Differentiation of Benign from Malignant Adnexal Masses by Functional 3 Tesla MRI Techniques: Diffusion-Weighted Imaging and Time-Intensity Curves of Dynamic Contrast-Enhanced MRI

Malek, Mahrooz; Pourashraf, Maryam; Mousavi, Azam Sadat; Rahmani, Maryam; Ahmadinejad, Nasrin; Alipour, Azam; Hashemi, Farhad B.; Shakiba, Madjid

doi:10.7314/apjcp.2015.16.8.3407

Cited by 15 publications

(7 citation statements)

References 31 publications

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“…(sensitivity 89%) and in 3 of 4 benign masses. So it could not be used in differentiation between benign and malignant tumors [12]. In this study, CHO peak was detected in 42 lesions (64.5%) including 17 (40%) benign lesions (5 abscesses, 3 mature teratomas, 2 mucinous and 6 serous cystadenomas (Fig.…”

Section: Discussionmentioning

confidence: 62%

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Value of magnetic resonance spectroscopy in assessment of adnexal lesions

Ibrahim

Fattah

Metwally

et al. 2019

Egypt J Radiol Nucl Med

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Background: The purpose of this study is to investigate the role of proton MR spectroscopy (1H-MRS) in the characterization and diagnosis of ovarian lesions. Results: From October 2015 to October 2017, a total of 57 female patients (65 adnexal lesions; 8 cases were bilateral) were included. The examined lesions were classified according to their histopathological findings, (37 (57%) benign lesions, 4 (6%) borderline lesions, and 24 (37%) malignant lesions). The mean choline/creatinine (CHO/ Cr) ratio was 1.29 ± 0.98 SD for malignant lesions, while the mean value in borderline lesions was 0.63 ± 0.15 SD, and the mean value for the benign lesions was 0.65 ± 0.34. Therefore, the mean CHO/Cr ratio was much higher in malignant than in benign lesions, which was statistically significant (P ≤ 0.001) as well as between the borderline and invasive lesions (P = 0.05), but not between the benign and borderline lesions. The diagnostic performance of conventional MRI in diagnosing adnexal lesions was 100%, specificity was 76%, and accuracy was 86%. However, MRS individual diagnostic performances are the following: sensitivity 89%, specificity, and 100% with an accuracy of 95%. Conclusion: MRS proved to be an accurate and efficient method for the analysis of adnexal lesions and in differentiation between benign and malignant tumors.

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Section: Discussionmentioning

confidence: 62%

“…Lactate is the end-product of anaerobic glycolysis and appears at 1.3 ppm [12]. Lactate signal is detected in the cystic portion of the ovarian tumors which were detected not only in all malignant tumors but also in some benign tumors as in dermoid cysts.…”

Section: Discussionmentioning

confidence: 99%

Value of magnetic resonance spectroscopy in assessment of adnexal lesions

Ibrahim

Fattah

Metwally

et al. 2019

Egypt J Radiol Nucl Med

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“…A study conducted by Malek et al [23] on 23 ovarian masses showed the presence of choline peak in 17 of 19 malignant masses (sensitivity 89%) and in 3 of 4 benign masses. So they considered that it could not be used in differentiating between benign and malignant tumors.…”

Section: Discussionmentioning

confidence: 97%

Functional MRI in the pre-operative assessment of GI-RADS 3, 4, and 5 ovarian masses

