DWI in characterization of complex ovarian masses, would it help?

tantawy, M.; Elrakhawy, Mohamed M.; El-Morsy, Ahmad; Saleh, Gehad A.

doi:10.1016/j.ejrnm.2018.01.006

Cited by 5 publications

(3 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Among benign and malignant masses, there was a substantial variation in the ADC values of the solid component in Tantawy et al, (15) investigation, which may be attributable to a lack of solid component in certain benign lesions or to histopathological inhomogeneity of the included benign lesions.…”

Section: Discussionmentioning

confidence: 80%

Role of diffusion-weighted magnetic resonance imaging in evaluation of gynecologic tumors

Hashish¹,

Baraya²

2023

World J. Adv. Res. Rev.

View full text Add to dashboard Cite

Background: Ovarian tumors are the second most common gynecological tumor and fifth commonest tumor in women and has the highest mortality rate among gynecologic malignancies. It is estimated to comprise 6% of all cancer-related deaths. It is desirable to preoperatively differentiate benign from malignant tumor to decide whether surgery is required, and which type of surgery is appropriate avoiding unnecessary surgery. Magnetic resonance imaging (MRI) has been established as an excellent modality for evaluation of gynecologic disease. However, morphologic MRI imaging has some limitations for lesion detection and characterization. The innovation of newer functional imaging sequences such as diffusion-weighted imaging has addressed many of these issues and enhanced diagnostic capabilities of MRI. Aim: To investigate the role of DWI in distinguishing between benign and malignant lesions in light of the increasing recognition of DWI. Patients & Methods: The current study is a prospective study that was conducted at diagnostic radiology department of Benha and Mansoura University Hospitals in the period from October 2018 till January 2022. The study included 80 female patients with any age complaining of gynecologic problem like mass lesion, vaginal bleeding or pelvic pain including any type of lesion inflammatory or neoplastic and excluding congenital malformation lesions. Ethical consideration, an informed consent was obtained from patients before enrollment in the study and an approval from research Ethics committee in Benha faculty of Medicine was obtained in 2015 with no code or number -code starts from 2019-. Axial T1-WI, Axial T2-WI, Sagittal T2-WI, and Coronal T2-WI, Gradient-echo sequences (GRE), Diffusion weighted MR images (DWI), ADC and Dynamic Contrast-Enhanced MRI- were all used in the MRI examination. Results: We found that the specificity and the accuracy of the DWI results were both 88.5 and 91.3 percent, respectively. ADC revealed a 94.7 percent sensitivity, 91.8 percent specificity, and 92.5 percent accuracy in the identification of malignant lesions with a cutoff value of 1.0075 (10-3mm). Conclusion: The addition of DWI to the conventional MRI increased the accuracy of the examination and lesions characterization provided that combined interpretation of both DWI and conventional MRI data. DWI can confirm or exclude potential malignancy in suspicious pelvic masses.

show abstract

Section: Discussionmentioning

confidence: 80%

Role of diffusion-weighted magnetic resonance imaging in evaluation of gynecologic tumors

Hashish¹,

Baraya²

2023

World J. Adv. Res. Rev.

View full text Add to dashboard Cite

show abstract

“…A cut-off c-ADC value of 1.31 × 10 -3 mm 2 /s, derived from the ROC curve, had a sensitivity of 95.8% and specificity of 89.5% in differentiating TOA from ovarian malignancy. The mean c-ADC value of TOAs reported in different studies ranges from 0.9 to 1.1 × 10 -3 mm 2 /s, except for a study by Tantawy et al, who reported a lower c-ADC value of 0.63 × 10 -3 mm 2 /s, whereas cystic areas in ovarian malignancies consistently showed a very high mean c-ADC value of > 2.0 × 10 -3 mm 2 /s across the different studies [10,15,16,25]. It is worth mentioning that the ADC value within the abscess cavity varies at different stages [28], which could be an important reason behind the variable c-ADC values from study to study.…”

Section: A B C D E Fmentioning

confidence: 97%

“…Wang et al reported diffusion restriction in the cystic part of all the included TOAs (n = 34), whereas only 11.4 % of ovarian malignancies exhibited diffusion restriction due to haemorrhage and debris [15]. Fan et al and Tantawy et al also demonstrated diffusion restriction in the cystic part of all the TOAs [10,25]. Another study by Chou et al revealed diffusion restriction within the cavities of 91% pelvic abscess (n = 23), whereas facilitated diffusion was found in cystic components of pelvic tumours [16].…”

Section: A B C D E Fmentioning

confidence: 99%

The role of “penumbra sign” and diffusion-weighted imaging in adnexal masses: do they provide a clue in differentiating tubo-ovarian abscess from ovarian malignancy?

