Magnetic Resonance Imaging of Endometrial Cancer and Clear Cell Cancer

Manabe, Tomoko; Hirose, Yoshinobu; Kiryuu, Takuji; Koudo, Hiroshi; Hoshi, Hiroaki

doi:10.1097/01.rct.0000238005.42129.64

Cited by 13 publications

(9 citation statements)

References 4 publications

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“…In our study, however, only CCC showed a significantly higher incidence of endometriosis when compared with SC in the univariate analysis. In addition, CCC was reported to appear as a larger unilocular cystic mass with eccentric mural nodules [ 27 , 28 ], whereas in our study a large number of CCC had multilocular cystic masses. Therefore, differentiating CCC from EC based only on the imaging findings seems to be difficult.…”

Section: Resultscontrasting

confidence: 56%

Differentiation of epithelial ovarian cancer subtypes by use of imaging and clinical data: a detailed analysis

et al. 2016

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BackgroundPrimary epithelial ovarian carcinoma is sub-classified into serous, mucinous, endometrioid and clear cell subtypes. Neoadjuvant chemotherapy has become an alternative treatment option past several years, as serous carcinoma, the most common subtype, is known as chemotherapy-sensitive tumor. On the other hand, mucinous and clear cell carcinoma are known as chemotherapy-resistive. Therefore, it may be meaningful to estimate subtype of ovarian carcinoma using imaging modality. The purpose of this study is to study whether CT or MRI can determine the subtypes of epithelial ovarian cancers.MethodsThe imaging and clinical findings obtained from 125 consecutive patients with primary ovarian carcinoma were retrospectively analyzed. Forty-four of the patients had serous carcinoma; 13, mucinous carcinoma; 53, clear cell carcinoma; and 15, endometrioid carcinoma. We studied the bilateralism, morphological type, tumor diameter, solid portion ratio, relative signal intensity on T2WI and DWI, contrast ratio, and endometriosis on MRI and the calcification, peritoneal dissemination and lymph node metastasis, clinical staging, and thromboembolism on CT. We also studied the tumor markers and serum calcium concentrations. Each parameter was statistically analyzed by univariate and multivariate analyses.ResultsSerous carcinoma showed a significantly higher incidence of bilateral disease, smaller tumor size, higher signal intensity on DWI, and less frequent hypercalcemia. The CA19-9 level was significantly higher in mucinous carcinoma, in which most of the tumors appeared as multilocular cystic masses. Clear cell carcinoma appeared as unilateral disease with a larger solid portion and hypercalcemia in younger patients. Endometrioid carcinoma only showed a lower incidence of intraperitoneal dissemination.ConclusionsCT and MRI combined with clinical data especially tumor markers and presence of paraneoplastic syndrome could partly predict epithelial ovarian cancer subtypes.

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Section: Resultscontrasting

confidence: 56%

Differentiation of epithelial ovarian cancer subtypes by use of imaging and clinical data: a detailed analysis

et al. 2016

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“…The following MRI morphologic features were assessed with both T1 and T2 phases, such as the maximal diameter of the cyst, tumor margin, multilocularity, growth patterns and surface irregularities of mural nodules, characteristics of solid components, and the presence of malignant ascites; all of these features are considered significant factors in distinguishing between benign and malignant ovarian tumors [23, 24]. A mural nodule was defined as a wall-based lesion projecting into the cystic space.…”

Section: Methodsmentioning

confidence: 99%

“…However, MRI findings, such as tumor size, fluid signal intensity, post-contrast enhancement pattern, and mean apparent diffusion coefficient values of the solid portion, may not be useful parameters for differentiating CCC from EC [22]. Manabe et al reported that the presence of endometrial disease was a key factor in differentiating EC from CCC [23]. Another MRI morphological feature of EC comprised an internal slit in the solid components [23].…”

Section: Introductionmentioning

confidence: 99%

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Magnetic resonance imaging findings for discriminating clear cell carcinoma and endometrioid carcinoma of the ovary

