Magnetic resonance relaxometry improves the accuracy of conventional MRI in the diagnosis of endometriosis‑associated ovarian cancer: A case report

Sho Matsubara, Naoki Kawahara, Akihito Horie, Ryusuke Murakami, Naoki Horikawa, Daichi Sumida, Takuya Wada, Tomoka Maehana, Aika Yamawaki, Mayuko Ichikawa, Chiharu Yoshimoto, Masaki Mandai, Hiroshi Kobayashi
Molecular and clinical oncology · 2019 · vol. 11(3) , pp. 296–300 · doi:10.3892/mco.2019.1889 · PMID:31396388 · W2953466295
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Abstract

Endometriosis is a precancerous condition for endometriosis‑associated ovarian cancer (EAOC). In the present study, conventional magnetic resonance imaging (MRI) and MR relaxometry were used to examine a case of clear cell carcinoma that arose in a pre‑existing right‑sided benign ovarian endometrioma (OE). The 42‑year‑old nulliparous woman suspected of EOAC, as assessed by conventional MRI, requested fertility‑sparing surgery such as laparoscopic endometrioma cystectomy. Furthermore, the MR transverse relaxation rate (R2) was determined using a single‑voxel, multi‑echo MR sequence using a 3 Tesla‑MR system. An R2 value <12.1 s‑1 was indicative of malignancy, as described in previous studies. In the present study, MR relaxometry identified an R2 value of 7.98 s‑1 in the right cyst, which suggested the malignant transformation of benign OE. Based on these findings, fertility‑sparing surgery was contraindicated. In conclusion, MR relaxometry may represent a new clinical approach as an adjunctive modality for the diagnosis of EAOC. When patients exhibiting a pelvic mass suspected of EAOC desire fertility‑sparing treatment options, MR relaxometry can facilitate the selection of conservative management.

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endometriosisendometrioma

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