Patel¹,

Garg²,

Dixit³

et al. 2021

Pol J Radiol

View full text Add to dashboard Cite

Purpose: To evaluate the role of "penumbra sign", diffusion-weighted imaging (DWI), and the apparent diffusion coefficient (ADC) value in differentiating tubo-ovarian abscess (TOA) from ovarian malignancy. Material and methods:Thirty-six patients with 50 adnexal masses (tubo-ovarian abscess, n = 24; ovarian malignancy, n = 26), who underwent magnetic resonance imaging (MRI) with DWI, were retrospectively evaluated. "Penumbra sign" (hyperintense rim on T1W images), diffusion restriction, and mean apparent diffusion coefficient (ADC) values from cystic (c-ADC) and solid (s-ADC) components were evaluated for all the masses. Results: "Penumbra sign" on T1W images was significantly more common in the TOA group (n = 21, 87.5%) than in the ovarian malignancy group (n = 2, 7.7%) (p < 0.001). Similarly, diffusion restriction in the cystic component was more frequent in the TOA group (n = 24, 100% vs. n = 2, 10.5%; p < 0.001). In contrast, diffusion restriction in the solid component was more common in the ovarian malignancy group (n = 5, 20.8% vs. n = 26, 100%; p < 0.001). The mean c-ADC value was significantly lower in TOAs (p < 0.001). A c-ADC value of 1.31 × 10 -3 mm 2 /s may be an optimal cut-off in distinguishing TOAs from ovarian malignancies. Conversely, the mean s-ADC value was significantly lower in the ovarian malignancy group (p < 0.001). An s-ADC value of 0.869 × 10 -3 mm 2 /s may be an optimal cut-off in differentiating ovarian malignancies from TOAs (p < 0.001). ROC curve analysis showed that c-ADC values had a higher diagnostic accuracy than s-ADC values.Conclusions: "Penumbra sign" on T1W images, diffusion characteristics, and ADC values provide important clues in addition to conventional MR imaging features in differentiating TOA from ovarian malignancy.

show abstract

The Added Value of Apparent Diffusion Coefficient and Histogram Analysis in Assessing Treatment Response of Locally Advanced Cervical Cancer

Saleh,

Elged,

Saleh

et al. 2024

J Comput Assist Tomogr

View full text Add to dashboard Cite

Objective The aim of the study is to assess the diagnostic performance of quantitative analysis of diffusion-weighted imaging in assessing treatment response in cervical cancer patients. Methods A retrospective analysis was done for 50 patients with locally advanced cervical cancer who received concurrent chemoradiotherapy and underwent magnetic resonance imaging and diffusion-weighted imaging. Treatment response was classified into 4 categories according to RECIST criteria 6 months after therapy completion. Apparent diffusion coefficient (ADC) values were measured using both region of interest (ROI) ADC and whole lesion (WL) ADC histogram for all cases at both baseline pretreatment and posttreatment Magnetic resonance imaging studies. Changes in ADC values were calculated and compared between groups. Results The percentage change of ROI-ADCmean at a cutoff value of >20 had excellent discrimination of responders versus nonresponders, while the percentage change of WL-ADCmean, ADCmin, and ADCmax at cutoff values of >12.5, >35.8, and > 19.6 had acceptable discrimination of responders versus nonresponders. Logistic regression analysis revealed that only baseline WL ADCmin was a statistically significant independent predictor of response. Cancer cervix patients with baseline ADCmin < or equal to 0.73 have 12.1 times higher odds of exhibiting a response. Conclusions The percentage change of ROI-ADCmean and WL histogram ADCmean values after concurrent chemoradiotherapy can predict response. Pretreatment WL histogram ADCmin was a statistically significant independent predictor of posttherapy response.

show abstract

DWI in characterization of complex ovarian masses, would it help?

Cited by 5 publications

References 18 publications

Role of diffusion-weighted magnetic resonance imaging in evaluation of gynecologic tumors

Role of diffusion-weighted magnetic resonance imaging in evaluation of gynecologic tumors

The role of “penumbra sign” and diffusion-weighted imaging in adnexal masses: do they provide a clue in differentiating tubo-ovarian abscess from ovarian malignancy?

The Added Value of Apparent Diffusion Coefficient and Histogram Analysis in Assessing Treatment Response of Locally Advanced Cervical Cancer

Contact Info

Product

Resources

About