Bilateral Tubo-Ovarian Abscess Mimics Ovarian Cancer on MRI and 18F-FDG PET/CT

Rakheja, Rajan; Makis, William; Hickeson, Marc

doi:10.1007/s13139-011-0089-5

Cited by 17 publications

(23 citation statements)

References 32 publications

(42 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Clinically, a patient with acute pelvic infection typically presents with fever, chills, leukocytosis and/or increased blood C-reactive protein (CRP), which is distinct from adnexal malignant tumor. However, previous reports suggest that approximately 50% of women with chronic infections such as TOA, can have normal body temperature and laboratory examination results [ 1 ]. Other symptoms and signs including abdominal pain, vaginal discharge and abnormal vaginal bleeding are nonspecific for TOA and malignancy [ 1 – 2 ].…”

Section: Introductionmentioning

confidence: 99%

“…In cases of complicated TOAs, purulent cavities, thickened walls or septa, and adjoining dilated fallopian tube (salpingitis or pyosalpinx), are usually demonstrative of large multilocular cystic lesions or mixed cystic and solid masses on magnetic resonance imaging (MRI) [ 1 , 3 ]. However, MRI findings of thickened wall or septa (> 3 mm) or various degrees of solid portions are strongly suggestive of ovarian malignancy [ 4 – 6 ].…”

Section: Introductionmentioning

confidence: 99%

“…Additionally, inflammation can often cause damage to the rectosigmoid colon and ureter, leading to reactive lymph node swelling and the production of moderate to considerable free fluid in the pelvis. These MRI findings associated with vague clinical symptoms of infection can further contribute to errors in diagnosis, and suspicion of ovarian malignancy [ 1 ].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Tubo-Ovarian Abscess (with/without Pseudotumor Area) Mimicking Ovarian Malignancy: Role of Diffusion-Weighted MR Imaging with Apparent Diffusion Coefficient Values

Wang

et al. 2016

PLoS ONE

View full text Add to dashboard Cite

ObjectiveTo assess the added value of diffusion-weighted magnetic resonance imaging (DWI) with apparent diffusion coefficient (ADC) values compared to MRI, for characterizing the tubo-ovarian abscesses (TOA) mimicking ovarian malignancy.Materials and MethodsPatients with TOA (or ovarian abscess alone; n = 34) or ovarian malignancy (n = 35) who underwent DWI and MRI were retrospectively reviewed. The signal intensity of cystic and solid component of TOAs and ovarian malignant tumors on DWI and the corresponding ADC values were evaluated, as well as clinical characteristics, morphological features, MRI findings were comparatively analyzed. Receiver operating characteristic (ROC) curve analysis based on logistic regression was applied to identify different imaging characteristics between the two patient groups and assess the predictive value of combination diagnosis with area under the curve (AUC) analysis.ResultsThe mean ADC value of the cystic component in TOA was significantly lower than in malignant tumors (1.04 ± 0 .41 × 10−3 mm2/s vs. 2.42 ± 0.38 × 10−3 mm2/s; p < 0.001). The mean ADC value of the enhanced solid component in 26 TOAs was 1.43 ± 0.16×10−3mm2/s, and 46.2% (12 TOAs; pseudotumor areas) showed significantly higher signal intensity on DW-MRI than in ovarian malignancy (mean ADC value 1.44 ± 0.20×10−3 mm2/s vs.1.18 ± 0.36 × 10−3 mm2/s; p = 0.043). The combination diagnosis of ADC value and dilated tubal structure achieved the best AUC of 0.996. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of MRI vs. DWI with ADC values for predicting TOA were 47.1%, 91.4%, 84.2%, 64%, and 69.6% vs. 100%, 97.1%, 97.1%, 100%, and 98.6%, respectively.ConclusionsDW-MRI is superior to MRI in the assessment of TOA mimicking ovarian malignancy, and the ADC values aid in discriminating the pseudotumor area of TOA from the solid portion of ovarian malignancy.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Tubo-Ovarian Abscess (with/without Pseudotumor Area) Mimicking Ovarian Malignancy: Role of Diffusion-Weighted MR Imaging with Apparent Diffusion Coefficient Values

Wang

et al. 2016

PLoS ONE

View full text Add to dashboard Cite

show abstract

“…These clinical signs and symptoms may mimic borderline or malignant ovarian tumours. In such cases, further assessment by pelvic MRI examination for better characterization of the lesions is recommended [24,25].…”

Section: Discussionmentioning

confidence: 99%

Diagnostic performance of GI-RADS reporting system in evaluation of adnexal masses

elsalam

Hamed

Sayed

2020

Egypt J Radiol Nucl Med

View full text Add to dashboard Cite

Background: Transvaginal and pelvic ultrasound are considered the primary imaging modality in evaluating adnexal masses. Gynaecologic Imaging Reporting and Data System (GI-RADS) depends on different ultrasound patterns and criteria adopted by the International Ovarian Tumour Analysis (IOTA) group. The current study aimed to detect the diagnostic accuracy of the GI-RADS classification in evaluating adnexal masses. In this prospective cross-sectional study, a total of 112 adnexal masses belonging to 100 women, age ranged 12 to 66 years old, were included. The study population was recruited throughout the period between January and November 2017. Ultrasound examination was performed to all patients; different US and Doppler criteria were assessed. Results: Out of the 112 lesions, 36 (32.1%) were GI-RADS 2, 32 (28.6%) GI-RADS 3, 13 (11.6%) GI-RADS 4, and 31 (27.7%) GI-RADS 5. The GI-RADS classification showed sensitivity 97%, specificity 84.8%, positive predictive value (PPV) 72.7%, negative predictive value (NPV) 98.5%, and accuracy 88.4%. Conclusion: The GI-RADS reporting system carried a high sensitivity in identifying adnexal masses at high risk of malignancy. The increased number of benign lesions misclassified as GI-RADS 4 required additional markers to improve the specificity in GI-RADS classification.

show abstract

“…27,28 In addition, benign ovarian lesions, including endometriosis, 29 hemorrhagic corpus luteal cysts, 30 thecoma, 31 and even normal ovaries, 32 can also show increased FDG uptake, mimicking malignant ovarian lesions. Previous case reports have already demonstrated intense FDG uptake in tubo-ovarian abscess lesions.…”

Section: Discussionmentioning

confidence: 99%

The Performance of Contrast-Enhanced FDG PET/CT for the Differential Diagnosis of Unexpected Ovarian Mass Lesions in Patients With Nongynecologic Cancer

Lee

Cho

et al. 2015

Clinical Nuclear Medicine

View full text Add to dashboard Cite

show abstract

Bilateral Tubo-Ovarian Abscess Mimics Ovarian Cancer on MRI and 18F-FDG PET/CT

Cited by 17 publications

References 32 publications

Tubo-Ovarian Abscess (with/without Pseudotumor Area) Mimicking Ovarian Malignancy: Role of Diffusion-Weighted MR Imaging with Apparent Diffusion Coefficient Values

Tubo-Ovarian Abscess (with/without Pseudotumor Area) Mimicking Ovarian Malignancy: Role of Diffusion-Weighted MR Imaging with Apparent Diffusion Coefficient Values

Diagnostic performance of GI-RADS reporting system in evaluation of adnexal masses

The Performance of Contrast-Enhanced FDG PET/CT for the Differential Diagnosis of Unexpected Ovarian Mass Lesions in Patients With Nongynecologic Cancer

Contact Info

Product

Resources

About