Role of MR Spectroscopy in differentiating benign from malignant ovarian tumors.

Abstract

Background: Ovarian cancer stands as a greatly dangerous gynecological malignancy with elevated mortality rate. Imaging plays a pivotal role in identification and planning of treatment of accidentally detected ovarian lesions, as earlier diagnosis of ovarian malignancy has strong relation with good prognosis. Objectives: This study goal is assessment of the effectiveness of proton magnetic resonance spectroscopy to discriminate malignancy & benign ovarian neoplasms. Patients & Method: Twenty cases with histopathologically determined complex and solid ovarian tumors (10 benign ,8 malignant and 2 borderline) had traditional MRI and magnetic resonance spectroscopy. The integrals of the peak of creatine, choline, lipid and (NAA) N-acetyl aspartate evaluated. The choline to creatine, lipid to creatine and NAA to Creatine ratios had been detected and then compared among the groups of malignant and benign neoplasms. Results: Our study showed mean of choline to creatine ratio was 4.29 ±1.7 in benign tumors in contrast to 8.06±1.4 in malignant ones, with significant differences in statics (PV of 0.000). There have been no significant statics differences of the malignancy or the benign neoplasms as regard NAA to creatine (PV of 0.12) and lipid to creatine ratio (PV of 0.19). An edge of 4.29 of choline to creatine for characterizing benign and malignant tumors had 91.7% sensitivity, 100% specificity and 95% accuracy. Conclusion: This experimental research reached that proton magnetic resonance spectroscopy is different in malignancy and in benign complex and solid ovarian neoplasms and that choline to creatine ratio will help to differ malignant and benign ovarian neoplasms.