MRI scoring systems for adnexal masses: A Comparative Review | ||
| Medicine Updates | ||
| Articles in Press, Accepted Manuscript, Available Online from 30 September 2025 | ||
| Document Type: Review Article | ||
| DOI: 10.21608/muj.2025.422368.1264 | ||
| Authors | ||
| Carmen Ali Zarad* 1; Asmaa M Yussif2; Waleed S Abo Shanab1; Mohamed Elrakhawy3; Khaled Abd El-Baky Ahmed1 | ||
| 1Diagnostic and interventional radiology department, faculty of medicine, Port Said University | ||
| 2Department of radiology Sinbellawin general hospital, Ministry of health, Egypt. | ||
| 3Diagnostic and interventional radiology department, Faculty of medicine Mansoura University | ||
| Abstract | ||
| Background: Ovarian cancer represents one of the most common cancers among females. Delayed diagnosis of ovarian malignancy is one of the commonest leading factors of high mortality. Diagnosis of ovarian malignancy depends on multidisciplinary techniques that depend on clinical picture, laboratory, and imaging investigations for the accurate assessment of adnexal masses. Magnetic resonance imaging (MRI) is a valuable imaging modality used for assessment of ultrasonography diagnosed indeterminate ovarian masses with high accuracy than that of ultrasound. Also the total MRI accuracy have been increased by addition of dynamic contrast enhanced (DCE) MRI and diffusion-weighted imaging (DWI) sequences to conventional MR imaging. Three MRI scoring systems have been developed to standardize risk stratification of ovarian masses which are Ovarian-Adnexal Reporting and Data System (O-RADS) MRI, MR-ADNEX and Modified MR-ADNEX scoring systems. Conclusion: MRI scoring systems have become indispensable tools for the characterization of adnexal masses, particularly in cases that remain indeterminate on ultrasound. Among the available approaches, O-RADS MRI provides the most validated and standardized framework, demonstrating excellent diagnostic accuracy and reproducibility. The MR-ADNEX model adds value by offering probabilistic classification that supports surgical decision-making, while Modified MR-ADNEX systems enhance feasibility in centers without full DCE protocols by incorporating DWI and ADC parameters. Collectively, these tools improve diagnostic confidence, reduce unnecessary surgical interventions, and optimize patient referral to specialized oncologic care. Future research should prioritize large-scale comparative studies, standardization of modified criteria, and integration with emerging technologies such as radiomics and artificial intelligence to further refine individualized risk stratification | ||
| Keywords | ||
| O-RADS MRI; MR-ADNEX; Modified MR-ADNEX; Ovarian masses | ||
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