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CT and MRI in Ovarian Carcinoma

  • Rosemarie ForstnerEmail author
Chapter
Part of the Medical Radiology book series (MEDRAD)

Abstract

Primary ovarian cancer is categorized as surface epithelial cancer, germ cell tumors, and sex cord stromal tumors.Epithelial ovarian cancer is now understood as a spectrum of different cancer entities that vary considerably on a clinicopathological and molecular level.Disseminated peritoneal spread and ascites is typical of the most common cancer type, high grade serous ovarian cancer. Other cancer subtypes may show distinct features in imaging.CT and MRI are usually complementary techniques to ultrasonography to furtherassess indeterminate or frankly malignant ovarian lesions. In the latter CT is the imaging modality of choice for triaging patients with ovarian cancer. MRI is emerging as a new technique to assess peritoneal spread and is superior to CT in lesion characterization.This chapter will make familiar with recent concepts in ovarian cancer. Typical imaging findings and differential diagnostic aspects of various types of ovarian malignancies as well as the update of the FIGO staging classification and respectability criteria will be covered.

Abbreviations

ADC

Apparent diffusion coefficient

BT

Borderline tumor

CT

Computed tomography

DCE

Dynamic contrast enhanced

DWI

Diffusion-weighted imaging

IV

Intravenous

MRI

Magnetic resonance imaging

SI

Signal intensity

References

  1. Akin O, Sala E, Chaya S et al (2008) Perihepatic metastases from ovarian cancer: sensitivity and specificity of CT for the detection of metastases with and those without liver parenchymal invasion. Radiology 248:511–517PubMedGoogle Scholar
  2. Alcazar JL, Galan MJ, Ceamanos C et al (2003) Transvaginal gray scale and color Doppler sonography in primary ovarian cancer and metastatic tumors to the ovary. J Ultrasound Med 22:243–247PubMedGoogle Scholar
  3. Alvarez RM, Vazquez-Vicente D (2015) Fertility sparing treatment in borderline ovarian tumors. Ecancermedicalscience 9:507. doi:10.3332/ecancer.2015.507CrossRefPubMedPubMedCentralGoogle Scholar
  4. Anthuber C, Engel J, Mayr D, Petrides P (2014) Keimstrangstromatumoren. www.journalonko.de 6:418–420
  5. Bachmann C, Bachmann R, Kraemer B, Brucker SY et al (2016) Prevalence and distribution pattern of nodal metastases in advanced ovarian cancer. Mol Clin Oncol 5:483–487PubMedPubMedCentralGoogle Scholar
  6. Bairey O, Blickstein D, Stark P et al (2003) Serum CA 125 as a prognostic factor in non-Hodgkin’s lymphoma. Leuk Lymphoma 44:1733–1738PubMedGoogle Scholar
  7. Bazot M, Cortez A, Sananes S, Boudghene F et al (1999) Imaging of dermoid cysts with foci of immature tissue. J Comput Assist Tomogr 23:703–706PubMedGoogle Scholar
  8. Bent CL, Sahdev A, Rockall A, Singh N, Sohaib A, Reznek RH (2009) MRI appearance of borderline ovarian tumors. Clin Radiol 64:430–438PubMedGoogle Scholar
  9. Bernardin L, Dilks P, Liyanage S, Miquel ME, Sahdev A, Rockall A (2012) Effectiveness of semi-quantitative multiphase dynamic contrast-enhanced MRI as a predictor of malignancy in complex adnexal masses: radiological and pathological correlation. Eur Radiol 22:880–890PubMedGoogle Scholar
  10. Bigorie V, Morice P, Pierre D, Antoine M et al (2010) Ovarian metastases from breast cancer: report of 29 cases. Cancer 116:799–804PubMedGoogle Scholar
