Characterization of Adnexal Masses by Detection of Choline Peak Using 1H MR Spectroscopy

Adnexal masses are among the common gynecologic problems. They may be of ovarian or non-ovarian origin. Most of the adnexal masses are benign and only a small number are malignant (Mohaghegh and Rockall, 2012; Kunpalin et al., 2014). Ovarian cancer is a major cause of death from gynecologic malignancies in women (Boyle et al., 2000). Preoperative characterization of adnexal masses and determining the likelihood of malignancy are important in the successful management of these masses (Arikan et al., 2014; Karadag et al., 2014; Tantipalakorn et al., 2014). Although ultrasound is the primary imaging modality, magnetic resonance (MR) imaging provides additional information on the nature of the lesions. Risk of malignancy index (RMI) is a quantitative tool for preoperative risk assessment of adnexal masses (ArunMuthuvel and Jaya, 2014; Simsek et al., 2014; Ozbay et al., 2015). MRI without and with intravenous contrast is required for indeterminate adnexal masses, either with uncertain origin or with intermediate RMI in the range of 25-200 (Mohaghegh and Rockall, 2012). In the recent years, studies have been carried out to