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Sadowski EA, Rockall A, Thomassin-Naggara I, Barroilhet LM, Wallace SK, Jha P, Gupta A, Shinagare AB, Guo Y, Reinhold C. Adnexal Lesion Imaging: Past, Present, and Future. Radiology 2023; 307:e223281. [PMID: 37158725 DOI: 10.1148/radiol.223281] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Currently, imaging is part of the standard of care for patients with adnexal lesions prior to definitive management. Imaging can identify a physiologic finding or classic benign lesion that can be followed up conservatively. When one of these entities is not present, imaging is used to determine the probability of ovarian cancer prior to surgical consultation. Since the inclusion of imaging in the evaluation of adnexal lesions in the 1970s, the rate of surgery for benign lesions has decreased. More recently, data-driven Ovarian-Adnexal Reporting and Data System (O-RADS) scoring systems for US and MRI with standardized lexicons have been developed to allow for assignment of a cancer risk score, with the goal of further decreasing unnecessary interventions while expediting the care of patients with ovarian cancer. US is used as the initial modality for the assessment of adnexal lesions, while MRI is used when there is a clinical need for increased specificity and positive predictive value for the diagnosis of cancer. This article will review how the treatment of adnexal lesions has changed due to imaging over the decades; the current data supporting the use of US, CT, and MRI to determine the likelihood of cancer; and future directions of adnexal imaging for the early detection of ovarian cancer.
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Affiliation(s)
- Elizabeth A Sadowski
- From the Departments of Radiology (E.A.S.) and Obstetrics and Gynecology (E.A.S., L.M.B., S.K.W.), University of Wisconsin School of Medicine and Public Health, 600 Highland Ave, E3/372, Madison, WI 53792-3252; Division of Surgery and Cancer, Imperial College London, Hammersmith Campus, London, UK (A.R.); Department of Radiology, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Hôpital Tenon, Paris, France (I.T.N.); Department of Radiology, Stanford University School of Medicine, Stanford, Calif (P.J.); Department of Imaging Sciences, University of Rochester, Rochester, NY (A.G.); Department of Radiology, Brigham and Women's Hospital, Boston, Mass (A.B.S., Y.G.); Augmented Imaging Precision Health Laboratory (AIPHL), Research Institute of the McGill University Health Centre, and Department of Radiology, McGill University, Montreal, Canada (C.R.); and Montreal Imaging Experts, Montreal, Canada (C.R.)
| | - Andrea Rockall
- From the Departments of Radiology (E.A.S.) and Obstetrics and Gynecology (E.A.S., L.M.B., S.K.W.), University of Wisconsin School of Medicine and Public Health, 600 Highland Ave, E3/372, Madison, WI 53792-3252; Division of Surgery and Cancer, Imperial College London, Hammersmith Campus, London, UK (A.R.); Department of Radiology, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Hôpital Tenon, Paris, France (I.T.N.); Department of Radiology, Stanford University School of Medicine, Stanford, Calif (P.J.); Department of Imaging Sciences, University of Rochester, Rochester, NY (A.G.); Department of Radiology, Brigham and Women's Hospital, Boston, Mass (A.B.S., Y.G.); Augmented Imaging Precision Health Laboratory (AIPHL), Research Institute of the McGill University Health Centre, and Department of Radiology, McGill University, Montreal, Canada (C.R.); and Montreal Imaging Experts, Montreal, Canada (C.R.)
| | - Isabelle Thomassin-Naggara
- From the Departments of Radiology (E.A.S.) and Obstetrics and Gynecology (E.A.S., L.M.B., S.K.W.), University of Wisconsin School of Medicine and Public Health, 600 Highland Ave, E3/372, Madison, WI 53792-3252; Division of Surgery and Cancer, Imperial College London, Hammersmith Campus, London, UK (A.R.); Department of Radiology, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Hôpital Tenon, Paris, France (I.T.N.); Department of Radiology, Stanford University School of Medicine, Stanford, Calif (P.J.); Department of Imaging Sciences, University of Rochester, Rochester, NY (A.G.); Department of Radiology, Brigham and Women's Hospital, Boston, Mass (A.B.S., Y.G.); Augmented Imaging Precision Health Laboratory (AIPHL), Research Institute of the McGill University Health Centre, and Department of Radiology, McGill University, Montreal, Canada (C.R.); and Montreal Imaging Experts, Montreal, Canada (C.R.)
| | - Lisa M Barroilhet
- From the Departments of Radiology (E.A.S.) and Obstetrics and Gynecology (E.A.S., L.M.B., S.K.W.), University of Wisconsin School of Medicine and Public Health, 600 Highland Ave, E3/372, Madison, WI 53792-3252; Division of Surgery and Cancer, Imperial College London, Hammersmith Campus, London, UK (A.R.); Department of Radiology, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Hôpital Tenon, Paris, France (I.T.N.); Department of Radiology, Stanford University School of Medicine, Stanford, Calif (P.J.); Department of Imaging Sciences, University of Rochester, Rochester, NY (A.G.); Department of Radiology, Brigham and Women's Hospital, Boston, Mass (A.B.S., Y.G.); Augmented Imaging Precision Health Laboratory (AIPHL), Research Institute of the McGill University Health Centre, and Department of Radiology, McGill University, Montreal, Canada (C.R.); and Montreal Imaging Experts, Montreal, Canada (C.R.)
