Diagnostic accuracy of gynecology imaging reporting and data system in evaluation of adnexal lesions

Abstract

Background: Considering the increasing incidence rate of ovarian cancer in worldwide and the utility of Gynecologic Imaging Reporting and Data System (GI-RADS) in diagnosing malignant adnexal lesions such as ovarian cancer, we aimed to evaluate the diagnostic performance of this reporting system in differentiating between malignant and benign adnexal lesions. Materials and Methods: In this cross-sectional study, women with suspected adnexal lesions were enrolled. For differentiating of malignant adnexal lesions, Grade II and III of GI-RADS system were classified as low risk for malignancy and Grades IV and V as high risk. Results of histopathologic diagnosis were compared with the results of the mentioned GI-RADS system classification, and the diagnosed accuracy of the system was determined. Patients who did not have histopathologic diagnosis were followed up. Results: In this study, 197 women with suspected adnexal lesions were evaluated. Frequency of GI-RADS II, III, IV, and V were 34.5 (69 cases), 38.0 (76 cases), 19.5 (39 cases), and 6.5 (13 cases), respectively. According to the low- and high-risk classification of GI-RADS, 72.5 were classified as GI-RADS II and III and 26 as GI-RADS IV and V, respectively. Definitive histopathologic diagnosis was reported for 158 cases. Histopathologic evaluation indicated that 12 (7.6) of the masses were malignant and 146 (92.6) were benign. Comparing with the histopathologic diagnosis, the GI-RADS system sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio (LR), and negative LR were 91.6, 80.82, 28.2, 99.1, 4.77, and 0.10, respectively. The accuracy of the scoring system was 81.64. Conclusion: Our findings indicated that using GI-RADS, we could quantify the risk of malignancy by such a structured as well as simple reporting system so that the system could be useful for clinicians for performing an appropriate clinical management.