Quantitative dynamic contrast-enhanced MR imaging for differentiating benign, borderline, and malignant ovarian tumors
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This study aimed to investigate the diagnostic performance of quantitative DCE-MRI for characterizing ovarian tumors.
We prospectively assessed the differences of quantitative DCE-MRI parameters (Ktrans, kep, and ve) among 15 benign, 28 borderline, and 66 malignant ovarian tumors; and between type I (n = 28) and type II (n = 29) of epithelial ovarian carcinomas (EOCs). DCE-MRI data were analyzed using whole solid tumor volume region of interest (ROI) method, and quantitative parameters were calculated based on a modified Tofts model. The non-parametric Kruskal–Wallis test, Mann–Whitney U test, Pearson’s chi-square test, intraclass correlation coefficient (ICC), variance test, and receiver operating characteristic curves (ROC) were used for statistical analysis.
The largest Ktrans and kep values were observed in ovarian malignant tumors, followed by borderline and benign tumors (all P < 0.001). Kep was the better parameter for differentiating benign tumors from borderline and malignant tumors, with a sensitivity of 89.3% and 95.5%, a specificity of 86.7% and 100%, an accuracy of 88.4% and 96.3%, and an area under the curve (AUC) of 0.94 and 0.992, respectively, whereas Ktrans was better for differentiating borderline from malignant tumors with a sensitivity of 60.7%, a specificity of 78.8%, an accuracy of 73.4%, and an AUC of 0.743. In addition, a combination with kep could further improve the sensitivity to 78.9%. The median Ktrans and kep values were significantly higher in type II than in type I EOCs.
DCE-MRI with volume quantification is a technically feasible method, and can be used for the differentiation of ovarian tumors and for discriminating between type I and type II EOCs.
KeywordsOvary Benign tumor Borderline tumor Malignant tumor Dynamic contrast-enhanced MR imaging
Compliance with ethical standards
This study was funded by National Natural Science Foundation of China (Nos. 81471628 and 81501439), Nantong Municipal Commission of Health and Family Planning Science Foundation for Youth (No. WQ2016065), and Shanghai Municipal Commission of Health and Family Planning (Nos. 2013ZYJB0201, 2013SY075, and ZK2015A05).
Conflicts of interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with 1964 Helsinki declaration and its later amendments or comparable ethical standard.
Informed consent was obtained from all individual participants included in the study.
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