Radiomic Analysis of MRI Images is Instrumental to the Stratification of Ovarian Cysts.

Roxana-Adelina Lupean,Balaji Ganeshan,Bianca Petresc,Csaba Csutak,Paul-Andrei Ștefan,Carmen Mihaela Mihu,Andrei Lebovici,Diana Sorina Feier

doi:10.3390/jpm10030127

Abstract

The imaging diagnosis of malignant ovarian cysts relies on their morphological features, which are not always specific to malignancy. The histological analysis of these cysts shows specific fluid characteristics, which cannot be assessed by conventional imaging techniques. This study investigates whether the texture-based radiomics analysis (TA) of magnetic resonance (MRI) images of the fluid content within ovarian cysts can function as a noninvasive tool in differentiating between benign and malignant lesions. Twenty-eight patients with benign (n = 15) and malignant (n = 13) ovarian cysts who underwent MRI examinations were retrospectively included. TA of the fluid component was undertaken on an axial T2-weighted sequence. A comparison of resulted parameters between benign and malignant groups was undertaken using univariate, multivariate, multiple regression, and receiver operating characteristics analyses, with the calculation of the area under the curve (AUC). The standard deviation of pixel intensity was identified as an independent predictor of malignant cysts (AUC = 0.738; sensitivity, 61.54%; specificity, 86.67%). The prediction model was able to identify malignant lesions with 84.62% sensitivity and 80% specificity (AUC = 0.841). TA of the fluid contained within the ovarian cysts can differentiate between malignant and benign lesions and potentially act as a noninvasive tool augmenting the imaging diagnosis of ovarian cystic lesions.

Highlights

Due to the complexity of their embryological and histological development, the ovaries represent a source of a wide variety of lesions [1]
Of the 221 patients with adnexal lesions referred to our department during the study period, the final study population comprised of 28 patients
The benign group comprised of five cystadenomas and ten functional cysts (FCs), while the malignant group incorporated five serous carcinomas and eight clear cell carcinomas

Summary

Introduction

Due to the complexity of their embryological and histological development, the ovaries represent a source of a wide variety of lesions [1]. Ovarian cysts represent a common gynecological encounter as a consequence of physiological or pathological processes [2]. The imaging characterization of ovarian cysts is of great importance to plan adequate therapeutic procedures and strongly influence the patient’s management [3]. Transvaginal ultrasonography (TVUS) is the first-line imaging modality used to characterize adnexal masses [4], a proportion of them remains indeterminate, mostly regarding their benign or malignant character [5]. Magnetic resonance imaging (MRI) is an important diagnostic tool that can offer accurate information about the features and the local invasion of a pelvic mass [6]. Used MRI sequences in this scenario include nonenhanced T1- and T2-weighted sequences [6], and advanced techniques such as diffusion-weighted (DWI) [7] and dynamic contrast-enhanced imaging [8]

Methods

Results

Discussion

Conclusion