{"paper_id":"575ce3c3-93a8-4e8d-a81e-ebf3c36e592d","body_text":"Abstract\nObjectives\nTo evaluate the feasibility of quantitative susceptibility mapping (QSM) and R2* mapping in assessing iron deposition in endometriotic ovarian cysts (EMO) and their potential implications for ovarian reserve.\nMaterials and methods\nThis prospective study included 28 patients (33 lesions) with histopathologically confirmed EMO who underwent preoperative MRI examinations, including R2* mapping and QSM. Cyst fluid iron concentration ([Fe]) was measured via inductively coupled plasma optical emission spectrometry. Serum anti-Müllerian hormone (AMH) levels were quantified as a marker of ovarian reserve. Pearson correlation and regression analyses were performed to assess associations among AMH, [Fe], R2*, and QSM values.\nResults\nIn Group All Ages, AMH was negatively correlated with age (r = −0.74, p < 0.001) and [Fe] (r = −0.35, p = 0.048), while [Fe] showed moderate positive correlations with R2* (r = 0.55, p < 0.001) and QSM (r = 0.56, p < 0.001). In Group < 40 years, AMH exhibited moderate negative correlations with [Fe] (r = −0.45, p = 0.031), R2* (r = −0.48, p = 0.019), QSM (r = −0.49, p = 0.018). Multiple regression analyses confirmed that [Fe], R2*, QSM were significant predictors of AMH levels (p < 0.05). R2* and QSM were highly correlated (r = 0.72, p < 0.001), validating their consistency in assessing iron content.\nConclusion\nR2* mapping and QSM reliably quantify iron deposition in EMO, with in vitro validation supporting their accuracy. 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Lingyu Chang: Conceptualization, Formal analysis, Investigation, Project administration, Software, Writing—original draft. Xuemei Wang: Conceptualization, Methodology, Resources, Supervision, Writing—original draft. Ying Xu: Data curation, Formal analysis, Investigation, Writing—original draft. Bo Yang: Data curation, Visualization, Writing—original draft. Dmytro Pylypenko: Software, Supervision, Writing—review & editing. Tianyong Xu: Software, Supervision, Writing—review & editing. Jingtao Wang: Conceptualization, Methodology, Resources, Supervision, Writing—review & editing. Dexin Yu: Conceptualization, Methodology, Resources, Supervision, Writing—review & editing. Fang Wang: Conceptualization, Methodology, Resources, Supervision, Writing—review & editing. Final manuscript approved by all authors.\nCorresponding author\nEthics declarations\nConflict of interest\nThe authors have no relevant fnancial or non-fnancial interests to disclose.\nEthical approval\nThe study was approved by the institutional review board of Qilu Hospital of Shandong University. Written informed consent was obtained from all patients.\nAdditional information\nPublisher's Note\nSpringer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.\nRights and permissions\nSpringer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.\nAbout this article\nCite this article\nDing, D., Chang, L., Wang, X. et al. Feasibility study on QSM and R2* mapping for quantitative evaluation of iron deposition and ovarian function assessment in endometriotic ovarian cysts. Radiol med 131, 386–394 (2026). https://doi.org/10.1007/s11547-025-02152-2\nReceived:\nAccepted:\nPublished:\nVersion of record:\nIssue date:\nDOI: https://doi.org/10.1007/s11547-025-02152-2","source_license":"public-domain-us","license_restricted":false}