Diffusion-weighted MR imaging for differentiating borderline from malignant epithelial tumours of the ovary: pathological correlation
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To investigate diffusion-weighted (DW) magnetic resonance (MR) imaging for differentiating borderline from malignant epithelial tumours of the ovary.
This retrospective study included 60 borderline epithelial ovarian tumours (BEOTs) in 48 patients and 65 malignant epithelial ovarian tumours (MEOTs) in 54 patients. DW imaging as well as conventional MR imaging was performed. Signal intensity on DW imaging was assessed and apparent diffusion coefficient (ADC) value was measured. The results were correlated with histopathology and cell density.
The majority of MEOTs showed high signal intensity on DW imaging, whereas most BEOTs showed low or moderate signal intensity (P = 0.000). The mean ADC value of the solid components in BEOTs (1.562 ± 0.346 × 10−3 mm2/s) was significantly higher than in MEOTs (0.841 ± 0.209 × 10−3 mm2/s). A threshold value of 1.039 × 10−3 mm2/s permitted the distinction with a sensitivity of 97.0 %, a specificity of 92.2 % and an accuracy of 96.4 %. There was an inverse correlation between ADC value and cell density (r = −0.609; P = 0.0000) which was significantly lower in BEOTs than in MEOTs.
DW imaging is useful for differentiating borderline from malignant epithelial tumours of the ovary.
• DW MR imaging is useful for differentiating BEOTs from MEOTs.
• Patients with BEOTs are treated differently from patients with MEOTs.
• Conservative fertility-sparing laparoscopic surgery can be performed in patients with BEOTs.
• BEOTs often affect young women of childbearing age.
KeywordsOvary Epithelial tumours Borderline Malignant Diffusion-weighted MR imaging
apparent diffusion coefficient
borderline epithelial ovarian tumour
malignant epithelial ovarian tumour
The scientific guarantor of this publication is Jin Wei Qiang. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. This study has received funding by Science and Technology Commission of Shanghai Municipality (no. 124119a3301). Ruo Kun Li kindly provided statistical advice for this manuscript. Institutional review board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. Methodology: retrospective, diagnostic study, performed at one institution.
Grants from Shanghai Municipal Commission of Science & Technology (No.124119a3300) and Shanghai Municipal Commission of Health and Family Planning (No. 2013SY075, No. ZK2012A16).
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