ARRS 2022 Abstracts

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E1881. MRI O-RADS Simplified: Case-Based Library of Radio-Pathological Correlation
Authors
  1. Aisha Lakhani; NKP Salve Lata Mangeshkar Hospital
  2. Ameya Kulkarni; Mc Master University
  3. Avinash Dhok; NKP Salve Lata Mangeshkar Hospital
  4. Kajal Mitra; NKP Salve Lata Mangeshkar Hospital
Background
After a brief review of published literature regarding MRI Ovarian-Adnexal Reporting & Data System (O-RADS) and definitions, explanation of a pathway to evaluate adnexal lesions on MRI, some cases will be presented in a quiz format. Key points on how to apply these points will be highlighted for each case, with follow-up imaging, or final histopathological diagnosis, and advice on avoiding pitfalls wherever applicable. Some of the cases included in this exhibit will include dermoid cyst, endometriomas and hemorrhagic cysts, hydrosalpinx/ hematosalpinx, borderline tumor, germ cell tumor, mucinous cystadenoma, serous cystadenocarcinoma, and sertoli cell Leydig tumor.

Educational Goals / Teaching Points
The American College of Radiology (ACR) has outlined five 0-RADS score categories for the evaluation and classification of ovarian lesions and their application on the US as well as MRI. This serves as a validated triage tool for risk stratification. The purpose of this exhibit is to review MRI findings associated with various O-RADS scores, provide a flowchart of how to approach ovarian lesions on MRI, and adhere to the lexicon to ensure proper application. After reviewing this exhibit, the radiologists/trainees will be able to improve their skills in applying these points to guide adnexal mass management.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
O-RADS MRI assessment utilizes a 5-point scale to indicate the likelihood of malignancy based on a combination of multi-parametric MRI findings. This score is mainly based on the analysis of solid tissue using morphological and functional criteria including T2W signal, DW signal, and the analysis of time-intensity curve on DCE MRI sequence, as most errors are due to misinterpretation of solid tissue or incorrect assignment of mass origin. The score is then correlated with histopathological diagnosis and each case is thus provided with essential imaging pearls and pitfalls.

Conclusion
Simplifying the assessment of the ovarian-adnexal lesions by adhering to this algorithmic step-by-step approach will ensure the purpose of the O-RADS tool and avoid unnecessary surgical intervention.