Abstract
Introduction:
Transvaginal ultrasound is the main reference technique in the evaluation of adnexal masses. Based on the Breast Imaging Reporting and Data System (BIRADS) classification Amor et al. suggested adapting this system to gynecologic ultrasound for the evaluation of adnexal masses: Gynecologic Imaging Reporting and Data System (GI-RADS) and based on recognition patterns and criteria recommended by the IOTA group.
Materials and methods:
A retrospective observational study was performed on women with adnexal masses who were diagnosed and operated consecutively at the Virgen de la Arrixaca Clinical University Hospital in Murcia between January 2013 and December 2014. All patients underwent transvaginal or transrectal ultrasound. GI-RADS1 was not included (no mass). GI-RADS2 and 3 lesions were classified as benign and GI-RADS4 and 5 as probably malignant.
Results:
387 patients, mean age 43 (13- 88), 246 premenopausal (63.5%) and 142 postmenopausal (36.5%).387 masses were classified: 3 GI-RADS2 (0.7%), 316 GI-RADS3 (811.7%), 20 GI-RADS4 (5.1%) and 48 GI-RADS5 (12.4%). GI-RADS2, none was malignant. GI-RADS3, 3.1% were malignant. GI-RADS4, 60% were malignant and GI-RADS5, 91.7% were positive for malignancy. Sensitivity 84.9% (95%CI 74.3–91.6%), Specificity 96.3% (95%CI 93.6-97.9%); LR+ 22.7 (CI95% 12.9–39.9), LR- 0.2 (95%CI 0.1-0.3); Odds Ratio 144.2 (95%CI 59.4 – 349.8). Area under the ROC curve 0.90.
Conclusion:
The GI-RADS reporting system has proved to perform well as a diagnostic system and it seems to be useful in everyday clinical practice. However, it would be advisable to check the classification criteria for GI-RADS 3 and 4 in order to achieve greater diagnostic reliability.
Citation
Fernández RO, Rama AP, Llanos Llanos MC, Mendoza AM, Linde FM and Díaz AN . Clinical Application of the Gynecologic Imaging Reporting and Data System (Gi-Rads) for the Evaluation of Adnexal Masses. SM J Gynecol Obstet. 2015;1(2):1009.