Differentiation between endometriosis-associated ovarian cancers and non- endometriosis-associated ovarian cancers based on magnetic resonance imaging

Ximing Zhang, Min Li, Zhuopeng Tang, Xinyi Li, Ting Song
The British journal of radiology · 2021 · vol. 94(1125) , pp. 20201441 · doi:10.1259/bjr.20201441 · PMID:33882252 · PMC9327745 · W3155865724
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Abstract

OBJECTIVES: Endometriosis-associated ovarian cancer (EAOC) patients show different clinical characteristics compared with non-EAOC patients. However, a few studies are focused on the imaging characteristics of EAOC until now. We assessed MRI characteristics in differentiating EAOC and non-EAOC. METHODS: We retrospectively analyzed clinical and MRI characteristics from 54 patients with 67 lesions diagnosed with primary epithelial ovarian carcinoma at the Third Affiliated Hospital of Guangzhou Medical University between January 2012 and October 2020. We studied MRI findings such as maximum diameter, morphology, configuration, locularity, features of mural nodules, lymphadenopathy, peritoneal implants, the presence of hyperintensity on T1WI, and hypointensity on T2WI. We also studied the clinical characteristics. Significant MRI variables in univariate analysis were selected for subsequent multivariate regression analysis. This study evaluated the diagnostic performance of the significant MRI variables in univariate analysis. RESULTS: We found that the patients with EAOC, compared with those with non-EAOC, were younger, more unilateral, and had earlier FIGO stage. Univariate analysis revealed that morphology, locularity, growth pattern of mural nodules, and hypointensity on T2WI were factors that significantly differed between EAOC and non-EAOC. In the multivariate logistic regression analysis, locularity and hypointensity on T2WI were independent predictors to distinguish EAOC from non-EAOC. CONCLUSIONS: EAOC typically presented as a unilocular mass with hypointensity on T2WI in cystic components. MRI could help distinguish EAOC from non-EAOC. ADVANCES IN KNOWLEDGE: MRI is a promising tool for preoperative diagnosis of EAOC.

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Condition tags

endometriosis

MeSH descriptors

Carcinoma, Ovarian Epithelial Carcinoma, Ovarian Epithelial Endometriosis Endometriosis Magnetic Resonance Imaging Ovarian Neoplasms Ovarian Neoplasms Adult Age Factors Carcinoma, Ovarian Epithelial Carcinoma, Ovarian Epithelial Diagnosis, Differential Endometriosis Endometriosis Female Humans Magnetic Resonance Imaging Middle Aged Neoplasm Staging Ovarian Neoplasms

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