Differentiation between benign and malignant ovarian masses using multiparametric MRI

Türkoğlu, Sefa; Kayan, Mustafa

doi:10.1016/j.diii.2020.01.006

Cited by 30 publications

(7 citation statements)

References 24 publications

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“…48 Multiparametric MRI can differentiate between benign and malignant lesions. 49 Therefore, imaging of ovarian cancer biomarkers with MRI simultaneously with other modalities in the preclinical setting constitutes an important step towards expanding MRI potential in the clinic.…”

Section: Discussionmentioning

confidence: 99%

Bimodal magnetic resonance and optical imaging of extracellular matrix remodelling by orthotopic ovarian tumours

et al. 2020

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BACKGROUND: The extracellular matrix modulates the development of ovarian tumours. Currently, evaluation of the extracellular matrix in the ovary is limited to histological methods. Both magnetic resonance imaging (MRI) and two-photon microscopy (2PM) enable dynamic visualisation and quantification of fibrosis by endogenous contrast mechanisms: magnetisation transfer (MT) MRI and second-harmonic generation (SHG) 2PM, respectively. METHODS: Here, we applied the MT-MRI protocol for longitudinal imaging of the stroma in orthotopic human ovarian cancer ES-2 xenograft model in CD1 athymic nude mice, and for orthotopically implanted ovarian PDX using a MR-compatible imaging window chamber implanted into NSG mice. RESULTS: We observed differences between ECM deposition in ovarian and skin lesions, and heterogeneous collagen distribution in ES-2 lesions. An MR-compatible imaging window chamber enabled visual matching between T2 MRI maps of orthotopically implanted PDX grafts and anatomical images of their microenvironment acquired with a stereomicroscope and SHG-2PM intravital microscopy of the collagen. Bimodal MRI/2PM imaging allowed us to quantify the fibrosis within the same compartments, and demonstrated the consistent results across the modalities. CONCLUSIONS: This work demonstrates a novel approach for measuring the stromal biomarkers in orthotopic ovarian tumours in mice, on both macroscopic and microscopic levels.

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Section: Discussionmentioning

confidence: 99%

Bimodal magnetic resonance and optical imaging of extracellular matrix remodelling by orthotopic ovarian tumours

et al. 2020

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“…Where solid, measurable components are present, the mean ADC value of solid components in benign ovarian masses has been reported as statistically significantly higher (1.49 ± 0.30 × 10 −3 mm 2 /s) compared to those in malignant masses (0.95 ± 0.13 × 10 −3 mm 2 /s) [ 29 ]. A recent small study showed that a cut-off ADC value of 0.93 × 10 −3 mm 2 /s gave a 5.59 times higher risk for malignancy [ 30 ]. Although alternatives to mean ADC values have been investigated, parameters such as ADC entropy (a statistical measure representing the irregularity of pixel distribution to reflect tissue heterogeneity) do not outperform reader experience for differentiating benign from malignant masses [ 31 ] and are not currently used.…”

Section: Dw-mri For Differentiating Benign From Malignant Adnexal Massesmentioning

confidence: 99%

Diffusion-Weighted Magnetic Resonance Imaging in Ovarian Cancer: Exploiting Strengths and Understanding Limitations

Gagliardi

Adejolu

deSouza

2022

JCM

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Detection, characterization, staging, and response assessment are key steps in the imaging pathway of ovarian cancer. The most common type, high grade serous ovarian cancer, often presents late, so that accurate disease staging and response assessment are required through imaging in order to improve patient management. Currently, computerized tomography (CT) is the most common method for these tasks, but due to its poor soft-tissue contrast, it is unable to quantify early response within lesions before shrinkage is observed by size criteria. Therefore, quantifiable techniques, such as diffusion-weighted magnetic resonance imaging (DW-MRI), which generates high contrast between tumor and healthy tissue, are increasingly being explored. This article discusses the basis of diffusion-weighted contrast and the technical issues that must be addressed in order to achieve optimal implementation and robust quantifiable diffusion-weighted metrics in the abdomen and pelvis. The role of DW-MRI in characterizing adnexal masses in order to distinguish benign from malignant disease, and to differentiate borderline from frankly invasive malignancy is discussed, emphasizing the importance of morphological imaging over diffusion-weighted metrics in this regard. Its key role in disease staging and predicting resectability in comparison to CT is addressed, including its valuable use as a biomarker for following response within individual lesions, where early changes in the apparent diffusion coefficient in peritoneal metastases may be detected. Finally, the task of implementing DW-MRI into clinical trials in order to validate this biomarker for clinical use are discussed, along with the trials that include it within their protocols.

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“…There is an increased likelihood of malignancy when there is a T2 intermediate signal with an increased signal on high b-value DWI corresponding to higher ORADS categories 3–5 [ 49 , 50 ]. Multiparametric MRI with DWI and DCE MRI have higher accuracy for differentiating between benign and malignant ovarian lesions [ 51 ]. DWI, ADC maps, and conventional MRI sequences improve sensitivity, specificity, and accuracy for detecting ovarian cancer and its nodal and metastatic peritoneal disease [ 24 ].…”

Section: Clinical Applications In Gynecological Malignanciesmentioning

confidence: 99%

Utility of the Diffusion Weighted Sequence in Gynecological Imaging: Review Article

Bonde

Lago

Foster

et al. 2022

Cancers

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Functional imaging with diffusion-weighted imaging (DWI) is a complementary tool to conventional diagnostic magnetic resonance imaging sequences. It is being increasingly investigated to predict tumor response and assess tumor recurrence. We elucidate the specific technical modifications of DWI preferred for gynecological imaging, including the different b-values and planes for image acquisition. Additionally, we discuss the problems and potential pitfalls encountered during DWI interpretation and ways to overcome them. DWI has a wide range of clinical applications in malignant and non-malignant gynecological conditions. It provides supplemental information helpful in diagnosing and managing tubo-ovarian abscess, uterine fibroids, endometriosis, adnexal torsion, and dermoid. Similarly, DWI has diverse applications in gynecological oncology in diagnosis, staging, detection of recurrent disease, and tumor response assessment. Quantitative evaluation with apparent diffusion coefficient (ADC) measurement is being increasingly evaluated for correlation with various tumor parameters in managing gynecological malignancies aiding in preoperative treatment planning. Newer advanced DWI techniques of diffusion tensor imaging (DTI) and whole body DWI with background suppression (DWIBS) and their potential uses in pelvic nerve mapping, preoperative planning, and fertility-preserving surgeries are briefly discussed.

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Differentiation between benign and malignant ovarian masses using multiparametric MRI

Cited by 30 publications

References 24 publications

Bimodal magnetic resonance and optical imaging of extracellular matrix remodelling by orthotopic ovarian tumours

Bimodal magnetic resonance and optical imaging of extracellular matrix remodelling by orthotopic ovarian tumours

Diffusion-Weighted Magnetic Resonance Imaging in Ovarian Cancer: Exploiting Strengths and Understanding Limitations

Utility of the Diffusion Weighted Sequence in Gynecological Imaging: Review Article

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