  11. Birrer MJ (2016) Medical treatment for relapsed ovarian fallopian tubal, or peritoneal cancer: platinum-resistant disease.www.uptodate.com
  12. Borley J, Wilhelm-Benartzi C, Williamson R, Bharwani N et al (2015) Radiological predictors of cytoreductive outcomes in patients with advanced ovarian cancer. BJOG 122:843–849PubMedGoogle Scholar
  13. Bristow RE, Duska LR, Lambrou NC et al (2000) A model for predicting surgical outcome in patients with advanced ovarian carcinoma using computed tomography. Cancer 89:1532–1540PubMedGoogle Scholar
  14. Brown DL, Zou KH, Tempany CM et al (2001) Primary versus secondary ovarian malignancy: imaging findings of adnexal masses in the radiology diagnostic oncology group study. Radiology 219:213–218PubMedGoogle Scholar
  15. Burghardt E (1993) Epithelial ovarian cancer. Recurrence. In: Burghardt E (ed) Surgical gynecological oncology. Thieme, Stuttgart, p 494Google Scholar
  16. Buy JN, Ghossain MA, Sciot C et al (1991) Epithelial tumors of the ovary: CT findings and correlation with US. Radiology 178:811–818PubMedGoogle Scholar
  17. Buys SS, Partrige EP, Black A, Johnson CC et al (2011) Effect of screening on ovarian cancer mortality. JAMA 305:2295–2303PubMedGoogle Scholar
  18. Carlson KJ (2016) Ovarian cancer screening. www uptodate 2016Google Scholar
  19. Chen C, Berek JS (2016) Epithelial cancer of the ovary, fallopian tube, and peritoneum. Clinical features and diagnosis. www.UpToDate.com
  20. Choi HJ, Lee JH, Kang S et al (2006) Contrast-enhanced CT for differentiation of ovarian metastasis from gastrointestinal tract cancer: stomach cancer versus colon cancer. AJR Am J Roentgenol 187:741–745PubMedGoogle Scholar
  21. Choudhary S, Fasih N, McInnes M, Marginean C (2009) Imaging of ovarian teratomas: appearances and complications. J Med Imaging Radiat Oncol 53:480–488PubMedGoogle Scholar
  22. Clarke-Pearson DL (2009) Screening for ovarian cancer. N Engl J Med 361:170–177PubMedGoogle Scholar
  23. Coakley FV, Choi PH, Gougoutas CA et al (2002) Peritoneal metastases: detection with spiral CT in patients with ovarian cancer. Radiology 223:495–499PubMedGoogle Scholar
  24. Comerci JT, Jr Licciardi F, Bergh PA et al (1994) Mature cystic teratoma. A clinicopathological evaluation of 517 cases and review of the literature. Obstet Gynecol 84:22–28PubMedGoogle Scholar
  25. De Waal YR, Thomas CM, Oei AL, Sweep FC, Massuger LF (2009) Secondary ovarian malignancies: frequency, origin, and characteristics. Int J Gynecol Cancer 19:1160–1165PubMedGoogle Scholar
  26. Dilks P, Narayan P, Reznek R, Sahdev A, Rockall A (2010) Can quantitative dynamic contrast-enhanced MRI independently characterize an ovarian mass. Eur Radiol 20:2176–2183PubMedGoogle Scholar
  27. Diop AD, Fontarensky M, Montoriol PF, Da Ines D (2014) CT imaging of peritoneal carcinomatosis and its mimics. Diagn Interv Imaging 95:861–872PubMedGoogle Scholar
  28. Dos Santos L, Mok E, Iasonos A et al (2007) Squamous cell carcinoma arising in mature cystic teratoma of the ovary: a case series and review of the literature. Gynecol Oncol 105:321–324PubMedGoogle Scholar
  29. Dujardin MI, Sekhri P, Turnbull LW (2014) Struma ovarii: role of imaging? Insights Imaging 5:41–51PubMedGoogle Scholar
  30. Ferrozzi F, Tognini G, Bova D et al (2000) Non-Hodgkin lymphomas of the ovaries: MR findings. J Comput Assist Tomogr 24:416–420PubMedGoogle Scholar
