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Are CT and MRI useful tools to distinguish between micropapillary type and typical type of ovarian serous borderline tumors?

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Abstract

Purpose

To investigate the computed tomography (CT) and magnetic resonance imaging (MRI) characteristics of ovarian serous borderline tumors (SBTs), and evaluate whether CT and MRI can be used to distinguish micropapillary from typical subtypes.

Materials and methods

We retrospectively reviewed the clinical features and CT and MR imaging findings of 47 patients with SBTs encountered at our institute from September 2013 to December 2019. 30 patients with 58 histologically proven typical SBT and 17 patients with 26 micropapillary SBT were reviewed. Preoperative CT and MR images were evaluated, by two observers in consensus for the laterality, maximum diameter (MD), morphology patterns, internal architecture, attenuation or signal intensity, ADC value, enhancement patterns of solid portions (SP), and extra-ovarian imaging features.

Results

The median age were similar between typical SBT and SBT-MP (32.5 years, 36 years, respectively, P>0.05). Morphology patterns between two subtypes were significantly different on CT and MR images (P < 0.001). Irregular solid tumor (21/37, 56.76%) was the major morphology pattern of typical SBT tumor, while unilocular cyst with mural nodules (14/20, 70%) was the major morphology pattern of SBT-MP on CT images. Similarly, papillary architecture with internal branching (PA&IB) (17/21, 80.95%) was the major morphology pattern of typical SBT tumor, while unilocular cyst with mural nodules (4/6, 66.67%) was the major pattern of SBT-MP on MR images. PA&IB all showed slightly hyperintense papillary architecture with hypointense internal branching on T2-weighted MRI. More calcifications were found in typical SBT (24/37, 64.86%) than SBT-MP mass lesion (6/20, 30%) (P < 0.05). Hemorrhage was less frequently visible in (20/37, 54.05%) typical SBT lessons than SBT-MP mass lesion (18/20, 90%) (P < 0.05). The ovarian preservation is more seen in typical SBT (38/58, 65.52%) than SBT-MP (12/28, 42.86%) in our series (P < 0.05). Mean ADC value of solid portions (papillary architecture and mural nodules) was 1.68 (range from 1.44 to 1.85) × 10−3 mm2/s for typical SBT and 1.62 (range from 1.45 to 1.7) × 10−3 mm2/s for that of SBT-MP. The solid components of the two SBT subtypes showed wash-in appearance enhancements after contrast injection both in CT and MR images except 2 of SBT-MP with no enhancement as complete focal hemorrhage on MR images.

Conclusion

Morphology and internal architecture are two major imaging features that can help to distinguish between SBT-MP and typical SBT.

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Funding

This study has received funding from Yunnan Applied Basic Research Projects-Joint Special Project (Grant Number 2019FE001-246).

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Authors and Affiliations

  1. Department of Radiology, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, No. 519 Kunzhou Road, Xishan District, Kunming, 650118, Yunnan, People’s Republic of China

    Ya Zhang, Jing Tan, Conghui Ai, Yan Jin, Hongbo Wang, Miaomiao Li, Huimei Zhang & Suixing Zhong

  2. Department of Radiology, The Second Affiliated Hospital of Kunming Medical University, No. 374 Dianmian Road, Kunming, 650101, Yunnan, People’s Republic of China

    Ya Zhang & Jiaping Wang

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  1. Ya Zhang
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  2. Jing Tan
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  3. Jiaping Wang
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  4. Conghui Ai
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Correspondence to Jiaping Wang.

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Zhang, Y., Tan, J., Wang, J. et al. Are CT and MRI useful tools to distinguish between micropapillary type and typical type of ovarian serous borderline tumors?. Abdom Radiol 46, 3354–3364 (2021). https://doi.org/10.1007/s00261-021-03000-3

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  • DOI: https://doi.org/10.1007/s00261-021-03000-3

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