Abstract

To clarify usefulness of apparent diffusion coefficient (ADC) value in the differential diagnosis of stage I malignant epithelial ovarian tumor (MOT) and borderline epithelial ovarian tumor (BOT), the ADC value of the solid portion or thickened wall of ovarian tumors was evaluated by a 1.5-T magnetic resonance imaging system in 18 cases of BOT and MOT. The median of average ADC value was 1.668 × 10?3 mm2 /s for BOT and 1.021 × 10?3 mm2 /s for MOT (p = 0.0005), and the median of minimum ADC value was 1.394 × 10?3 mm2 /s for BOT and 0.812× 10?3 mm2 /s for MOT (p = 0.0006), both of which were significantly lower in MOT than that in BOT. So the ADC value is useful and especially the minimum ADC value is useful in that it can easily measure the ROI so that it contains solid portion or thickened wall.

Highlights

  • Preoperative diagnosis of ovarian tumors is mainly performed by imaging techniques such as ultrasonography, computed tomography (CT), and magnetic resonance imaging (MRI)

  • A vast majority of borderline epithelial ovarian tumors (BOTs) are limited to the ovary at the initial presentation with 75% being diagnosed as International Federation of Gynecology and Obstetrics (FIGO) stage I, compared with those of malignant epithelial ovarian tumors (MOTs), which are diagnosed at an early stage only in 10% of the patients [6]

  • We investigated the usefulness of apparent diffusion coefficient (ADC) value in the solid portion or thickened wall of ovarian tumors for the differential diagnosis of FIGO stage I BOTs from MOTs

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Summary

Introduction

Preoperative diagnosis of ovarian tumors is mainly performed by imaging techniques such as ultrasonography, computed tomography (CT), and magnetic resonance imaging (MRI). The accuracy of the preoperative and intraoperative frozen section diagnosis for borderline epithelial ovarian tumors (BOTs) is reported to be about 60%-75% owing to the heterogeneity of tumor cells and large tumor size [1, 2]. The operation mode for ovarian tumors is sometimes determined by an intraoperative frozen section, and fertility preservation is considered in patients with BOT according to the patients’ wish. BOTs have a much better prognosis [3, 4] than malignant epithelial ovarian tumors (MOTs), and fertility preservation is a very important issue in young patients [5]. If the accurate diagnosis of BOTs could be preoperatively obtained, fertility preservation would be prepared. The apparent diffusion coefficient (ADC) value in MRI diffusion-weighted imaging (DWI), which has the potential to replace contrast-enhanced sequences, is increasingly used for the differential diagnosis between BOT and MOT [7-9]. The ADC value may be an index that indirectly captures the properties of the tumor [10]

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