  31. Forstner R, Hricak H, Azizi L et al (1995) Ovarian cancer recurrence: value of MR imaging. Radiology 196:715–720PubMedGoogle Scholar
  32. Forstner R, Sala E, Kinkel K, Spencer JA (2010) ESUR guidelines: ovarian cancer staging and follow-up. Eur Radiol 20:2773–2780PubMedPubMedCentralGoogle Scholar
  33. Forstner R, Thomassin-Naggara I, Cunha TM, Kinkel K, Masselli G, Kubik-Huch R, Spencer JA, Rockall A (2016a) ESUR recommendations for MR imaging of the sonographically indeterminate adnexal mass: an update. Eur Radiol [Epub ahead of print] PMID: 27921156Google Scholar
  34. Forstner R, Meissnitzer M, Cunha TM (2016b) Update on imaging of ovarian cancer. Curr Radiol Rep 4:31Google Scholar
  35. Genetic/Familial High-Risk Assessment: Breast and Ovarian, Version 1.2016 multigene testing National Comprehensive Cancer Network (NCCN). NCCN Clinical practice guidelines in oncology. http://www.nccn.org/professionals/physician_gls/f_guidelines.asp. Accessed on 27 Feb 2016
  36. Gomes FV, Dias JL, Lucas R, Cunha TM (2015) Primary fallopian tube carcinoma: review of MR imaging findings. Insights Imaging 6:431–439Google Scholar
  37. Ha HK, Baek SY, Kim SH et al (1995) Krukenberg’s tumors of the ovary: MR imaging features. AJR Am J Roentgenol 164:1435–1439PubMedGoogle Scholar
  38. Heifetz SA, Cushing B, Giller R et al (1998) Immature teratomas in children: pathologic considerations. Am J Surg Pathol 22:1115–1124PubMedGoogle Scholar
  39. Höhn AK, Einenekel J, Wittekind C, Horn LC (2014) Neue FIGO-Klassifikation des Ovarial-Tuben und primären Peritonealkarzinoms. Pathologe 35:322–326PubMedGoogle Scholar
  40. Holschneider C, Hoang Y, Tieu K, Karlan B, Cass I (2005) Coexisting ovarian malignancy in young women with endometrial cancer. Obstet Gynecol 106:693–699PubMedGoogle Scholar
  41. Horta M, Cunha TM (2015) Sex cord-stromal tumors of the ovary: a comprehensive review and update for radiologists. DIR 21:277–286Google Scholar
  42. Hricak H, Chen M, Coakley FV et al (2000) Complex adnexal masses: detection and characterization with MRI: multivariate analysis. Radiology 214:39–46PubMedGoogle Scholar
  43. Hricak H, Reinhold C, Ascher SM (2004) Ovarian dysgerminomas. In: Hricak H, Reinhold C, Ascher SM (eds) Gynecology top 100 diagnoses. WB Saunders Company, Amirsys/Salt Lake City, pp 98–100Google Scholar
  44. Iver VR, Lee SI (2010) MRI, CT and PET/CT for ovarian cancer detection and adnexal characterization. AJR 194:311–321Google Scholar
  45. Javadi S, Ghaneshan DM, Quayyum A, Iyer RB, Bhosale P (2016) Ovarian cancer, the revised FIGO staging system, and the role of Imaging. AJR 206:1351–1360PubMedGoogle Scholar
  46. Jayson GC, Kohn EC, Kitchener HC, Ledermann JA (2014) Ovarian cancer. Lancet 384:1376–1388PubMedGoogle Scholar
  47. Jung SE, Lee JM, Rha SE et al (2002) CT and MR imaging of ovarian tumors with emphasis on differential diagnosis. Radiographics 22:1305–1325PubMedGoogle Scholar
  48. Kaijser J, Vandecaveye V, Deroose CM et al (2014) Imaging techniques for the pre-surgical diagnosis of adnexal tumours. Best Pract Res Clin Obstet Gynaecol 28:683–695PubMedGoogle Scholar
  49. Kandukuri SR, Rao J (2015) FIGO 2013 staging system for ovarian cancer: what is new in comparison to the 1988 staging system. Curr Opin Obstet Gynecol 27:48–52PubMedGoogle Scholar
  50. Kawakami S, Togashi K, Kimura I et al (1993) Primary malignant tumor of the fallopian tube: appearance at CT and MR imaging. Radiology 186:503–508PubMedGoogle Scholar
