MR diffusion versus MR perfusion in patients with ovarian tumors; how far could we get?

Ameen, Nadia F. El; Eissawy, Mohamed Gaber; Mohsen, Laila; Nada, Omnia Mokhtar; Beshreda, Gerges M.

doi:10.1186/s43055-020-0141-5

Cited by 5 publications

(4 citation statements)

References 21 publications

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“…A lower mean ADC value of benign ovarian masses in this study may attribute to the presence of non-malignant ovarian lesions with low ADC value as tubo-ovarian abscess, infarcted ovary, and necrotizing caseating granuloma, such cases not included in their study as their study only included ovarian lesions originated from surface epithelium. This is in contrary to the results of El Ameen et al [20] who had a lower cut off value, and mean ADC value for malignancy (1 × 10 −3 mm 2 /s, and 0.8 × 10 -3 mm 2 /s ± 0.1 SD respectively). This may attribute to the presence of metastatic cystic tumors from colon included in this study with high ADC values of 1.7 × 10 −3 mm 2 /s and 1.9 × 10 −3 mm 2 /s.…”

Section: Discussioncontrasting

confidence: 99%

The Role of Diffusion Weighted Imaging in suspected cases of ovarian cancer

Ali

Nassef

Ibrahim

et al. 2020

Egypt J Radiol Nucl Med

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Background: Ovarian cancer is a common gynecological malignancy and often diagnosed late with extensive peritoneal and nodal metastasis. Diffusion-weighted imaging (DWI) provides valuable information about the structural properties of the tissue and has shown great value in cancer imaging. Recently developed postprocessing three-dimensional apparent diffusion coefficient (3D ADC) map has a significant value in variable tumors yet its role in ovarian cancer is not well established. We aim to evaluate the added value of DWI and 3D ADC maps in the diagnosis of ovarian masses, detection of nodal and peritoneal deposits, and so appropriate management planning. Results: Conventional MRI and DWI were performed to fifty-one patients with complex cystic or solid adnexal lesions depicted by gynecological ultrasonography. Results were compared with surgical and histopathologic findings revealing 23/51 (45%) had malignant ovarian tumors and 28/51 (55%) had benign ovarian pathologies. The mean 3D ADC values were 0.977 ± 0.32, 0.934 ± 0.27, and 0.956 ± 0.25 × 10 −3 mm 2 /s for ovarian, nodal, and peritoneal malignancy respectively which were significantly lower than the mean 3D ADC values of benign ovarian lesions, non-metastatic lymph nodes and benign peritoneal lesions/fat which were measured 1.516 ± 0.6, 1.208 ± 0.25, and 1.46 ± 0.43 × 10 −3 mm 2 /s respectively. Conclusion: Adding DWI and 3D ADC maps to routine MRI improves the sensitivity, specificity, and accuracy for detecting ovarian malignancy, nodal, and peritoneal metastasis. They also provide qualitative data helping in the differentiation of malignant and non-malignant entities.

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Section: Discussioncontrasting

confidence: 99%

The Role of Diffusion Weighted Imaging in suspected cases of ovarian cancer

Ali

Nassef

Ibrahim

et al. 2020

Egypt J Radiol Nucl Med

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“…El Ameen and colleagues conducted a research recently [17] on 47 individuals with pelvic tumors (25 malignant, 18 benign, and 4 borderline,), with a mean age of 39 ±15.9 years old; in our study, it was 38.17 ±11.7 years. The DWI-based diagnosis in this investigation had 100% sensitivity, while the specificity was just 88%.…”

Section: Discussionmentioning

confidence: 66%

“…There was no type-I TIC in any of the malignant tumors, and no type-III TIC in any of the benign masses. 47 individuals with ovarian masses were the subjects of a research by El Ameen and colleagues [17]. (25 malignant, 18 benign, and 4 borderline).…”

Section: Discussionmentioning

confidence: 99%

Diffusion Weighted MR and Dynamic Contrast Enhanced MRI for Characterization of Ovarian Tumors

