Publication:

Diagnostic accuracy of magnetic resonance imaging in the preoperative characterization of ovarian neoplasms: a retrospective study with histopathological correlation

Background To evaluate the diagnostic accuracy of magnetic resonance imaging (MRI) in the preoperative characterization of ovarian neoplasms using histopathological examination (HPE) as the reference standard.

Methods This retrospective observational study included 105 women with indeterminate or suspicious adnexal masses who underwent preoperative MRI followed by surgical management and histopathological examination at a tertiary care centre. MRI findings were categorized as benign or borderline/malignant based on morphological and tissue-specific imaging characteristics. Histopathological examination served as the reference standard. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), overall diagnostic accuracy, and Cohen's kappa coefficient were calculated.

Results Histopathological examination identified 73 (69.5%) benign and 32 (30.5%) borderline/malignant ovarian neoplasms. MRI correctly classified all 73 benign lesions and 27 of the 32 borderline/malignant lesions, while five borderline/malignant lesions were incorrectly classified as benign. MRI demonstrated a sensitivity of 84.4%, specificity of 100%, PPV of 100%, NPV of 93.6%, and overall diagnostic accuracy of 95.2%. Agreement between MRI and histopathological classification was excellent (κ=0.88).

Conclusion MRI demonstrated high diagnostic accuracy and excellent agreement with histopathological examination in differentiating benign from borderline/malignant ovarian neoplasms. Its high specificity supports its role as a valuable problem-solving modality in the preoperative characterization of ovarian masses. However, histopathological examination remains essential for definitive diagnosis.