Abstract
AimsTo find specific magnetic resonance imaging (MRI) features to differentiate metastatic ovarian tumors from primary epithelial ovarian cancers.MethodsEleven cases with metastatic ovarian tumors and 26 cases with primary malignant epithelial ovarian cancers were retrospectively studied. All features such as patient characteristics, MRI findings and biomarkers were evaluated. The differences including laterality, configuration, uniformity of locules, diffusion weighted imaging (DWI) signal of solid components and enhancement of solid portions between metastatic ovarian tumors and primary epithelial ovarian cancers were compared by Fisher’s exact test. Median age of patients, the maximum diameter of lesions and biomarkers were compared by the Mann-Whitney test.ResultsPatients with metastatic ovarian tumors were younger than patients with primary epithelial ovarian cancers in the median age (P = 0.015). Patients with bilateral tumors in metastatic ovarian tumors were more than those of primary epithelial ovarian cancers (P = 0.032). The maximum diameter of lesions in metastatic ovarian tumors was smaller than that of primary epithelial ovarian cancers (P = 0.005). The locules in metastatic ovarian tumors were more uniform than those of primary epithelial ovarian cancers (P = 0.024). The enhancement of solid portions in metastatic ovarian tumors showed more moderate than that of primary epithelial ovarian cancers (P = 0.037). There was no statistically significant difference between the two groups in configuration, DWI signal of solid components and ascites. Biomarkers such as CA125 and human epididymis protein 4 (HE4) in metastatic ovarian tumors showed less elevated than that of primary epithelial ovarian cancers.ConclusionsSignificant differences between metastatic ovarian tumors and primary epithelial ovarian cancers were found in the median age of patients, laterality, the maximum diameter of lesions, uniformity of locules, enhancement patterns of solid portions and biomarkers. Metastatic ovarian tumors usually presented in the younger patients, smaller-sized, more bilateral lesions, more uniform of locules, more moderate enhancement of solid portions, and less elevated levels of CA125 and HE4 than those of primary epithelial ovarian cancers.
Highlights
The optimal management and prognosis of metastatic ovarian tumors depend on the origin of the primary tumor [1, 2]
Seventeen tumors were found in 11 patients with metastatic ovarian tumors—bilateral tumors in six patients and unilateral tumors in five patients; thirty-one tumors were found in 26 patients with primary epithelial ovarian cancers—bilateral tumors in five patients and unilateral tumors in 21 patients (P = 0.032)
The locules of a metastatic ovarian tumors on the right ovary were uniform on FS T2-weighted images (T2WI) and the solid portion was moderate enhancement on liver acquisition with a volume acceleration (LAVA) DCE-magnetic resonance imaging (MRI) (B and D)
Summary
The optimal management and prognosis of metastatic ovarian tumors depend on the origin of the primary tumor [1, 2]. Management will be based on cytoreductive surgery and systemic therapy (depending on stage). It is difficult to discriminate these tumors by imaging, or even by histopathology in. Xu et al Journal of Ovarian Research (2015) 8:61. Magnetic resonance imaging (MRI) is a useful tool for investigation and description of characteristic signs for the preoperative diagnosis of an ovarian lesion [1]. The object of this study is to detect specific MRI features of metastatic ovarian tumors that can be discriminated from primary epithelial ovarian cancers
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