Al-Nabarawy

Nassar

Ghannam

et al. 2023

JAMMR

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Background: For comprehensive internal architecture identification of ovarian tumors, DCE-MRI is advised. An imaging technique known as diffusion weighted (DW) assists in differentiating between benign and malignant lesions. The purpose of this study was to assess the effectiveness of DCE-MRI and diffusion-weighted MRI in characterizing ovarian cancers and distinguishing malignant from benign tumors. Methods: This retrospective study was carried out on 40 patients aged from 21 to 63 years old presented by ovarian masses based on clinical examinations and on US study. All patients were subjected to full history taking, laboratory investigations including pregnancy tests, complete blood counts and some tumour markers, pelvi-abdominal ultrasound and MRI. Results: MRI have a sensitivity of 53.85%, a specificity of 92.59%, positive predictive value (PPV) of 77.78%, negative predictive value (NPV) of 80.65% and accuracy of 80% compared to pathology of the studied patient. DCE has a sensitivity of 67.15%, a specificity of 100%, PPV of 100%, NPV of 79.4% and accuracy of 82.5%. compared to pathology of the studied patient. DWI score at a cut-off point (≤1.1) predicted patients with malignant ovarian tumours, with 97% accuracy, sensitivity of 88.89% and specificity of 100% (p < 0.001). There was a high statistical significance between findings on DWI-MRI, DCE-MRI, and pathological types (P <0.001 for benign versus malignant lesions). Higher magnetic resonance elastography (MRE) was seen with malignant ovarian lesions (MRE < 85% suspected malignancy). Conclusions: Conventional MR images are the mainstays for assessment of patients with adnexal lesions. The addition of DWI and DCE-MR imaging enhances the specificity of MRI, boosting the radiologist's confidence in picture interpretation and ultimately affecting the patients’ prognosis.

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“…MRI has an advantage for imaging ovaries with high-contrast resolution in adolescents and obese women. Although perfusion MRI was not studied in patients with PCOS, it is mentioned that DWI and MRI perfusion have approximately the same sensitivity and positive impact on operative management [49]. Further studies comparing IVIM MRI-derived perfusion and diffusion parameters with either histopathological findings of perfusion MRI will be useful for elucidating the hypothesis underlying the pathogenesis.…”

Section: Discussionmentioning

confidence: 99%

Intravoxel incoherent motion magnetic resonance imaging and derived parameters in the assessment for polycystic ovary syndrome

Özkök

Sorkun²,

Doğan³

et al. 2022

Egypt J Radiol Nucl Med

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Background Polycystic ovary syndrome (PCOS) is the most common endocrinologic disorder in reproductive age. Diagnosis is based on clinical, laboratory, and ultrasonography findings. However, the application of ultrasound for the diagnosis of PCOS in overweight and sexually inactive patients may be limited. The purpose of this study was to display the imaging characteristics of intravoxel incoherent motion (IVIM) magnetic resonance imaging (MRI)-derived parameters as Dtrue (slow diffusion coefficient), D* (perfusion-related diffusion), f (perfusion fraction), and apparent diffusion coefficient (ADC) in PCOS. Results A total of 43 women, 20 with PCOS (mean age, 24.09 ± 3.92 years) and 23 healthy control (mean age, 23 ± 1.67 years), were included. IVIM MRI-derived parameters of the ovarian stroma were measured by two observers. Mean D* and f values were found to be higher in PCOS patients than in individuals in the control group (p = 0.011 and p = 0.004, respectively). The ADC value was found to be significantly lower in the patient group (p = 0.003). There was no statistically significant difference between two groups in Dtrue (p = 0.742). The interclass correlation analysis of two observers for both groups showed a good-to-excellent agreement. The ROC produced an AUC of 0.521, a sensitivity of 50%, a specificity of 57%, and a cut-off value of 1.48 × 10−3 mm2/s for Dtrue; an AUC of 0.769, a sensitivity of 55%, a specificity of 67%, and a cut-off value of 22.25 × 10−3 mm2/s for D*; an AUC of 0.734, a sensitivity of 55%, a specificity of 62%, and a cut-off value of 20.87% for f; an AUC of 0.893, a sensitivity of 90%, a specificity of 33%, and a cut-off value of 1.37 × 10−3 mm2/s for ADC. Conclusions IVIM MRI would be an alternative imaging tool in the diagnosis of PCOS with a good-to-excellent agreement and with acceptable sensitivity and specificity.

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MR diffusion versus MR perfusion in patients with ovarian tumors; how far could we get?

Cited by 5 publications

References 21 publications

The Role of Diffusion Weighted Imaging in suspected cases of ovarian cancer

The Role of Diffusion Weighted Imaging in suspected cases of ovarian cancer

Diffusion Weighted MR and Dynamic Contrast Enhanced MRI for Characterization of Ovarian Tumors

Intravoxel incoherent motion magnetic resonance imaging and derived parameters in the assessment for polycystic ovary syndrome

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