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CT and MR Imaging of Ovarian Adenocarcinoma (Serous/Mucinous/Endometrioid)

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Abstract

MR imaging (MRI) and multidetector computed tomography (MCT) play a major role for characterization of suspicious adnexal masses and staging of advanced-stage ovarian tumors. The most frequent ovarian cancers are mainly represented by serous, mucinous, and endometrioid epithelial-stromal ovarian tumors. Each histologic subtype has characteristics allowing their preoperative presumable diagnosis on MRI and MCT.

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References

  1. Scully E, Young J, Clement PB. Surface epithelial-stromal tumors. In: Rosai J, editor. Tumors of the ovary and maldeveloped gonads, fallopian tube, and broad ligament. Washington, D.C.: Armed Forces Institute of Pathology; 1998. p. 53–168.

    Google Scholar 

  2. Buy JN, Ghossain MA, Sciot C, Bazot M, Guinet C, Prevot S, et al. Epithelial tumors of the ovary: CT findings and correlation with US. Radiology. 1991;178:811–8.

    CAS  PubMed  Google Scholar 

  3. Ghossain MA, Buy JN, Ligneres C, Bazot M, Hassen K, Malbec L, et al. Epithelial tumors of the ovary: comparison of MR and CT findings. Radiology. 1991;181:863–70.

    CAS  PubMed  Google Scholar 

  4. Forstner R, Hricak H, Occhipinti KA, Powell CB, Frankel SD, Stern JL. Ovarian cancer: staging with CT and MR imaging. Radiology. 1995;197:619–26.

    CAS  PubMed  Google Scholar 

  5. Hricak H, Chen M, Coakley FV, Kinkel K, Yu KK, Sica G, et al. Complex adnexal masses: detection and characterization with MR imaging– multivariate analysis. Radiology. 2000;214:39–46.

    Article  CAS  PubMed  Google Scholar 

  6. Kinkel K, Lu Y, Mehdizade A, Pelte MF, Hricak H. Indeterminate ovarian mass at US: incremental value of second imaging test for characterization – meta-analysis and Bayesian analysis. Radiology. 2005;236:85–94.

    Article  PubMed  Google Scholar 

  7. Qayyum A, Coakley FV, Westphalen AC, Hricak H, Okuno WT, Powell B. Role of CT and MR imaging in predicting optimal cytoreduction of newly diagnosed primary epithelial ovarian cancer. Gynecol Oncol. 2005;96:301–6.

    Article  PubMed  Google Scholar 

  8. Sala E, DeSouza N, Lee SI, Atri M, Hricak H. Ovarian cancer: the role of functional imaging as an end point in clinical trials. Int J Gynecol Cancer. 2010;20:971–8.

    Article  PubMed  Google Scholar 

  9. Stevens SK, Hricak H, Stern JL. Ovarian lesions: detection and characterization with gadolinium- enhanced MR imaging at 1.5 T. Radiology. 1991;181:481–8.

    CAS  PubMed  Google Scholar 

  10. Sohaib SA, Sahdev A, Van Trappen P, Jacobs IJ, Reznek RH. Characterization of adnexal mass lesions on MR imaging. AJR Am J Roentgenol. 2003;180:1297–304.

    Article  PubMed  Google Scholar 

  11. Bazot M, Darai E, Nassar-Slaba J, Lafont C, Thomassin-Naggara I. Value of magnetic resonance imaging for the diagnosis of ovarian tumors: a review. J Comput Assist Tomogr. 2008;32:712–23.

    Article  PubMed  Google Scholar 

  12. Bazot M, Nassar-Slaba J, Thomassin-Naggara I, Cortez A, Uzan S, Darai E. MR imaging compared with intraoperative frozen-section examination for the diagnosis of adnexal tumors; correlation with final histology. Eur Radiol. 2006;16:2687–99.

    Article  PubMed  Google Scholar 

  13. Thomassin-Naggara I, Bazot M, Darai E, Callard P, Thomassin J, Cuenod CA. Epithelial ovarian tumors: value of dynamic contrast-enhanced MR imaging and correlation with tumor angiogenesis. Radiology. 2008;248:148–59.

    Article  PubMed  Google Scholar 

  14. Thomassin-Naggara I, Darai E, Cuenod CA, Fournier L, Toussaint I, Marsault C, et al. Contribution of diffusion-weighted MR imaging for predicting benignity of complex adnexal masses. Eur Radiol. 2009;19:1544–52.

    Article  PubMed  Google Scholar 

  15. Thomassin-Naggara I, Darai E, Cuenod CA, Rouzier R, Callard P, Bazot M. Dynamic contrast-enhanced magnetic resonance imaging: a useful tool for characterizing ovarian epithelial tumors. J Magn Reson Imaging. 2008;28:111–20.

