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Diffusion-weighted MR imaging for differentiating borderline from malignant epithelial tumours of the ovary: pathological correlation

  • Oncology
  • Published:
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Abstract

Objectives

To investigate diffusion-weighted (DW) magnetic resonance (MR) imaging for differentiating borderline from malignant epithelial tumours of the ovary.

Methods

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.

Results

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.

Conclusions

DW imaging is useful for differentiating borderline from malignant epithelial tumours of the ovary.

Key Points

• 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.

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Abbreviations

ADC:

apparent diffusion coefficient

BEOT:

borderline epithelial ovarian tumour

DW:

diffusion-weighted

MEOT:

malignant epithelial ovarian tumour

MR:

magnetic resonance

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Acknowledgments

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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Authors and Affiliations

  1. Department of Radiology, Jinshan Hospital, Fudan University, 1508 Longhang Road, Shanghai, 201508, China

    Shu Hui Zhao, Jin Wei Qiang, Feng Hua Ma, Song Qi Cai & Hai Ming Li

  2. Department of Radiology, Obstetrics & Gynecology Hospital, Fudan University, 419 Fangxie Road, Shanghai, 200011, China

    Guo Fu Zhang

  3. Department of Pathology, Jinshan Hospital, Fudan University, 1508 Longhang Road, Shanghai, 201508, China

    Li Wang

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  1. Shu Hui Zhao
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  2. Jin Wei Qiang
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  4. Feng Hua Ma
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  7. Li Wang
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Correspondence to Jin Wei Qiang or Guo Fu Zhang.

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Zhao, S.H., Qiang, J.W., Zhang, G.F. et al. Diffusion-weighted MR imaging for differentiating borderline from malignant epithelial tumours of the ovary: pathological correlation. Eur Radiol 24, 2292–2299 (2014). https://doi.org/10.1007/s00330-014-3236-4

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  • DOI: https://doi.org/10.1007/s00330-014-3236-4

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