Morioka¹,

Kawaguchi²,

Yamada³

et al. 2019

J Ovarian Res

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Background Common cancerous histological types associated with endometriosis are clear cell carcinoma (CCC) and endometrioid carcinoma (EC). CCC is regarded as an aggressive, chemoresistant histological subtype. Magnetic resonance imaging (MRI) offers some potential advantages to diagnose ovarian tumors compared with ultrasonography or computed tomography. This study aimed to identify MRI features that can be used to differentiate between CCC and EC. Methods We searched medical records of patients with ovarian cancers who underwent surgical treatment at Nara Medical University Hospital between January 2008 and September 2018; we identified 98 patients with CCC or EC who had undergone preoperative MRI. Contrasted MRI scans were performed less than 2 months before surgery. Patients were excluded from the study if they had no pathology, other pathological subtype of epithelial ovarian cancer, and/or salvage treatment for recurrence and metastatic ovarian cancer at the time of study initiation. Clinically relevant variables that were statistically significant by univariate analysis were selected for subsequent multivariate regression analysis to identify independent factors to distinguish CCC from EC. Results MRI of CCC and EC showed a large cystic heterogeneous mixed mass with mural nodules protruding into the cystic space. Univariate logistic regression analysis revealed that the growth pattern (broad-based nodular structures [multifocal/concentric sign] or polypoid structures [focal/eccentric sign]), surface irregularity (a smooth/regular surface or a rough/irregular/lobulated surface), “Width” of mural nodule, “Height-to-Width” ratio (HWR), and presence of preoperative ascites were factors that significantly differed between CCC and EC. In the multivariate logistic regression analysis, the growth pattern of the mural nodule (odds ratio [OR] = 0.69, 95% confidence interval [CI]: 0.013–0.273, p = 0.0004) and the HWR (OR = 3.71, 95% CI: 1.128–13.438, p = 0.036) were independent predictors to distinguish CCC from EC. Conclusions In conclusion, MRI data showed that the growth pattern of mural nodules and the HWR were independent factors that could allow differentiation between CCC and EC. This finding may be helpful to predict patient prognosis before operation.

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“…In contrast, Manabe T, et al [11] reported that endometrioid cancer had a predominantly multilocular appearance, and clear cell carcinoma had almost equally multilocular and unilocular appearances. In the present study, benign lesions (groups 1 and 3) tended to show a unilocular appearance and be small-sized.…”

Section: Size Thickness Of the Wall The Septum And Lateralitymentioning

confidence: 95%

MR Differentiation of Endometriomas Complicated with and without Malignancy: Comparison with Pathological Findings

Kohno¹,

Tajima²,

Hashimoto³

et al. 2014

OJMI

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Introduction: The purposes were to clarify the magnetic resonance imaging (MRI) findings of malignant ovarian lesions arising from endometriomas, and to compare the lesions' histopathology and MRI characteristics. Materials and Methods: Between May 2004 and December 2012, 140 patients, all of whom were diagnosed as having an endometrioma by using MR imaging, underwent surgery. We compared the MR characteristics including size and signal intensity of the tumor and mural nodules, the thickness of the septum, and the thickness of the wall with the pathological diagnoses. The attached angles of the mural nodules to the cyst wall were also evaluated. Results: Among the 179 lesions, preoperative MR imaging diagnosed 153 benign and 26 malignant. Based on the pathological results, 169 were diagnosed as benign and 10 were diagnosed as malignant. Finally, preoperative MR imaging correctly diagnosed 152 benign (group 1) and nine malignant (group 2), misdiagnosed 17 benign as malignant (group 3) and misdiagnosed one malignant as benign (group 4). As for mural nodules, there was a significant difference between groups 1 and 2 in the mean maximum diameter of the mural nodules. An acute attached angle was shown in 1 of 7 in group 1, in 11 of 16 in group 2, and in 14 of 22 in group 3. We also compared benign group with malignant group on the final pathological findings. As for mural nodules, there was a significant difference between groups 1 + 3 and group 2 in the mean maximum diameter of the mural nodules. On dynamic study, there were 22 enhanced mural nodules (75.9%) on group 1 + 3. Conclusion: Most of endometriomas preoperatively diagnosed as benign were pathological benign lesions. Endometriomas that contain many enhanced mural nodules with papillary shape, larger size, M. Kohno et al. 143 showing hypointense on T1WI, hyperintense on T2WI and showing an acute attached angle may have malignant potential.

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Magnetic Resonance Imaging of Endometrial Cancer and Clear Cell Cancer

Abstract: The magnetic resonance imaging appearance of the internal slit in solid components and the presence of endometrial disease are key factors in differentiating endometrioid cancer from clear cell cancer, although lesion locularity and growth pattern are not specific in both.

Cited by 13 publications

References 4 publications

Differentiation of epithelial ovarian cancer subtypes by use of imaging and clinical data: a detailed analysis

Differentiation of epithelial ovarian cancer subtypes by use of imaging and clinical data: a detailed analysis

Magnetic resonance imaging findings for discriminating clear cell carcinoma and endometrioid carcinoma of the ovary

MR Differentiation of Endometriomas Complicated with and without Malignancy: Comparison with Pathological Findings

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