  51. Kawamoto S, Urban BA, Fishman EK (1999) CT of epithelial ovarian tumors. Radiographics 19:S85–S102PubMedGoogle Scholar
  52. Khasper A, Addley HC, Abourokbah N, Nougaret S et al (2012) T2-hypointense adnexal lesions: an imaging algorithm. Radiographics 32:1047–1061Google Scholar
  53. Kido A, Togashi K, Konishi I et al (1999) Dermoid cysts of the ovary with malignant transformation: MR appearance. AJR 172:445–449PubMedGoogle Scholar
  54. Kim SH (2002) Granulosa cell tumor of the ovary: common findings and unusual appearances on CT and MR. J Comput Assist Tomogr 26:756–761PubMedGoogle Scholar
  55. Kim SH, Kim WH, Park KL et al (1996) CT and MR findings of Krukenberg tumors: comparison with primary ovarian tumors. J Comput Assist Tomogr 20:393–398PubMedGoogle Scholar
  56. Kim TH, Lim MC, Kim SI, Seo SS et al (2016) Preoperative prediction of cardiophrenic lymph node metastasis in advanced ovarian cancer using CT. Ann Surg Oncol 23:1302–1308PubMedGoogle Scholar
  57. Komatsu KI, Konishi I, Mandai M et al (1996) Adnexal masses: transvaginal US and gadolinium-enhanced MR imaging assessment of intratumoral structure. Radiology 198:109–115PubMedGoogle Scholar
  58. Koonings PP, Campbell K, Mishell DR, Grimes DA (1989) Relative frequency of primary ovarian neoplasm: a 10-year review. Obstet Gynecol 74:921–926PubMedGoogle Scholar
  59. Kosari F, Daneshbod Y, Parwaresch R, Krams M, Wacker HH (2005) Lymphomas of the female genital tract: a study of 186 cases and review of the literature. Am J Surg Pathol 29:1512–1520PubMedGoogle Scholar
  60. Kottarathil VD, Anthony MA, Nair IR, Pvithran K (2013) Recent advances in granulosa cell tumory ovary: a review. Indian J Surg Oncol 4:37–47PubMedGoogle Scholar
  61. Kurman R, Shih LM (2011) Molecular pathogenesis and extraovarian origin of epithelial ovarian cancer. Shifting the paradigm. Hum Pathol 42:918–931PubMedPubMedCentralGoogle Scholar
  62. Kurman RJ, Carcangiu ML, Herrington CS et al (2014) WHO classification of tumours of temale reproductive organs. In: WHO classification of tumours, 4th edn. WHO Press, LyonGoogle Scholar
  63. Kwek JW, Iyer RB (2006) Recurrent ovarian cancer: spectrum of imaging findings. Am J Roentgenol AJR 187:99–104Google Scholar
  64. Kyriazi S, Kaye SB, deSouza NM (2010) Imaging ovarian cancer and peritoneal metastases – current and emerging techniques. Nat Rev Clin Oncol 7:381–393PubMedGoogle Scholar
  65. Lagoo AS, Robboy SJ (2006) Lymphoma of the female genital tract: current status. Int J Gynecol Pathol 25:1–21PubMedGoogle Scholar
  66. Lalwani N, Shanbhogue AKP, Vikram R, Nagar A, Jagirdar J, Prasad S (2010) Current update on Borderline ovarian neoplasm. AJR 194:330–336PubMedGoogle Scholar
  67. Lalwani N, Prassad SR, Vikram R, Shanboghue AK et al (2011) Histologic, molecular, and cytogenetic features of ovarian cancers: implication for diagnosis and treatment. Radiographics 31:625–646PubMedGoogle Scholar
  68. Leake JF, Currie JL, Rosenshein NB (1992) Long-term follow-up of serous ovarian tumors of low malignant potential. Gynecol Oncol 47:150–158PubMedGoogle Scholar
  69. Lee SI, Catalano OA, Dehdashti F (2015) Evaluation of gynecologic cancer with MR imaging. 18F-FDG PET/CT, and PET/MR imaging. J Nucl Med 56:436–443PubMedGoogle Scholar
