When this occurs, patients may need to undergo surgery in order to confirm if the cyst is malignant or benign. This is invasive and the majority turn out to be benign. In some small cases, this can also lead to a loss of fertility in younger patients.
If the nature of the cysts could be known before surgery, patients would potentially benefit from a more limited surgical approach or follow-up, saving the patients from additional risks as well as cutting unnecessary costs for the NHS.
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In the new study, researchers looked at the effectiveness of a tool called Ovarian-Adnexal Reporting Data System Magnetic Resonance Imaging (O-RADS MRI) in identifying the risk of malignancy in ovarian cysts that could not be categorised by ultrasound in 1340 women. The study took place from March 2013 to March 2016 at 15 centres across Europe, including Hammersmith Hospital, part of Imperial College Healthcare NHS Trust.
Each patient underwent a routine pelvic MRI examination which looked for particular features in cysts that could not be identified during an ultrasound examination such as changes to tissue structure. The researchers developed a risk stratification score which scored the cysts based on five categories. Radiologists then used this tool to score the cysts.
A score of one to three was identified as no mass or benign and a score between four and five was deemed high risk. The women then underwent appropriate standard care, such as surgery if they were identified as high risk or a two year follow-up if their cysts were benign.
A team of radiologists also analysed patients' medical records and ultrasound scans to compare the tool.
The team found that the system outperformed current methods and was 90 per cent accurate at identifying malignant and benign cysts.
The team also found that in patients who scored two or three the risk of a malignant tumour was very low. The researchers believe that these patients can make an informed decision, with the support of their physicians, to undergo a minimally invasive approach towards their treatment such as close monitoring and follow-up rather than surgery.
The research was funded Societé d'Imagerie de la Femme and supported by National Institute of Health Research Imperial Biomedical Research Centre (NIHR- Imperial BRC), the Cancer Research UK Imperial Centre.
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