ACR Appropriateness Criteria® Clinically Suspected Adnexal Mass, No Acute Symptoms: 2023 Update

Krupa K. Patel-Lippmann, Vanderbilt University Medical Center, Nashville, Tennessee. Electronic address: krupa.k.patel-lippmann@vumc.org.
Ashish P. Wasnik, Panel Chair, University of Michigan, Ann Arbor, Michigan.
Esma A. Akin, The George Washington University Medical Center, Washington, District of Columbia; Commission on Nuclear Medicine and Molecular Imaging.
Rochelle F. Andreotti, Vanderbilt University Medical Center, Nashville, Tennessee; O-RADS Committee.
Susan M. Ascher, MedStar Georgetown University Hospital, Washington, District of Columbia.
Olga R. Brook, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
Ramez N. Eskander, University of California, San Diego, San Diego, California; American College of Obstetricians and Gynecologists.
Myra K. Feldman, Cleveland Clinic, Cleveland, Ohio.
Lisa P. Jones, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.
Martin A. Martino, Ascension St. Vincent's, Jacksonville, Florida; University of South Florida, Tampa, Florida, Gynecologic oncologist.
Maitray D. Patel, Mayo Clinic Arizona, Phoenix, Arizona; IF Committee.
Michael N. Patlas, Department of Medical Imaging, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Margarita A. Revzin, Yale University School of Medicine, New Haven, Connecticut; Committee on Emergency Radiology-GSER.
Wendaline VanBuren, Mayo Clinic, Rochester, Minnesota.
Catheryn M. Yashar, University of California, San Diego, San Diego, California; Commission on Radiation Oncology.
Stella K. Kang, Specialty Chair, New York University Medical Center, New York, New York.

Document Type

Journal Article

Publication Date

6-1-2024

Journal

Journal of the American College of Radiology : JACR

Volume

21

Issue

6S

DOI

10.1016/j.jacr.2024.02.017

Keywords

AUC; Appropriateness Criteria; MRI; adnexal mass; appropriate use criteria; asymptomatic; postmenopausal; premenopausal; ultrasound

Abstract

Asymptomatic adnexal masses are commonly encountered in daily radiology practice. Although the vast majority of these masses are benign, a small subset have a risk of malignancy, which require gynecologic oncology referral for best treatment outcomes. Ultrasound, using a combination of both transabdominal, transvaginal, and duplex Doppler technique can accurately characterize the majority of these lesions. MRI with and without contrast is a useful complementary modality that can help characterize indeterminate lesions and assess the risk of malignancy is those that are suspicious. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision process support the systematic analysis of the medical literature from peer reviewed journals. Established methodology principles such as Grading of Recommendations Assessment, Development, and Evaluation or GRADE are adapted to evaluate the evidence. The RAND/UCLA Appropriateness Method User Manual provides the methodology to determine the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where peer reviewed literature is lacking or equivocal, experts may be the primary evidentiary source available to formulate a recommendation.

Department

Radiology

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