Contemporary Guidelines for Adnexal Mass Imaging: A 2020 Update

Abdom Radiol (NY). 2021 May;46(5):2127-2139. doi: 10.1007/s00261-020-02812-z. Epub 2020 Oct 20.


Incidental adnexal masses are commonly encountered at ultrasound, computed tomography, and magnetic resonance imaging. Since many of these lesions are surgically resected and ultimately found to be benign, patients may be exposed to personal and economic costs related to unnecessary oophorectomy. Thus, accurate non-invasive risk stratification of adnexal masses is essential for optimal management and outcomes. Multiple consensus guidelines in radiology have been published to assist in characterization of these masses as benign, indeterminate, or likely malignant. In the last two years, several new and updated stratification systems for assessment of incidental adnexal masses have been published. The purpose of this article is to offer a concise review of four recent publications: ACR 2020 update on the management of incidental adnexal findings on CT and MRI, SRU 2019 consensus update on simple adnexal cysts, O-RADS ultrasound risk stratification system (2020), and O-RADS MRI risk stratification system (2020).

Keywords: Adnexal; Magnetic resonance imaging; O-RADS; Ovarian; Simple cyst; Ultrasound.

Publication types

  • Review

MeSH terms

  • Adnexal Diseases* / diagnostic imaging
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Ovarian Neoplasms*
  • Radiology*
  • Tomography, X-Ray Computed
  • Ultrasonography