MRI scoring tool can differentiate between malignant and benign ovarian cysts: 90% accurate

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At the Gynecologic Oncology Institute, we focus on benign and malignant, or cancerous, ovarian masses.  It is crucial to be able to tell the difference but this is not always possible. Minimally invasive surgery is possible for both, but ideally, it is best to know what the chances are that an ovarian cyst is benign or malignant.  This study sheds some light on the topic.

“Researchers have developed a new MRI scoring tool that can be used to identify cases of ovarian cancer that are difficult to diagnose using standard methods.

The tool has shown encouraging results in a clinical study. The management implications and outcomes of women with ovarian cancer are now being investigated in a large study in 18 hospitals across the UK, including Imperial College Healthcare’s NHS Trust.

The tool can differentiate between malignant and benign ovarian cysts with an accuracy of 90 percent if this is not possible on ultrasound. It was developed by researchers led by Professor Isabelle Thomassin-Naggara at the APHP-Sorbonne Université with Professor Andrea Rockall at Imperial College London.

Currently, doctors use ultrasound scans and blood tests to check for possible cases of ovarian cancer. However, in a quarter of the time, these methods cannot determine with certainty whether a patient’s cyst is benign or malignant. This leads to surgical examinations that are invasive and involve risks, such as: B. possible loss of fertility. In most cases, women will then be diagnosed with a benign cyst.

The team believes the new tool can be used as a triage test to help determine whether patients need further follow-up or treatment. They also believe the results of the study, published on the JAMA Network Open, could help stratify high-risk patients so they can be treated much sooner.

In the new study, researchers looked at the effectiveness of a tool called the Ovarian-Adnexal Reporting Data System (O-RADS-MRI) in identifying the risk of malignancy in ovarian cysts that could not be categorized by ultrasound in 1,340 women. The study took place in 15 centers across Europe from March 2013 to March 2016, including Hammersmith Hospital, which is part of the NHS Trust of Imperial College Healthcare.

Each patient underwent a routine pelvic MRI exam that looked for features in cysts that could not be identified during an ultrasound scan, such as: B. Changes in tissue structure. The researchers developed a risk stratification score that rated the cysts across five categories. Radiologists then used this tool to evaluate the cysts.

A score of one to three was identified as no mass or benign, and a score between four and five was classified as high risk. The women were then given adequate standard of care, such as surgery if they were found to be high risk or a two-year follow-up visit if their cysts were benign.

The team also found that patients with two or three points were at very low risk of developing a malignant tumor. The researchers believe that with the help of their physicians, these patients can make an informed decision to take a minimally invasive approach to their treatment, such as: B. close monitoring and follow-up instead of surgery.

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“I help and guide women to beat endometriosis and gynecologic cancers that are associated with endo, like ovarian cancer, using a unique combination of minimally invasive robotic surgery, precision medicine therapies and complementary holistic natural support towards thriving in survivorship." Dr. Vasilev is the only physician triple board certified in Ob-Gyn, Gynecologic Oncology and Integrative & Holistic Medicine in the United States. He is an accomplished advanced robotic master surgeon, and is internationally vetted by iCareBetter (https://icarebetter.com/doctor/dr-steven-vasilev/). He serves as Professor at the world-renowned Saint John's Cancer Institute in Santa Monica, California and is Clinical Professor at Loma Linda University School of Medicine. He is former faculty and professor at UC Irvine, UCLA, USC and City of Hope and was the founding Medical Director of Integrative Medicine at Providence Saint John's Health Center. He is an active member of multiple medical societies and has been nationally listed in "Best Doctors" for over 20 years.