Ibrahim

Maher

Abdalaziz

et al. 2019

Egypt J Radiol Nucl Med

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Background: Characterization of an ovarian lesion is a diagnostic challenge. A correct preoperative assessment is of great importance so as to arrange adequate therapeutic procedures. The aim of the current study is to evaluate the diagnostic performance of functional MRI in differentiation between malignant, borderline, and benign ovarian masses. Results: This study included 56 adnexal lesions. Bilateral synchronous ovarian lesions are detected in 16 cases. Postoperative histologically proved to be benign in 17 (30%), borderline (low potential malignancy) in 12 (22%), and malignant in 27 (48%). The overall diagnostic performance of conventional MRI in the diagnosis of adenexal lesion was a sensitivity of 74%, specificity of 47%, positive predictive value (PPV) of 76%, negative predictive value (NPV) of 44%, and an accuracy of 66%. Functional pelvic MRI examination showed an increase in overall diagnostic performance compared to conventional values with the highest sensitivity of 90% and NPV of 67% using DWI, and the highest specificity of 88%, PPV of 94%, and an accuracy of 82% using DCE MRI. Conclusion: Functional MRI in conjugation with conventional MRI plays a key role in the ovarian lesion detection, characterization, and staging. Functional MRI is currently being evaluated as possible predictive and prognostic biomarkers in ovarian lesions.

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“…An ovarian neoplasm accompanied by ascites may lead to a misdiagnosis as a malignant tumor, such as cystadenocarcinoma. The solid region and the septum of cystadenocarcinomas typically exhibit vivid enhancement, which is higher than that observed in fibrothecomas (15). Thus, when a large ovarian tumor is found with pelvic ascites and the solid region of the tumor exhibits mild to moderate enhancement, fibrothecoma should be considered as a potential diagnosis.…”

Section: Discussionmentioning

confidence: 97%

Computed tomography and magnetic resonance imaging features of ovarian fibrothecoma

Chen¹,

Wang²,

Chen³

et al. 2017

Oncology Letters

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Abstract. The aim of the present study was to investigate the imaging characteristics of ovarian fibrothecoma. The cases of 25 female patients with pathologically confirmed ovarian fibrothecomas were retrospectively reviewed. Tumor location, size, density, signal intensity, cystic degeneration, calcification, enhancement pattern and ascites were assessed by computed tomography (CT) (n=20) and magnetic resonance imaging (MRI) (n=5). Clinical and histological features were also evaluated. The results revealed that 23 (92.0%) patients were postmenopausal, with a mean age ± standard deviation (SD) of 60.7±10.8 years old. All 25 tumors were unilateral and a thickened endometrium was observed in 7 (28.0%) patients. In total, 24 (96.0%) tumors appeared to have well-defined boundaries, with 1 (4%) tumor exhibiting an obscure boundary. Tumors had a mean size of 9.8±5.3 cm. Solid and predominantly solid masses were found in 16 cases (64.0%), and cystic and predominantly cystic masses were found in 9 patients (36.0%). Solid regions of masses exhibited hypodensity or isodensity in 24 patients (96.0%), with 1 patient (4.0%) exhibiting hyperdensity. The mean CT value (± SD) was 44.2±12.8 HU (range, 31-79HU) in unenhanced images. All masses exhibited isointensity or slight hypointensity on T1-weighted imaging, and tumor parenchyma also exhibited slight hypointensity or isointensity on T2-weighted imaging compared with the myometrium, with or without areas of patchy hyperintensity. Contrast-enhanced CT or MRI scans were performed on 19 patients, and the solid components (94.7%) exhibited mild to moderate enhancement in 18 patients and 1 patient (5.3%) exhibited intense enhancement. Tumor size was positively correlated with the tumor cystic degeneration (r=0.77, P<0.001) and ascites (r= 0.41, P<0.001). Therefore, ovarian fibrothecoma typically presents as solid or predominant solid masses with clear boundaries; the parenchyma of the tumor exhibits isodensity on CT scans, slight hypointensity or isointensity on MRI and mild enhancement following contrast-medium injection. The thickened endometrium observed in postmenopausal woman may also be a valuable imaging feature.

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Differentiation of Benign from Malignant Adnexal Masses by Functional 3 Tesla MRI Techniques: Diffusion-Weighted Imaging and Time-Intensity Curves of Dynamic Contrast-Enhanced MRI

Cited by 15 publications

References 31 publications

Value of magnetic resonance spectroscopy in assessment of adnexal lesions

Value of magnetic resonance spectroscopy in assessment of adnexal lesions

Functional MRI in the pre-operative assessment of GI-RADS 3, 4, and 5 ovarian masses

Computed tomography and magnetic resonance imaging features of ovarian fibrothecoma

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