MRI Guides Treatment For Indeterminate Pelvic Mass in Women

Magnetic resonance imaging after diagnosis of an indeterminate pelvic mass reduces the number of unnecessary surgeries or long-term follow up, according to a study published in the American Journal of Roentgenology.

Researchers from Yale University in New Haven, CT undertook a study to assess the clinical impact of pelvic MRI performed following the diagnosis of an indeterminate pelvic mass on ultrasound or CT.

Researchers reviewed radiologic records of 214 females (median age 45.5, ranging from 7 to 84) who underwent pelvic MRI for evaluation of a gynecologic mass detected on a preceding ultrasound or CT examination; 76% had undergone an initial evaluation with ultrasound and 24% with CT. Eighty percent of the women underwent only ultrasound (83%), CT (16%) or PET/CT (1%). Nineteen percent of the 214 subjects underwent imaging on two modalities before MRI. Of those, the second examination was ultrasound (75%) or CT (25%). The time from the first (or second) radiologic examination to MRI was between zero to 98 days, median 27 days.

The results showed that MRI findings altered clinical management of patients in 77% of cases. Surgery was avoided in 36%, and surgery was changed to a more appropriate method (laparoscopy versus laparotomy, involvement or not of a gynecologic oncologist) in an additional 17% of cases.

The researchers concluded that had the subjects not undergone MRI following initial imaging, many would have had unnecessary or inappropriate surgery for their condition.