  70. Lee SJ, Bae JH, Lee AW, Tong SY, Park YG, Park JS (2009) Clinical characteristics of metastatic tumors to the ovaries. J Korean Med Sci 24:114–119PubMedPubMedCentralGoogle Scholar
  71. Lengyel E (2010) Ovarian cancer development and metastasis. Am J Pathol 177:1053–1064PubMedPubMedCentralGoogle Scholar
  72. Levy AD, Shaw JC, Sobin LH (2009) Secondary tumors and tumorlike lesions of the peritoneal cavity: imaging features with pathologic correlation. Radiographics 29:347–373PubMedGoogle Scholar
  73. Li W, Wang H, Wang J et al (2012) Ovarian metastases resection from extragenital primary sites: outcome and prognostic factor analysis of 147 patients. BMC Cancer 12:278–286PubMedPubMedCentralGoogle Scholar
  74. Lorraine C, Pelosof LC, Gerber DE (2010) Paraneoplastic syndromes: an approach to diagnosis and treatment. Mayo Clin Proc 85:838–854Google Scholar
  75. Low RN, Saleh F, Song SYT et al (1999) Treated ovarian cancer: comparison of MR imaging with serum CA-125 level and physical examination: a longitudinal study. Radiology 211:519–528PubMedGoogle Scholar
  76. Low RN, Chen SC, Barone R et al (2003) Distinguishing benign from malignant bowel obstruction in patients with malignancy: findings at MRI. Radiology 228:157–165PubMedGoogle Scholar
  77. Low RN, Duggan B, Barone RM et al (2005) Treated ovarian cancer: MR imaging, laparotomy reassessment, and serum CA-125 values compared with clinical outcome at 1 year. Radiology 235:918–926PubMedGoogle Scholar
  78. Low RN, Barone RM, Lucero J (2015) comparison of MRI and CT for predicting the peritoneal cancer index (PCI) preoperatively in patients being considered for cytoreductive surgical procedures. Ann Surg Oncol 22:1708–1715PubMedGoogle Scholar
  79. Megibow AJ, Hulnik DH, Bosniak MA et al (1985) Ovarian metastases: computed tomographic appearances. Radiology 156:161–164PubMedGoogle Scholar
  80. Michielsen K, Vergote I, de Beeck O et al (2014) Whole–body MRI with diffusion-weighted sequence for staging of patients with suspected ovarian cancer: a clinical feasibility study in comparison to CT and FDG-PET/CT. Eur Radiol 24:889–901PubMedGoogle Scholar
  81. Mironov O, Ishill NM, Mironov S, Vargas HA et al (2011) Pleural effusion detected at CT prior to primary cytoreduction for stage III or IV ovarian carcinoma: effect on survival. Radiology 258:776–784PubMedPubMedCentralGoogle Scholar
  82. Mitchell DG, Javitt MC, Glanc P et al (2013) ACR appropriateness criteria staging and follow-up of ovarian cancer. J Am Coll Radiol 10:822–827Google Scholar
  83. Moyer VA (2012) Screening for ovarian cancer. US preventive service task force reaffirmation recommendation statement. Ann Intern Med 157:900–904PubMedGoogle Scholar
  84. Neto N, Cunha TM (2015) Do hereditary syndrome-related gynecologic cancers have any specific features. Insights Imaging 6:545–552PubMedPubMedCentralGoogle Scholar
  85. Nougaret S, Addley HC, Colombo PE, Fujii S, Al Sharif SS, Tirumani SH, Jardon K, Sala E, Reinhold C (2012) Ovarian carcinomatosis: how the radiologist can help plan the surgical approach. Radiographics 32:1775–1800PubMedGoogle Scholar
  86. Onyiuke I, Kirby AB, McCarthy S (2013) Primary gynecologic lymphoma: imaging findings. AJR 201:W648–W655PubMedGoogle Scholar
  87. Outwater EK, Wagner BJ, Mannion C et al (1998) Sex cord stromal and steroid cell tumors of the ovary. Radiographics 18:1523–1546PubMedGoogle Scholar
  88. Ovarian Cancer Statistics. www.cancerresearchuk.org
