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Role of Diffusion-Weighted Magnetic Resonance Imaging in the Evaluation of Ovarian Tumours

  • Sandya C. Jayasankaran
  • Prameela G. ChelakkotEmail author
  • Prabash Prabhakaran
  • Resmi Sekhar
Original Article

Abstract

Background

Characterization of adnexal masses calls for multidisciplinary involvement. Though a definitive pathological diagnosis mandates surgical intervention, a pre-interventional near-accurate characterization helps in treatment planning. Imaging is a mainstay in this regard.

Aim

This study aimed at analysing ADC values of ovarian lesions observed on a DW–MRI, with an intent to arrive at a probable demarcating value differentiating benign and malignant tumours. The significance of contrast enhancement pattern of lesions was also analysed.

Materials and Methods

All patients with histopathologically proven ovarian tumour (benign and malignant) who had pelvic MRI with DW sequence with b value of 0 and 1000 were included.

Results

Total patients were 62. Mean age was 44 ± 16.8 years. 33.88% were malignant. DWI and ADC values were plotted in 48 of the 62. Diffusion restriction was seen in 81.25% of malignant and 56.25% of benign lesions. The sensitivity and specificity of DWI in differentiating malignancies were 81.25% and 43.75%, respectively. The probable cut-off value of ADC differentiating a malignant and a benign lesion was found to be ≥ 1.13 × 10−3 mm2/s, statistically, using the receiver operating characteristics. 35.48% had early contrast enhancement, and 64.51% delayed enhancement.

Conclusion

DWI has an optimal sensitivity of 81.25% and a low specificity of 43.75% in differentiating malignant from benign lesions. In our study, we found an ADC cut-off of ≥ 1.13 × 10−3 mm2/s, to differentiate between malignant and benign tumours with a sensitivity of 84.4% and specificity of 87.5%. In differentiating between benign and malignant lesions, early enhancement on dynamic contrast study had a good sensitivity.

Keywords

Magnetic resonance imaging Diffusion-weighted imaging Diffusion restriction Ovarian neoplasm Perfusion-weighted imaging 

Notes

Funding

The authors have not received any funding either from the institution or from an external source.

Compliance with Ethical Standards

Conflict of interest

None of the authors have any conflict of interest to disclose.

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Copyright information

© Association of Gynecologic Oncologists of India 2019

Authors and Affiliations

  • Sandya C. Jayasankaran
    • 1
  • Prameela G. Chelakkot
    • 2
    Email author
  • Prabash Prabhakaran
    • 1
  • Resmi Sekhar
    • 1
  1. 1.Department of Radiodiagnosis, Amrita Institute of Medical SciencesAmrita UniversityKochiIndia
  2. 2.Department of OncologySevana Hospital and Research CentrePattambi, Palakkad DistrictIndia

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