Abdusselim Adil Peker

Diagnostic utility of Magnetic Resonance Imaging in discriminating immature teratoma: Insights from a case series

AbstractImmature teratomas (IT) are rare germ cell tumors with malignant behavior, distinct from the benign mature teratomas. Clinical differentiation poses challenges, demanding a comprehensive, multidisciplinary diagnostic approach. This case series delves into the detailed radiological imaging findings of ITs. Pelvic MRI was conducted on five cases with adnexal masses, all of which were histopathologically confirmed as ITs. Radiologically, larger tumor size and scattered fatty components were key diagnostic indicators. This study underlines the importance of comprehensive evaluation in IT diagnosis and management, with MRI as an essential tool in the clinical workflow.

Dynamic versus nondynamic magnetic resonance imaging (MRI) protocols in Ovarian-Adnexal Reporting and Data System for magnetic resonance imaging (O-RADS MRI) scoring of adnexal masses: a comparative performance analysis

AİM: To compare the diagnostic performance of the Ovarian-Adnexal Reporting and Data System for magnetic resonance imaging (O-RADS MRI) using dynamic and nondynamic contrast-enhanced protocols in the characterisation of adnexal masses. MATERİALS AND METHODS: This retrospective study included 369 patients (mean age, 43.6 ± 15 years) with 479 adnexal lesions who underwent pelvic MRI between January 2020 and March 2025. Dynamic contrast-enhanced MRI (DCE-MRI) was performed in 97 lesions and nondynamic contrast-enhanced MRI in 382. Two radiologists, with 8 and 4 years of experience, independently reviewed all examinations while blinded to clinical and histopathological data. Lesions scored as O-RADS 2-3 were classified as benign and O-RADS 4-5 as malignant. Histopathology or ≥12 months of imaging follow-up served as the reference standard. Diagnostic accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated for both protocols. RESULTS: Among 479 lesions, 302 (76.8%) were benign, 28 (7.1%) borderline, and 63 (16.0%) malignant. The dynamic protocol achieved a sensitivity of 97.4%, specificity of 93.2%, PPV of 90.2%, NPV of 98.2%, and accuracy of 94.8%. The nondynamic protocol showed comparable results (sensitivity 96.4%, specificity 94.6%, PPV 91.2%, NPV 97.9%, accuracy 95.0%), with no significant difference in diagnostic accuracy (P =0.794). Malignancy rates increased progressively with higher O-RADS categories in both protocols. CONCLUSION: O-RADS MRI provides a reliable framework for risk stratification of adnexal masses. Nondynamic contrast-enhanced MRI achieves diagnostic performance equivalent to DCE-MRI and can be confidently used when dynamic acquisition is not feasible, supporting broader clinical adoption of simplified O-RADS MRI protocols.