Abstract
PurposeTo investigate magnetic resonance imaging (MRI) features for differentiating ovarian endometrioid adenocarcinoma (OEC) from high-grade serous adenocarcinoma (HGSC).Materials and methodsTwenty-three patients with 25 OECs and 93 patients with 139 HGSCs confirmed by surgery and pathology underwent conventional MRI and diffusion-weighted imaging (DWI). The MRI features of the tumors, including laterality, size, shape, configuration, signal intensity, ADC value of solid component, enhancement, ascites, synchronous primary cancer (SPC) of the ovary and endometrium, and clinical stage, were evaluated and compared between two groups.ResultsThe following characteristics were significantly more common for OECs than HGSCs: unilateral (91.3% vs 50.5%, P < 0.001), larger mass (80.0% vs 48.2%, P = 0.005), round or oval shape (64.0% vs 17.3%, P < 0.001), mainly cystic with mural nodules or papillary projections (72.0% vs 18.7%, P < 0.001), cystic component with homogeneous iso- or hyperintensity on T1WI (82.6% vs 4.3%, P < 0.001), moderate enhancement (52.0% vs 26.6%, P = 0.011), no or mild ascites (91.3% vs 57.0%, P = 0.002), and SPC (43.5% vs 4.3%, P < 0.001). The ADC value of the solid component was higher in OECs (0.979 ± 0.197 × 10−3 mm2/s) than in HGSCs (0.820 ± 0.112 × 10−3 mm2/s) (P = 0.002). When a mainly cystic mass with mural nodules or papillary projections was associated with any one of homogeneously iso- or hyperintense cystic component on TIWI, a relatively higher ADC value and SPC, the sensitivity, specificity, accuracy, and positive and negative predictive values for characterizing OEC were 87.0%, 93.5%, 92.2%, 76.9%, and 96.7%, respectively.ConclusionsConventional MRI combining DWI is helpful for differentiating OECs from HGSCs.
Highlights
The apparent diffusion coefficient (ADC) value of the solid component was higher in OECs (0.979 ± 0.197 × 10−3 mm2/s) than in high-grade serous adenocarcinoma (HGSC) (0.820 ± 0.112 × 10−3 mm2/s) (P = 0.002)
Conventional magnetic resonance imaging (MRI) combining diffusion weighted imaging (DWI) is helpful for differentiating OECs from HGSCs
When an adnexal mass is suspected to be an epithelial ovarian carcinoma by magnetic resonance imaging (MRI), the primary concern of clinicians is that the patient has a high-grade serous adenocarcinoma (HGSC), which is the most frequent epithelial carcinoma and is typically aggressive clinically [1]
Summary
When an adnexal mass is suspected to be an epithelial ovarian carcinoma by magnetic resonance imaging (MRI), the primary concern of clinicians is that the patient has a high-grade serous adenocarcinoma (HGSC), which is the most frequent epithelial carcinoma and is typically aggressive clinically [1]. Conventional MRI and diffusion weighted imaging (DWI) have not been investigated for their ability to differentiate between OEC and HGSC. Preoperative imaging differentiation of OEC from HGSC will be helpful for the management of patient with OEC, because a conservative fertility-sparing surgery can be considered for patients with early-stage OEC who wish to preserve fertility [8]. This retrospective study evaluated conventional MRI and DWI for distinguishing OEC from HGSC to improve the preoperative characterization and surgical planning of these two distinctive types of ovarian cancers
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