Comparison of Benign, Borderline, and Malignant Ovarian Seromucinous Neoplasms on MR Imaging

Tsukasa Saida, Miki Yoshida, Toshitaka Ishiguro, Sodai Hoshiai, Masafumi Sakai, Taishi Amano, Saki Shibuki, Toyomi Satoh, Takahito Nakajima
Magnetic resonance in medical sciences : MRMS : an official journal of Japan Society of Magnetic Resonance in Medicine · 2025 · vol. 24(4) · doi:10.2463/mrms.mp.2024-0064 · PMID:39218642
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This study compared MRI findings of ovarian seromucinous neoplasms, finding malignant tumors had taller mural nodules with lower ADC values compared to benign and borderline tumors, while most tumors showed an intermediate-risk time-intensity curve pattern.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-09 · read from full text ⓘ

This retrospective study compared MRI features of benign (n=7), borderline (n=13), and malignant (n=6) ovarian seromucinous neoplasms by evaluating tumor size and morphology, number and height of mural nodules, ADC values, T2 ratios, and time-intensity curve (TIC) descriptors/patterns, as well as T2 and T1 ratios of cyst contents, tumor markers, and the presence of endometriosis. The authors found that papillary architecture with internal branching was more common in borderline than benign or malignant cases, and that malignant neoplasms showed mural nodules with significantly greater height and lower mean ADC values than benign and borderline tumors, along with lower T2 ratios versus benign tumors. Most lesions across all groups demonstrated an intermediate-risk TIC pattern, with no significant group differences, and the study’s small, uneven sample sizes across categories were a practical limitation. Relevance to endometriosis: the paper evaluated the presence of endometriosis as an associated factor while its main focus is distinguishing benign, borderline, and malignant ovarian seromucinous neoplasms using MRI.

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Abstract

PURPOSE: This study aimed to compare MRI findings among benign, borderline, and malignant ovarian seromucinous neoplasms. METHODS: We retrospectively analyzed MRI data from 24 patients with ovarian seromucinous neoplasms-seven benign, thirteen borderline, and six malignant. The parameters evaluated included age, tumour size, morphology, number, height, apparent diffusion coefficient (ADC) values, T2 ratios, time-intensity curve (TIC) descriptors, and TIC patterns of the mural nodules. Additionally, we examined the T2 and T1 ratios of the cyst contents, tumour markers, and the presence of endometriosis. We used statistical tests, including the Kruskal-Wallis and Fisher-Freeman-Halton exact tests, to compare these parameters among the three aforementioned groups. RESULTS: The cases showed papillary architecture with internal branching in 57% of benign, 92% of borderline, and 17% of malignant cases. Three or fewer mural nodules were seen in 57% of benign, 8% of borderline, and 17% of malignant cases. Compared to benign and borderline tumours, mural nodules of malignant neoplasms had significantly increased height (P = 0.015 and 0.011, respectively), lower means ADC values (P = 0.003 and 0.035, respectively). The mural nodules in malignant cases also demonstrated significantly lower T2 ratios than those in the benign cases (P = 0.045). Most neoplasms displayed an intermediate-risk TIC pattern, including 80% benign, 83% borderline, and 60% malignant neoplasms, and no significant differences were observed. CONCLUSION: Most benign and borderline tumours exhibited a papillary architecture with an internal branching pattern, whereas this feature was less common in malignant neoplasms. Additionally, benign tumours had fewer mural nodules compared to borderline tumours. Malignant neoplasms were characterized by mural nodules with increased height and lower ADC values than those in benign and borderline tumours. Interestingly, all three groups predominantly exhibited an intermediate-risk TIC pattern, emphasizing the complexity of diagnosing seromucinous neoplasms using MRI.
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Abstract

Purpose: This study aimed to compare MRI findings among benign, borderline, and malignant ovarian seromucinous neoplasms.

Methods

We retrospectively analyzed MRI data from 24 patients with ovarian seromucinous neoplasms—seven benign, thirteen borderline, and six malignant. The parameters evaluated included age, tumour size, morphology, number, height, apparent diffusion coefficient (ADC) values, T2 ratios, time-intensity curve (TIC) descriptors, and TIC patterns of the mural nodules. Additionally, we examined the T2 and T1 ratios of the cyst contents, tumour markers, and the presence of endometriosis. We used statistical tests, including the Kruskal–Wallis and Fisher–Freeman–Halton exact tests, to compare these parameters among the three aforementioned groups.

Results

The cases showed papillary architecture with internal branching in 57% of benign, 92% of borderline, and 17% of malignant cases. Three or fewer mural nodules were seen in 57% of benign, 8% of borderline, and 17% of malignant cases. Compared to benign and borderline tumours, mural nodules of malignant neoplasms had significantly increased height (P = 0.015 and 0.011, respectively), lower means ADC values (P = 0.003 and 0.035, respectively). The mural nodules in malignant cases also demonstrated significantly lower T2 ratios than those in the benign cases (P = 0.045). Most neoplasms displayed an intermediate-risk TIC pattern, including 80% benign, 83% borderline, and 60% malignant neoplasms, and no significant differences were observed.

Conclusion

Most benign and borderline tumours exhibited a papillary architecture with an internal branching pattern, whereas this feature was less common in malignant neoplasms. Additionally, benign tumours had fewer mural nodules compared to borderline tumours. Malignant neoplasms were characterized by mural nodules with increased height and lower ADC values than those in benign and borderline tumours. Interestingly, all three groups predominantly exhibited an intermediate-risk TIC pattern, emphasizing the complexity of diagnosing seromucinous neoplasms using MRI. © 2025 by Japanese Society for Magnetic Resonance in Medicine This article is licensed under a Creative Commons [Attribution-NonCommercial-NoDerivatives 4.0 International] license. https://creativecommons.org/licenses/by-nc-nd/4.0/ Favorites & Alerts Recently viewed articles

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Condition tags

endometriosis

MeSH descriptors

Magnetic Resonance Imaging Magnetic Resonance Imaging Magnetic Resonance Imaging Magnetic Resonance Imaging Magnetic Resonance Imaging Magnetic Resonance Imaging Magnetic Resonance Imaging Magnetic Resonance Imaging Magnetic Resonance Imaging Magnetic Resonance Imaging Magnetic Resonance Imaging Magnetic Resonance Imaging Magnetic Resonance Imaging Magnetic Resonance Imaging Magnetic Resonance Imaging Magnetic Resonance Imaging Magnetic Resonance Imaging Magnetic Resonance Imaging Ovarian Neoplasms Ovarian Neoplasms

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