  89. Ozols RF, Schwartz PE, Eifel PJ (2001) Ovarian cancer, fallopian tube carcinoma, and peritoneal carcinoma. In: De Vita Jr VT, Hellman S, Rosenberg SA (eds) Cancer: principles and practice of oncology, 6th edn. Lippincott Williams & Wilkins, Philadelphia, pp 1597–1632Google Scholar
  90. Patel CM, Sahdev A, Reznek RH (2011) CT, MRI and PET imaging in peritoneal malignancy. Cancer Imaging 11:123–139PubMedPubMedCentralGoogle Scholar
  91. Pennington KP, Wsisher EM (2012) Hereditary ovarian cancer: beyond usual aspects. Gynecol Oncol 124:347–353PubMedGoogle Scholar
  92. Pfanneberg C, Schwenzer NF, Bruecher BL (2013) State of the Art Bildgebung bei Peritonealkarzinose. Fortschr Röntgenstr 184:205–213Google Scholar
  93. Quayyum A, Coakley FV, Westphalen AC et al (2005) Role of CT and MRI in predicting optimal cytoreduction of newly diagnosed primary epithelial ovarian cancer. Gynecol Oncol 96:301–306Google Scholar
  94. Queiroz MA, Kubik-Huch R, Hauser N, Freiwald-Chilla B et al (2015) PET/MRI and PET/CT in advanced gynecological tumors: initial experience and comparison. Eur Radiol 25:2222–2230PubMedGoogle Scholar
  95. Rockall A (2014) Diffusion weighted MRI in ovarian cancer. Curr Opin Oncol 26:529–535PubMedGoogle Scholar
  96. Runnebaum IB, Arnold N (2013) Genetik des Ovarialkarzinoms. Gynäkologe 46:553–559Google Scholar
  97. Sala E, Rockall AG, Freeman SJ et al (2013) The added role of MR imaging in treatment stratification of patients with gynecologic malignancies: what the radiologists needs to know. Radiology 266:717–740PubMedPubMedCentralGoogle Scholar
  98. Schmidt S, Meuli RA, Achtari C, Prior JO (2015) Peritoneal carcinomatosis in primary ovarian cancer staging: comparison between MDCT, MRI and 18F-FDGPET/CT. Clin Nucl Med 40:371–377PubMedGoogle Scholar
  99. Seidman JD, Russell P, Kurman RJ (2002) Surface epithelial tumors of the ovary. In: Kurman RJ (ed) Blaustein’s pathology of the female genital tract. Springer, Berlin/Heidelberg/New York, pp 791–904Google Scholar
  100. Sohaib SAA, Sahdev A, Trappen V et al (2003) Characterization of adnexal lesions on MRI. AJR Am J Roentgenol 180:1297–1304PubMedGoogle Scholar
  101. Spencer JA, Perren TJ (2010) Recent EORTC and MRCUK studies: implications for imaging ovarian cancer. Cancer Imaging 10:135–136PubMedPubMedCentralGoogle Scholar
  102. Stevens SK, Hricak H, Stern JL (1991) Ovarian lesions: detection and characterization with gadolinium-enhanced MRI at 1.5 T. Radiology 181:481–488PubMedGoogle Scholar
  103. Suidan RS, Ramirez PT, Sarasohn DM, Teitcher JB et al (2014) A multicenter prospective trial evaluating the ability of preoperative computed tomography scan and serum CA-125 to predict suboptimal cytoreduction at primary debulking surgery for advanced ovarian, fallopian tube, and peritoneal cancer. Gynecol Oncol 34:455–461Google Scholar
  104. Tanaka YU, Kurosaki Y, Nishida M et al (1994) Ovarian dysgerminoma: MR and CT appearance. J Comput Assist Tomogr 18:443–448PubMedGoogle Scholar
  105. Tanaka YO, Tsunoda H, Kitagawa Y et al (2004) Functioning ovarian tumors: direct and indirect findings at MRI. Radiographics 24:S147–S166PubMedGoogle Scholar
  106. Tanaka YO, Okada S, Yagi T, Satoh T, Oki A, Tsunoda H, Yoshikawa H (2010) MRI of endometriotic cysts in association with ovarian carcinoma. AJR 194:355–361PubMedGoogle Scholar
