Diffusion-weighted MRI: a useful technique to discriminate benign versus malignant ovarian surface epithelial tumors with solid and cystic components

Abstract

To evaluate differences in apparent diffusion coefficient (ADC) values for the solid component of benign and malignant ovarian surface epithelial tumors with the goal of differentiating benign versus malignant ovarian tumors preoperatively. A total of 127 patients with 131 pelvic masses identified by ultrasound between January 2006 and January 2011 were enrolled in this study. 46 patients were diagnosed with benign tumors, and 85 patients were diagnosed with malignant pathologies. For all of the patients, routine spin-echo MRI and diffusion-weighted imaging were performed. ADC values were determined for all of the masses, and the mean ADC values for the benign and malignant tumors were analyzed using Student's t test. A P value <0.05 was considered statistically significant. Mean ADC values associated with malignant ovarian surface epithelial tumors were significantly lower than the mean ADC values of the benign tumors. In addition, the range of ADC values associated with a 95% confidence interval did not overlap between the two groups. ROC analysis indicated that a cutoff ADC value of 1.25 × 10(-3) mm(2)/s was associated with 90.1% sensitivity and 89.9% specificity. ADC values determined from 1.5 T MR DWI of benign and malignant ovarian masses were found to be significantly different.