Quantitative dynamic contrast-enhanced MR imaging analysis of complex adnexal masses: a preliminary study
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To evaluate the ability of quantitative dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) to differentiate malignant from benign adnexal tumours.
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.
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).
Quantitative DCE-MRI is a feasible and accurate technique to differentiate malignant from benign adnexal tumours and could potentially help oncologists with management decisions.
• 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
KeywordsPerfusion MRI Complex adnexal masses Dynamic contrast-enhanced MRI Ovarian tumour
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