 · 2024: 25 · 2023: 24 · 2022: 28 · 2021: 21 · 2020: 20 · 2019: 20 · 2018: 12 · 2017: 15
- FWCI
- 13.60
- Type
- journal article
- Language
- en
- Update notices
- correction (2016-12-05)
- Open access
- hybrid
- doi.org
- Locations
- European Radiology (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Repositório Comum (Repositório Científico de Acesso Aberto de Portugal) (submittedVersion)
- Funders
- National Institute for Health and Care Research (HTA/14/31/04, 14/31/04)
- Paracelsus Medizinische Privatuniversität
- Topics
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › MRI in cancer diagnosis
- Health Sciences › Medicine › Reproductive Medicine › Ovarian cancer diagnosis and treatment
- Health Sciences › Medicine › Pathology and Forensic Medicine › Breast Lesions and Carcinomas
- Keywords
- adnexal mass, differential diagnosis, adnexal cystic mass, diffusion-weighted imaging, dynamic contrast-enhanced MRI, ovarian malignancy, benign versus malignant differentiation
- MeSH terms
- Adnexal Diseases, Diagnosis, Differential, Female, Humans, Image Enhancement, Magnetic Resonance Imaging, Middle Aged, Ovarian Neoplasms, Ultrasonography, Practice Guidelines as Topic
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
