, Volume 22, Issue 4, pp 738-745
Date: 23 Nov 2011

Quantitative dynamic contrast-enhanced MR imaging analysis of complex adnexal masses: a preliminary study

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Abstract

Objective

To evaluate the ability of quantitative dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) to differentiate malignant from benign adnexal tumours.

Methods

Fifty-six women with 38 malignant and 18 benign tumours underwent MR imaging before surgery for complex adnexal masses. Microvascular parameters were extracted from high temporal resolution DCE-MRI series, using a pharmacokinetic model in the solid tissue of adnexal tumours. These parameters were tissue blood flow (FT), blood volume fraction (Vb), permeability-surface area product (PS), interstitial volume fraction (Ve), lag time (Dt) and area under the enhancing curve (rAUC). Area under the receiver operating curve (AUROC) was calculated as a descriptive tool to assess the overall discrimination of parameters.

Results

Malignant tumours displayed higher FT, Vb, rAUC and lower Ve than benign tumours (P < 0.0001, P = 0.0006, P = 0.04 and P = 0.0002, respectively). FT was the most relevant factor for discriminating malignant from benign tumours (AUROC = 0.86). Primary ovarian invasive tumours displayed higher FT and shorter Dt than borderline tumours. Malignant adnexal tumours with associated peritoneal carcinomatosis at surgery displayed a shorter Dt than those without peritoneal carcinomatosis at surgery (P = 0.01).

Conclusion

Quantitative DCE-MRI is a feasible and accurate technique to differentiate malignant from benign adnexal tumours and could potentially help oncologists with management decisions.

Key Points

Quantitative DCE MR imaging allows accurate differentiation between malignant and benign tumours

Quantitative DCE MRI may help predict peritoneal carcinomatosis associated with ovarian tumors

Quantitative DCE MRI helps distinguish between invasive and borderline primary ovarian tumours