 Gynecological ultrasound is well known as the preferred exam to assess patients with ovarian tumors. The International Ovarian Tumor Analysis IOTA group developed the Simple Rules to classify an ovarian tumor as benign or malignant. In about 15 of patients the Simple Rules give an inconclusive result and therefore a suitable second line test is necessary. Recently the ADNEXMR SCORING system was developed, this is the first Magnetic Resonance Imaging MRI score system that focuses on ovarian tumors. 