Background We sought to determine the value of combining diffusion-weighted (DW) and perfusion-weighted (PW) sequences with a conventional magnetic resonance (MR) sequence to assess solid components of borderline ovarian tumors (BOTs) and stage I carcinomas.
Methods Conventional, DW, and PW sequences in the tumor imaging studies of 70 patients (BOTs, n=38; stage I carcinomas, n=32) who underwent surgery with pathologic correlation were assessed. Two independent radiologists calculated the parameters apparent diffusion coefficient (ADC), Ktrans (vessel permeability), and Ve (cell density) for the solid components. The distribution on conventional MR sequence and mean, standard deviation, and 95% confidence interval of each DW and PW parameter were calculated. The inter-observer agreement among the two radiologists was assessed. Area under the receiver operating characteristic curve (AUC) and multivariate logistic regression were performed to compare the effectiveness of DW and PW sequences for average values and to characterize the diagnostic performance of combined DW and PW sequences.
Results There were excellent agreements for DW and PW parameters between radiologists. The distributions of ADC, Ktrans and Ve values were significantly different between BOTs and stage I carcinomas, yielding AUCs of 0.58 and 0.68, 0.78 and 0.82, and 0.70 and 0.72, respectively, with ADC yielding the lowest diagnostic performance. The AUCs of the DW, PW, and combined PW and DW sequences were 0.71±0.05, 0.80±0.05, and 0.85±0.05, respectively.
Conclusion Combining PW and DW sequences to a conventional sequence potentially improves the diagnostic accuracy in the differentiation of BOTs and stage I carcinomas.
Citations
Citations to this article as recorded by
Comparison of conventional diffusion-weighted imaging, diffusion kurtosis imaging and intravoxel incoherent motion in characterization of sonographically indeterminate adnexal masses Gurkawal Kaur, Smita Manchanda, Raju Sharma, Surabhi Vyas, Devasenathipathy Kandasamy, Smriti Hari, Neerja Bhatla, Sandeep R. Mathur Abdominal Radiology.2024; 49(5): 1512. CrossRef
Advances in fertility preserving surgery for borderline ovarian tumors Mingdan Wang, Kuiran Liu European Journal of Obstetrics & Gynecology and Reproductive Biology.2022; 270: 206. CrossRef
Recurrence characteristics and clinicopathological results of borderline ovarian tumors Lina Niu, Huihui Tian, Yongjun Xu, Jieqiong Cao, Xu Zhang, Junli Zhang, Jiajia Hou, Weiqin Lv, Junxia Wang, Li Xin, XuFeng Dong, Tao Xu, Yuan Nan, Hua Wei, Xinting Chai, Na Li, Yan Ni, Yun Shang, Lizhen Zhang, Ye Zhao BMC Women's Health.2021;[Epub] CrossRef
Erratum to “Assessment of solid components of borderline ovarian tumor and stage I carcinoma: added value of combined diffusion- and perfusion-weighted magnetic resonance imaging” See Hyung Kim Yeungnam University Journal of Medicine.2020; 37(2): 147. CrossRef
Minimal apparent diffusion coefficient value of the solid component to differentiate borderline and malignant ovarian epithelial tumours: a preliminary report Sahat B.R.E. Matondang, Avrilia Ekawati, Andrijono Andrijono, Hartono Tjahjadi, Joedo Prihartono Polish Journal of Radiology.2020; 85: 250. CrossRef