Diagnostic Accuracy of Diffusion Weighted Imaging in Diagnosing Malignant Adnexal Masses Taking Histopathology as Gold Standard

Abstract

ABSTRACT

Objective: This study aimed to determine the accuracy of diffusion-weighted magnetic resonance imaging (DWI) in differentiating malignant from benign adnexal masses, using histopathology as the reference standard.

Materials and Methods: A prospective cross-sectional design was employed at the Radiology Department, Punjab Institute of Neurosciences, Lahore, over period of six months. One hundred women with adnexal masses meeting the eligibility criteria underwent pelvic MRI, including DWI and apparent diffusion coefficient (ADC) mapping. All lesions were surgically excised and subjected to histopathological confirmation. Imaging results were compared with histopathology to establish diagnostic accuracy.

Results: Histopathology confirmed malignancy in 88 out of 100 cases (88%). DWI/ADC analysis detected malignant features in 86 patients. The technique yielded a sensitivity of 94.3%, specificity of 75.0%, overall accuracy of 92.0%, positive predictive value of 96.5%, and negative predictive value of 64.3%.

Conclusion: DWI with ADC assessment provides a dependable, non-invasive approach for preoperative characterisation of adnexal masses. With high sensitivity and accuracy, it is a valuable adjunct for identifying malignancy and guiding clinical management, while histopathology remains the definitive gold standard.

Keywords: Adnexal mass, Diffusion-weighted MRI, Apparent diffusion coefficient, Histopathology.