| | - Sumer K Wallace
- From the Departments of Radiology (E.A.S.) and Obstetrics and Gynecology (E.A.S., L.M.B., S.K.W.), University of Wisconsin School of Medicine and Public Health, 600 Highland Ave, E3/372, Madison, WI 53792-3252; Division of Surgery and Cancer, Imperial College London, Hammersmith Campus, London, UK (A.R.); Department of Radiology, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Hôpital Tenon, Paris, France (I.T.N.); Department of Radiology, Stanford University School of Medicine, Stanford, Calif (P.J.); Department of Imaging Sciences, University of Rochester, Rochester, NY (A.G.); Department of Radiology, Brigham and Women's Hospital, Boston, Mass (A.B.S., Y.G.); Augmented Imaging Precision Health Laboratory (AIPHL), Research Institute of the McGill University Health Centre, and Department of Radiology, McGill University, Montreal, Canada (C.R.); and Montreal Imaging Experts, Montreal, Canada (C.R.)
| | - Priyanka Jha
- From the Departments of Radiology (E.A.S.) and Obstetrics and Gynecology (E.A.S., L.M.B., S.K.W.), University of Wisconsin School of Medicine and Public Health, 600 Highland Ave, E3/372, Madison, WI 53792-3252; Division of Surgery and Cancer, Imperial College London, Hammersmith Campus, London, UK (A.R.); Department of Radiology, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Hôpital Tenon, Paris, France (I.T.N.); Department of Radiology, Stanford University School of Medicine, Stanford, Calif (P.J.); Department of Imaging Sciences, University of Rochester, Rochester, NY (A.G.); Department of Radiology, Brigham and Women's Hospital, Boston, Mass (A.B.S., Y.G.); Augmented Imaging Precision Health Laboratory (AIPHL), Research Institute of the McGill University Health Centre, and Department of Radiology, McGill University, Montreal, Canada (C.R.); and Montreal Imaging Experts, Montreal, Canada (C.R.)
| | - Akshya Gupta
- From the Departments of Radiology (E.A.S.) and Obstetrics and Gynecology (E.A.S., L.M.B., S.K.W.), University of Wisconsin School of Medicine and Public Health, 600 Highland Ave, E3/372, Madison, WI 53792-3252; Division of Surgery and Cancer, Imperial College London, Hammersmith Campus, London, UK (A.R.); Department of Radiology, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Hôpital Tenon, Paris, France (I.T.N.); Department of Radiology, Stanford University School of Medicine, Stanford, Calif (P.J.); Department of Imaging Sciences, University of Rochester, Rochester, NY (A.G.); Department of Radiology, Brigham and Women's Hospital, Boston, Mass (A.B.S., Y.G.); Augmented Imaging Precision Health Laboratory (AIPHL), Research Institute of the McGill University Health Centre, and Department of Radiology, McGill University, Montreal, Canada (C.R.); and Montreal Imaging Experts, Montreal, Canada (C.R.)
| | - Atul B Shinagare
- From the Departments of Radiology (E.A.S.) and Obstetrics and Gynecology (E.A.S., L.M.B., S.K.W.), University of Wisconsin School of Medicine and Public Health, 600 Highland Ave, E3/372, Madison, WI 53792-3252; Division of Surgery and Cancer, Imperial College London, Hammersmith Campus, London, UK (A.R.); Department of Radiology, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Hôpital Tenon, Paris, France (I.T.N.); Department of Radiology, Stanford University School of Medicine, Stanford, Calif (P.J.); Department of Imaging Sciences, University of Rochester, Rochester, NY (A.G.); Department of Radiology, Brigham and Women's Hospital, Boston, Mass (A.B.S., Y.G.); Augmented Imaging Precision Health Laboratory (AIPHL), Research Institute of the McGill University Health Centre, and Department of Radiology, McGill University, Montreal, Canada (C.R.); and Montreal Imaging Experts, Montreal, Canada (C.R.)
| | - Yang Guo
- From the Departments of Radiology (E.A.S.) and Obstetrics and Gynecology (E.A.S., L.M.B., S.K.W.), University of Wisconsin School of Medicine and Public Health, 600 Highland Ave, E3/372, Madison, WI 53792-3252; Division of Surgery and Cancer, Imperial College London, Hammersmith Campus, London, UK (A.R.); Department of Radiology, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Hôpital Tenon, Paris, France (I.T.N.); Department of Radiology, Stanford University School of Medicine, Stanford, Calif (P.J.); Department of Imaging Sciences, University of Rochester, Rochester, NY (A.G.); Department of Radiology, Brigham and Women's Hospital, Boston, Mass (A.B.S., Y.G.); Augmented Imaging Precision Health Laboratory (AIPHL), Research Institute of the McGill University Health Centre, and Department of Radiology, McGill University, Montreal, Canada (C.R.); and Montreal Imaging Experts, Montreal, Canada (C.R.)
| | - Caroline Reinhold
- From the Departments of Radiology (E.A.S.) and Obstetrics and Gynecology (E.A.S., L.M.B., S.K.W.), University of Wisconsin School of Medicine and Public Health, 600 Highland Ave, E3/372, Madison, WI 53792-3252; Division of Surgery and Cancer, Imperial College London, Hammersmith Campus, London, UK (A.R.); Department of Radiology, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Hôpital Tenon, Paris, France (I.T.N.); Department of Radiology, Stanford University School of Medicine, Stanford, Calif (P.J.); Department of Imaging Sciences, University of Rochester, Rochester, NY (A.G.); Department of Radiology, Brigham and Women's Hospital, Boston, Mass (A.B.S., Y.G.); Augmented Imaging Precision Health Laboratory (AIPHL), Research Institute of the McGill University Health Centre, and Department of Radiology, McGill University, Montreal, Canada (C.R.); and Montreal Imaging Experts, Montreal, Canada (C.R.)
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