Factors that Differentiate between Endometriosis-associated Ovarian Cancer and Benign Ovarian Endometriosis with Mural Nodules

Tanase, Yasuhito; Kawaguchi, Ryuji; Takahama, Junko; Kobayashi, Hiroshi

doi:10.2463/mrms.mp.2016-0149

Cited by 40 publications

(32 citation statements)

References 19 publications

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“…Malignant transformation typically manifests as cystic lesions with mural nodules, with various (low, intermediate and high) signal intensities on T1-weighted images, high-signal intensity on T2-weighted images, and a lower proportion of shading in women undergoing screening MR imaging. Malignant mural nodules was also found in the anterior location of the cyst (5). When compared to subjects with benign nodules, the patients with malignant mural nodules were older (>43 years), had larger cyst diameters (>7.9 cm) and larger mural nodule sizes (Height of mural nodules >1.5 cm), and were more likely to exhibit a taller than wider lesion (height-width ratio of mural nodules >0.9).…”

Section: Modern Approaches To Noninvasive Diagnosis Of Malignant Tranmentioning

confidence: 90%

“…Typical ultrasound features of EAOC include well-circumscribed masses with mural nodules resembling 'xiaolongbao' (Personal communication from Prof. Dr. Mikami Y. Kumamoto University). However, the overlapping appearances of benign and malignant lesions make ultrasound less useful in differentiating malignant lesions, resulting in a large number of surgery for benign tumors (5). Therefore, ultrasonic morphological features are not relevant for the discrimination between EAOC and benign OE with mural nodules.…”

Section: Modern Approaches To Noninvasive Diagnosis Of Malignant Tranmentioning

confidence: 99%

“…Zhou and Hua (6), recently demonstrated that times of pregnancy >1.5, tumor size >8.3 cm, and the presence of uterine leiomyoma and multiple foci of endometriosis were independent risk factors for EAOC. Tanase et al (5), identified the patient demographics, clinical features and preoperative MR imaging characteristics helpful to the differential diagnosis between EAOC and benign OE with mural nodules. A majority (~80%) of the mural nodular lesions of benign OE showed the pattern described as 'cyst with retracted blood clots'.…”

Section: Modern Approaches To Noninvasive Diagnosis Of Malignant Tranmentioning

confidence: 99%

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Modern approaches to noninvasive diagnosis of malignant transformation of endometriosis

et al. 2018

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Endometriosis-associated ovarian cancer (EAOC) is a rare entity and has highly variable morphological presentations. Mural nodules can be seen in EAOC and benign ovarian endometrioma (OE), which causes a diagnostic dilemma. The differential diagnosis between early-stage EAOC with predominantly cystic appearances and benign OE remains a challenge for physicians. This study will summarize recent knowledge of diagnosis of malignant transformation of endometriosis that have been studied through an innovative approach based on a wide array of novel technologies. Using PubMed database, we focused on the biochemical and technical advancement in the differential diagnosis of benign and malignant endometriosis. Compared with the subjects with benign OE, cyst fluid hemoglobin and iron-related compounds levels were significantly lower in patients with EAOC. This observation opens up the possibility of early diagnosis before morphological variations are captured through ultrasonographic and magnetic resonance (MR) imaging diagnosis. The metallobiology technology offers one solution to this challenge. We discuss the noninvasive diagnosis of EAOC via various imaging methods, including electronic absorption spectroscopy, near infrared approach and MR transverse relaxometry. Special emphasis is given to recent advances in the noninvasive imaging modalities.

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Section: Modern Approaches To Noninvasive Diagnosis Of Malignant Tranmentioning

confidence: 90%

Section: Modern Approaches To Noninvasive Diagnosis Of Malignant Tranmentioning

confidence: 99%

Section: Modern Approaches To Noninvasive Diagnosis Of Malignant Tranmentioning

confidence: 99%

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Modern approaches to noninvasive diagnosis of malignant transformation of endometriosis

et al. 2018

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“…В исследованиях, изучающих данную проблему, выделены следующие закономерности: по сравнению с пациентами с доброкачественной эндометриомой, пациенты со злокачественными пристеночными узелками были старше (> 43 лет), имели больший диаметр кисты (> 7,9 см) и больший размер пристеночного компонента (высота узелков > 1,5 см), а также отношение высоты узелков к их ширине более 0,9. По мнению ряда авторов, высота узелкового компонента > 1,5 см была самым ценным предиктором для отличия эндометриоз-ассоциированного рака от доброкачественной эндометриомы яичников (AUC = 0,99; 95 % ДИ = 0,97-1,0; чувствительность 95,0 %, специфичность 95,2 %) [9].…”

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Difficulties in the differential diagnosis of tumors in the female reproductive system

