MRI for differentiating ovarian endometrioid adenocarcinoma from high-grade serous adenocarcinoma

Abstract

PurposeTo investigate magnetic resonance imaging (MRI) features for differentiating ovarian endometrioid adenocarcinoma (OEC) from high-grade serous adenocarcinoma (HGSC).Materials and methodsTwenty-three patients with 25 OECs and 93 patients with 139 HGSCs confirmed by surgery and pathology underwent conventional MRI and diffusion-weighted imaging (DWI). The MRI features of the tumors, including laterality, size, shape, configuration, signal intensity, ADC value of solid component, enhancement, ascites, synchronous primary cancer (SPC) of the ovary and endometrium, and clinical stage, were evaluated and compared between two groups.ResultsThe following characteristics were significantly more common for OECs than HGSCs: unilateral (91.3% vs 50.5%, P < 0.001), larger mass (80.0% vs 48.2%, P = 0.005), round or oval shape (64.0% vs 17.3%, P < 0.001), mainly cystic with mural nodules or papillary projections (72.0% vs 18.7%, P < 0.001), cystic component with homogeneous iso- or hyperintensity on T1WI (82.6% vs 4.3%, P < 0.001), moderate enhancement (52.0% vs 26.6%, P = 0.011), no or mild ascites (91.3% vs 57.0%, P = 0.002), and SPC (43.5% vs 4.3%, P < 0.001). The ADC value of the solid component was higher in OECs (0.979 ± 0.197 × 10−3 mm2/s) than in HGSCs (0.820 ± 0.112 × 10−3 mm2/s) (P = 0.002). When a mainly cystic mass with mural nodules or papillary projections was associated with any one of homogeneously iso- or hyperintense cystic component on TIWI, a relatively higher ADC value and SPC, the sensitivity, specificity, accuracy, and positive and negative predictive values for characterizing OEC were 87.0%, 93.5%, 92.2%, 76.9%, and 96.7%, respectively.ConclusionsConventional MRI combining DWI is helpful for differentiating OECs from HGSCs.

The value of DCE-MRI in assessing histopathological and molecular biological features in induced rat epithelial ovarian carcinomas

“…TIC has been applied in the differential diagnosis of breast, prostate, ovary and other lesions, suggesting that all benign tumors had type I, the majority of malignant tumors had type III, only a small number of them had type II, and none had type I; type III TIC appeared to be specific for malignant tumors and was never observed in benign tumors [ 26 , 27 ]. Our study showed that type III TIC outnumbered type II considerably, which was in accordance with the previous literatures [ 28 , 29 ]. Moreover, compared with EOCs with curve type II TIC, EOCs with type III demonstrated significantly higher histological grade, MVD, VEGF expression, Ki67-positive cells and serum CA125 level, indicating a poor prognosis due to its high but immature neovascularization, low differentiation and active proliferative capacity.…”

Magnetic resonance imaging in categorization of ovarian epithelial cancer and survival analysis with focus on apparent diffusion coefficient value: correlation with Ki-67 expression and serum cancer antigen-125 level

“…The possible reason may be that Type II cancer comprised of only one pathological subtype, while there were four subtypes identified in Type I OEC patients resulting in much heterogeneity in the lesion. Also, previous research found that hyperintense cystic components were often detected on T1WI in clear cell and endometroid ovarian cancer than in other subtypes [29, 30]. These findings are supported by our study.…”

Magnetic resonance imaging for distinguishing ovarian clear cell carcinoma from high-grade serous carcinoma

“…In recent years, considerable advances have been achieved in the understanding and identification of the underlying pathogenesis in different subtypes [ 1 , 14 ]. Our previous study showed that conventional MRI combining DWI may be helpful for differentiating ovarian endometrioid carcinomas from HGSC [ 15 ]. Previous studies have indicated that there are different risk factors, origins, genetic alterations, biological behaviors, clinicopathological characteristics and chemotherapy sensitivities between ovarian CCC and HGSC [ 2 – 6 , 16 ].…”