  107. Tanaka Y, Okada S, Satoh T, Matsumoto K, Oki A et al (2016) Differentiation of epithelial ovarian cancer subtypes by use of imaging and clinical data: a detailed analysis. Cancer Imaging 16:3PubMedPubMedCentralGoogle Scholar
  108. Tayfur M, Kocabas A, Kaygisiz A, Tiryaki S, Polat M, Cefle K (2007) Dysgerminoma arising in Swyer syndrome. Internet J Pathology 7:2Google Scholar
  109. Thomassin-Naggara I, Daraï E, Cuenod CA et al (2008a) Dynamic contrast-enhanced magnetic resonance imaging: a useful tool for characterizing ovarian epithelial tumours. J Magn Reson Imaging 28:111–1120PubMedGoogle Scholar
  110. Thomassin-Naggara I, Bazot M, Daraï E et al (2008b) Epithelial ovarian tumours: value of dynamic contrast-enhanced MR imaging and correlation with tumour angiogenesis. Radiology 248:148–159PubMedGoogle Scholar
  111. Thomassin-Naggara I, Daraï E, Cuenod CA, Fournier L, Toussaint C, Bazot M (2009) Contribution of diffusion-weighted MR imaging for predicting benignity of complex adnexal masses. Eur Radiol 19:1544–1552PubMedGoogle Scholar
  112. Thomassin-Naggara I, Balvay D, Aubert E et al (2012) Quantitative dynamic contrast-enhanced MR imaging analysis of complex adnexal masses: a preliminary study. Eur Radiol 22:738–745PubMedGoogle Scholar
  113. Thomassin-Naggara I, Aubert E, Rockall A et al (2013) Adnexal masses: development and preliminary validation of an MR imaging scoring system. Radiology 267:432–443Google Scholar
  114. Timmerman D, Valentin L, Bourne TH, Collins WP, Verrelst H (2000) Terms, definitions and measurements to describe the sonographic features of adnexal tumors: a consensus opinion from the International Ovarian Tumor Analysis (IOTA) group. Ultrasound Obstet Gynecol 16:500–505PubMedGoogle Scholar
  115. Togashi K (2003) Ovarian cancer: the role of US, CT and MRI. Eur Radiol 13(Suppl 4):L87–L104PubMedGoogle Scholar
  116. Tsili AC, Tsampoulas C, Argyropoulou M et al (2008) Comparative evaluation of multidetector CT and MR imaging in the differentiation of adnexal masses. Eur Radiol 18:1049–1057PubMedGoogle Scholar
  117. Yamaoka T, Togashi K, Koyama T et al (2003) Immature teratoma of the ovary: correlation of MR imaging and pathologic findings. Eur Radiol 13:313–319PubMedGoogle Scholar
  118. Young RH, Scully RE (2002a) Sex-cord-stromal, steroid cell, and other ovarian tumors. In: Kurman RJ (ed) Blaustein’s pathology of the female genital tract, 5th edn. Springer, Berlin\Heidelberg\New York, pp 905–965Google Scholar
  119. Young RH, Scully RE (2002b) Metastatic tumors of the ovary. In: Kurmann RJ (ed) Blausteins’s pathology of the female genital tract, 5th edn. Springer, Berlin\Heidelberg\New York, pp 1063–1101Google Scholar
  120. Zhao SH, Quiang JW, Zhang GF, Ma FH, Cai SQ, LiHM WL (2014a) Diffusion-weighted MR imaging for differentiating borderline from malignant epithelial tumours of the ovary: pathological correlation. Eur Radiol 24:2292–2299PubMedGoogle Scholar
  121. Zhao SH, Quiang JW, Zhang GF, Wang SJ, Qiu HJ, Wang L (2014b) MRI in differentiating ovarian borderline from benign mucinous cystadenoma: pathologic correlation. J Magn Reson Imaging 39:162–166PubMedGoogle Scholar

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© Springer International Publishing AG 2017

Authors and Affiliations

  1. 1.Salzburger Landeskliniken, Paracelsus Medical UniversityMüllner Hauptstr. 48Austria

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