Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Jan 22;15(1):13.
doi: 10.1186/s13048-021-00920-y.

Quantitative analysis of the MRI features in the differentiation of benign, borderline, and malignant epithelial ovarian tumors

Fuxia Xiao #  1 , Lin Zhang #  1 , Sihua Yang  1 , Kun Peng  1 , Ting Hua  1 , Guangyu Tang  2
Affiliations

Quantitative analysis of the MRI features in the differentiation of benign, borderline, and malignant epithelial ovarian tumors

Fuxia Xiao et al. J Ovarian Res. .

Abstract

Objective: This study aims to investigate the value of the quantitative indicators of MRI in the differential diagnoses of benign, borderline, and malignant epithelial ovarian tumors (EOTs).

Materials and methods: The study population comprised 477 women with 513 masses who underwent MRI and operation, including benign EOTs (BeEOTs), borderline EOTs (BEOTs), and malignant EOTs (MEOTs). The clinical information and MRI findings of the three groups were compared. Then, multivariate logistic regression analysis was performed to find the independent diagnostic factors. The receiver operating characteristic (ROC) curves were also used to evaluate the diagnostic performance of the quantitative indicators of MRI and clinical information in differentiating BeEOTs from BEOTs or differentiating BEOTs from MEOTs.

Results: The MEOTs likely involved postmenopausal women and showed higher CA-125, HE4 levels, ROMA indices, peritoneal carcinomatosis and bilateral involvement than BeEOTs and BEOTs. Compared with BEOTs, BeEOTs and MEOTs appeared to be more frequently oligocystic (P < 0.001). BeEOTs were more likely to show mild enhancement (P < 0.001) and less ascites (P = 0.003) than BEOTs and MEOTs. In the quantitative indicators of MRI, BeEOTs usually showed thin-walled cysts and no solid component. BEOTs displayed irregular thickened wall and less solid portion. MEOTs were more frequently characterized as solid or predominantly solid mass (P < 0.001) than BeEOTs and BEOTs. The multivariate logistic regression analysis showed that volume of the solid portion (P = 0.006), maximum diameter of the solid portion (P = 0.038), enhancement degrees (P < 0.001), and peritoneal carcinomatosis (P = 0.011) were significant indicators for the differential diagnosis of the three groups. The area under the curves (AUCs) of above indicators and combination of four image features except peritoneal carcinomatosis for the differential diagnosis of BeEOTs and BEOTs, BEOTs and MEOTs ranged from 0.74 to 0.85, 0.58 to 0.79, respectively.

Conclusion: In this study, the characteristics of MRI can provide objective quantitative indicators for the accurate imaging diagnosis of three categories of EOTs and are helpful for clinical decision-making. Among these MRI characteristics, the volume, diameter, and enhancement degrees of the solid portion showed good diagnostic performance.

Keywords: Differential diagnosis; Magnetic resonance imaging; Ovarian neoplasms.

PubMed Disclaimer

Conflict of interest statement

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.

Figures

Fig. 1
Fig. 1
A 74-year-old woman with right serous cystadenoma. A–B Tumor with few loculi shows low and high signal intensities on T1WI and T2WI, respectively. The pelvis region has no peritoneal carcinomatosis and ascite. The thin wall and septum (arrows) in contrast-enhanced T1WI (C–D) exhibit mild enhancement
Fig. 2
Fig. 2
A 25-year-old woman with right mucinous borderline neoplasm. A–B Multilocular cystic mass with mild thickened capsule wall on the axial T1W and T2W images in the pelvis (arrow). C–D Prominent enhancement of the unevenly thickened capsule wall and septum on axial and sagittal contrast-enhanced T1W images with FS (arrows)
Fig. 3
Fig. 3
A 52-year-old woman with bilateral high grade of serous ovarian carcinoma. A–B Irregular solid mass on the bilateral ovarian regions with unclear boundaries present isointensity and slight hyperintensity signals on axial T1WI and T2WI, respectively. Ascite in rectum lacuna (pentastar) was found. C–D Axial and coronary contrast-enhanced fat-suppressed T1-weighted MR image shows markedly and unevenly enhanced solid component within complex solid and follicular mass in pelvis (arrows)
Fig. 4
Fig. 4
Receiver operating characteristic (ROC) curve analysis of MR imaging parameters, including volume of solid portion, maximum diameter of solid portion, enhancement degrees, peritoneal carcinomatosis, and their combination for discriminating BeEOTs and BEOTs (A) and BEOTs and MEOTs (B)
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Cobb LP, Gershenson DM. Treatment of rare epithelial ovarian tumors. Hematol Oncol Clin North Am. 2018;32(6):1011–24. - PubMed
    1. Eskander R, Berman M, Keder L. Practice bulletin no. 174: evaluation and Management of Adnexal Masses. American College of Obstetricians and Gynecologists’ committee on practice bulletins—gynecology. Obstet Gynecol. 2016;128(5):e210–e226. - PubMed
    1. Liang F, Xu X, Liang B. Comparison of intraoperative indicators and postoperative efficacy in treatment of benign ovarian tumor: laparoscopy versus open surgery. Am J Ther. 2017;24(6):e681–e688. - PubMed
    1. Guillaume A, Pirrello O. Preservation of fertility in surgery of benign and borderline malignant ovarian tumors. J Visc Surg. 2018;155(Suppl 1):S17–S21. - PubMed
    1. Ozlem Dural MD, Cenk Yasa MD, Ercan Bastu MD. Laparoscopic outcomes of adnexal surgery in older children and adolescents. J Pediatr Adolesc Gynecol. 2017;30(1):128–131. - PubMed

MeSH terms