Nosova

Solopova

Khabas

et al. 2020

Akušerstvo, ginekologiâ i reprodukciâ

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Introduction. Most pelvic tumors originate from reproductive organs. Even using the up-to-date imaging techniques, radiologists experience difficulties in determining the source of the lesion since a wide range of tumors look similar to each other on the distorted backdrop of pelvic anatomy, large invasive formations, and an active inflammatory reaction of the pelvic peritoneum.Aim: to evaluate “pitfalls” in the preoperative noninvasive diagnosis of female pelvic tumors by applying the clinical diagnostic tools.Materials and methods. Four rare clinical cases were analyzed; all of them posed difficulties in interpreting the diagnostic examination due to their atypical characteristics. There were 2 cases of ovarian cancer, initially identified by an experienced team of radiologists as benign pelvic pathology. Also, there were fibroids with degeneration, marked proliferative activity, and a massive inflammatory reaction of the peritoneum – that was diagnosed as a malignant ovarian tumor. Tumor biopsies were examined using morphological and immunohistochemical methods (with the р16, Ki-67, p53, CD 117, S 100, CD 34 markers). Immunohistochemical (IHC) studies were performed with formalin-fixed paraffin materials using the avidin-biotin-peroxidase method. Antibodies to estrogen receptor (ER), progesterone receptor (PR), cytokeratin 7 (CK7), cytokeratin 20 (CK20) and Wilms tumor protein 1 (WT1) were also used.Results. A thorough analysis of the clinical picture and a joint multidisciplinary discussion (gynecologist, oncologist, radiologist, etc.) made it possible to avoid diagnostic errors.Conclusion. These observations demonstrate the difficulties of differential diagnosis between ovarian metastases of uterine cancer and primary multiple ovarian and uterine cancer, as well between leiomyosarcoma and uterine myoma with high mitotic activity. Obviously, the change in diagnosis calls for a change in the treatment strategy.

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“…Correctly identifying the two lesions is crucial to eschew unneeded surgery [ 7 ], but also because endometriomas are a marker of the presence of other endometriotic lesions at the pelvic and intestinal level, which can cause a series of complications [ 8 ]. Thus, the imaging differentiation of the two entities can influence the course of both medical and surgical treatment [ 9 ]. Transvaginal ultrasonography (TVUS) is the primary diagnostic tool in the diagnosis of endometriomas.…”

Section: Introductionmentioning

confidence: 99%

Differentiation of Endometriomas from Ovarian Hemorrhagic Cysts at Magnetic Resonance: The Role of Texture Analysis

et al. 2020

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Background and Objectives: To assess ovarian cysts with texture analysis (TA) in magnetic resonance (MRI) images for establishing a differentiation criterion for endometriomas and functional hemorrhagic cysts (HCs) that could potentially outperform their classic MRI diagnostic features. Materials and Methods: Forty-three patients with known ovarian cysts who underwent MRI were retrospectively included (endometriomas, n = 29; HCs, n = 14). TA was performed using dedicated software based on T2-weighted images, by incorporating the whole lesions in a three-dimensional region of interest. The most discriminative texture features were highlighted by three selection methods (Fisher, probability of classification error and average correlation coefficients, and mutual information). The absolute values of these parameters were compared through univariate, multivariate, and receiver operating characteristic analyses. The ability of the two classic diagnostic signs (“T2 shading” and “T2 dark spots”) to diagnose endometriomas was assessed by quantifying their sensitivity (Se) and specificity (Sp), following their conventional assessment on T1-and T2-weighted images by two radiologists. Results: The diagnostic power of the one texture parameter that was an independent predictor of endometriomas (entropy, 75% Se and 100% Sp) and of the predictive model composed of all parameters that showed statistically significant results at the univariate analysis (100% Se, 100% Sp) outperformed the ones shown by the classic MRI endometrioma features (“T2 shading”, 75.86% Se and 35.71% Sp; “T2 dark spots”, 55.17% Se and 64.29% Sp). Conclusion: Whole-lesion MRI TA has the potential to offer a superior discrimination criterion between endometriomas and HCs compared to the classic evaluation of the two lesions’ MRI signal behaviors.

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Factors that Differentiate between Endometriosis-associated Ovarian Cancer and Benign Ovarian Endometriosis with Mural Nodules

Cited by 40 publications

References 19 publications

Modern approaches to noninvasive diagnosis of malignant transformation of endometriosis

Modern approaches to noninvasive diagnosis of malignant transformation of endometriosis

Difficulties in the differential diagnosis of tumors in the female reproductive system

Differentiation of Endometriomas from Ovarian Hemorrhagic Cysts at Magnetic Resonance: The Role of Texture Analysis

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