Abstract
BackgroundThe study aimed to investigate the utility of dynamic contrast enhanced MRI (DCE-MRI) in the differentiation of malignant, borderline, and benign complex ovarian tumors.MethodsDCE-MRI data of 102 consecutive complex ovarian tumors (benign 15, borderline 16, and malignant 71), confirmed by surgery and histopathology, were analyzed retrospectively. The patterns (I, II, and III) of time-signal intensity curve (TIC) and three semi-quantitative parameters, including enhancement amplitude (EA), maximal slope (MS), and time of half rising (THR), were evaluated and compared among benign, borderline, and malignant ovarian tumors. The types of TIC were compared by Pearson Chi-square χ2 between malignant and benign, borderline tumors. The mean values of EA, MS, and THR were compared using one-way ANOVA or nonparametric Kruskal-Wallis test.ResultsFifty-nine of 71 (83%) malignant tumors showed a type-III TIC; 9 of 16 (56%) borderline tumors showed a type-II TIC, and 10 of 15 (67%) benign tumors showed a type-II TIC, with a statistically significant difference between malignant and benign tumors (P < 0.001) and between malignant and borderline tumors (P < 0.001). MS was significantly higher in malignant tumors than in benign tumors and in borderline than in benign tumors (P < 0.001, P = 0.013, respectively). THR was significantly lower in malignant tumors than in benign tumors and in borderline than in benign tumors (P < 0.001, P = 0.007, respectively). There was no statistically significant difference between malignant and borderline tumors in MS and THR (P = 0.19, 0.153) or among malignant, borderline, and benign tumors in EA (all P > 0.05).ConclusionsDCE-MRI is helpful for characterizing complex ovarian tumors; however, semi-quantitative parameters perform poorly when distinguishing malignant from borderline tumors.
Highlights
The study aimed to investigate the utility of dynamic contrast enhanced MRI (DCE-MRI) in the differentiation of malignant, borderline, and benign complex ovarian tumors
The preoperative qualitative diagnosis and accurate characterization of ovarian tumors are the key steps for an optimal clinical treatment strategy, which is helpful for improving patient prognosis [2,3,4]
A significant difference was found in the bilaterality (P = 0.021, 0.006), shape (P = 0.001, 0.001), mass configuration (P = 0.009, 0.001), and peritoneal implants/ lymph nodes (P = 0.006, 0.003) among the three groups and between benign and malignant tumours, respectively
Summary
The study aimed to investigate the utility of dynamic contrast enhanced MRI (DCE-MRI) in the differentiation of malignant, borderline, and benign complex ovarian tumors. Ovarian tumors represent a remarkably heterogeneous group of benign, borderline, and malignant neoplasms that usually result in significant diagnostic challenges to radiologists, surgeons, and pathologists [1,2,3]. The preoperative qualitative diagnosis and accurate characterization of ovarian tumors are the key steps for an optimal clinical treatment strategy, which is helpful for improving patient prognosis [2,3,4]. Some have already voiced strong concerns about the individualized treatment of ovarian tumors, especially in borderline and some subtypes of early-stage malignant tumors, because a conservative, fertility-sparing surgery can be considered for patients who wish it [5,6,7,8].
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
