Diagnostic Value of DCE-MRI for Differentiating Malignant Adnexal Masses Compared with Contrast-enhanced-T1WI

Abstract

To compare the diagnostic performance of dynamic contrast-enhanced-MR (DCE-MR) and delayed contrast-enhanced (CE)-MRI added to unenhanced MRI, including diffusion weighted image (DWI) for differentiating malignant adnexal tumors, conducting a retrospective blinded image interpretation study.Methods: Data of 80 patients suspected of having adnexal tumors by ultrasonography between April 2008 and August 2018 were used for the study. All patients had undergone preoperative MRI and surgical resection at our institution. Four radiologists (two specialized in gynecological radiology and two nonspecialized) were enrolled for blinded review of the MR images. A 3-point scale was used: 0 = benign, 1 = indeterminate, and 2 = malignant. Three imaging sets were reviewed: Set A, unenhanced MRI including DWI; Set B, Set A and delayed CE-T1WI; and Set C, Set A and DCE-MRI. Imaging criteria for benign and malignant tumors were given in earlier reports. The diagnostic performance of the three imaging sets of the four readers was calculated. Their areas under the curve (AUCs) were compared using the DeLong method.Results: Accuracies of Set B were 81%-88%. Those of Set C were 81%-85%. The AUCs of Set B were 0.83 and 0.89. Those of Set C were 0.81-0.86. For two readers, Set A showed lower accuracy and AUC than Set B/Set C (less than 0.80), although those were equivalent in other readers. No significant difference in AUCs was found among the three sequence sets. Intrareader agreement was moderate to almost perfect in Sets A and B, and substantial to almost perfect in Set C. Conclusion:DCE-MR showed no superiority for differentiating malignant adnexal tumors from benign tumors compared to delayed CE-T1WI with conventional MR and DWI.

Comparing Characteristics of Pelvic High-grade Serous Carcinomas with and without Breast Cancer Gene Variants on MR Imaging

“…16,17 However, in this study, there was no significant difference in the size and appearance of the tumors and the nature of the solid components on MRI between BRCA variant-positive and negative HGSCs. Although DWI and DCE studies have been useful in differentiating benign from malignant lesions, 18,19 ADC and TIC pattern are widely used as clinically quantifiable indicators; however, in this study, both BRCA variant-positive and negative HGSCs showed nonspecific malignant patterns, without significant differences.…”

Dynamic contrast-enhanced magnetic resonance imaging assessment of residual tumor angiogenesis after insufficient microwave ablation and donafenib adjuvant therapy

“…Morphological evaluation alone may not be able to accurately reflect the sensitivity of the tumor to drug therapy in a timely manner, while metabolic parameters such as blood flow and metastatic parameters are associated with perfusion information inside the tumor, which may change before the size of the tumor changes. DCE-MRI can observe and evaluate the functional state of microcirculation in tissues and organs at the microvascular level 22 – 24 . In this experiment, we focused on the angiogenic status of the residual tumor and did not perform "sufficient microwave ablation" because the area of the completely ablated lesion contained only necrotic tissue resulting from the microwave ablation, and the ROI within the ablation area provided very few parameters.…”

Applying multiparametric magnetic resonance imaging in differentiating benign and malignant ovarian tumors

“…In malignant tumors, MRI manifestations were irregular with unclear boundaries, complex composition, ascites, hyperintense signal on DWI, and obvious enhancement. Therefore, magnetic resonance plain scan combined with DWI imaging and contrast-enhanced can make preliminary qualitative diagnosis of ovarian tumor before surgery, and provide clinical basis for patient treatment [7][8][9][10][11] .…”