    Article  PubMed  Google Scholar 

  16. Thomassin-Naggara I, Toussaint I, Perrot N, Rouzier R, Cuenod CA, Bazot M, et al. Characterization of complex adnexal masses: value of adding perfusion- and diffusion-weighted MR imaging to conventional MR imaging. Radiology. 2011;258:793–803.

    Article  PubMed  Google Scholar 

  17. Forstner R, Sala E, Kinkel K, Spencer JA. ESUR guidelines: ovarian cancer staging and follow-up. Eur Radiol. 2010;20:2773–80.

    Article  PubMed  Google Scholar 

  18. Spencer JA. A multidisciplinary approach to ovarian cancer at diagnosis. Br J Radiol. 2005;78 Spec No 2:S94–102.

    Article  CAS  PubMed  Google Scholar 

  19. Spencer JA, Forstner R, Cunha TM, Kinkel K. ESUR guidelines for MR imaging of the sonographically indeterminate adnexal mass: an algorithmic approach. Eur Radiol. 2011;20:25–35.

    Article  Google Scholar 

  20. Van Vierzen PB, Massuger LF, Ruys SH, Barentsz JO. Borderline ovarian malignancy: ultrasound and fast dynamic MR findings. Eur J Radiol. 1998;28:136–42.

    Article  PubMed  Google Scholar 

  21. Russell P. Surface epithelial-stromal tumors of the ovary. In: Kurman R, editor. Blaustein’s pathology of the female genital tract. New York: Springer; 1995. p. 705–82.

    Google Scholar 

  22. Boger-Megiddo I, Weiss NS. Histologic subtypes and laterality of primary epithelial ovarian tumors. Gynecol Oncol. 2005;97:80–3.

    Article  PubMed  Google Scholar 

  23. Boyd C, McCluggage WG. Low-grade ovarian serous neoplasms (low-grade serous carcinoma and serous borderline tumor) associated with high-grade serous carcinoma or undifferentiated carcinoma: report of a series of cases of an unusual phenomenon. Am J Surg Pathol. 2012;36:368–75.

    Article  PubMed  Google Scholar 

  24. Kurman RJ, McConnell TG. Characterization and comparison of precursors of ovarian and endometrial carcinoma: parts I and II. Int J Surg Pathol. 2010;18:181S–9.

    Article  PubMed  Google Scholar 

  25. Lee KR, Russel P, Tavassoli FA. Tumours of the ovary and peritoneum. In: Tavassoli FA, Devilee P, editors. WHO classification: tumors of the breast and female genital organs. Lyon: IARC Press; 2003. p. 113–202.

    Google Scholar 

  26. Brown DL, Doubilet PM, Miller FH, Frates MC, Laing FC, DiSalvo DN, et al. Benign and malignant ovarian masses: selection of the most discriminating gray-scale and Doppler sonographic features. Radiology. 1998;208:103–10.

    CAS  PubMed  Google Scholar 

  27. Jeong YY, Outwater EK, Kang HK. Imaging evaluation of ovarian masses. Radiographics. 2000;20:1445–70.

    Article  CAS  PubMed  Google Scholar 

  28. Outwater EK, Huang AB, Dunton CJ, Talerman A, Capuzzi DM. Papillary projections in ovarian neoplasms: appearance on MRI. J Magn Reson Imaging. 1997;7:689–95.

    Article  CAS  PubMed  Google Scholar 

  29. Granberg S, Wikland M, Jansson I. Macroscopic characterization of ovarian tumors and the relation to the histological diagnosis: criteria to be used for ultrasound evaluation. Gynecol Oncol. 1989;35:139–44.

    Article  CAS  PubMed  Google Scholar 

  30. Thomassin-Naggara I, Cuenod CA, Darai E, Marsault C, Bazot M. Dynamic contrast-enhanced MR imaging of ovarian neoplasms: current status and future perspectives. Magn Reson Imaging Clin N Am. 2008;16:661–72, ix.

    Article  PubMed  Google Scholar 

  31. Thomassin-Naggara I, Balvay D, Aubert E, Darai E, Rouzier R, Cuenod CA, et al. Quantitative dynamic contrast-enhanced MR imaging analysis of complex adnexal masses: a preliminary study. Eur Radiol. 2012;22:738–45.

    Article  PubMed  Google Scholar 

  32. Roussel A, Thomassin-Naggara I, Darai E, Marsault C, Bazot M. Value of diffusion-weighted imaging in the evaluation of adnexal tumors. J Radiol. 2009;90:589–96.

    Article  CAS  PubMed  Google Scholar 

  33. deSouza NM, O’Neill R, McIndoe GA, Dina R, Soutter WP. Borderline tumors of the ovary: CT and MRI features and tumor markers in differentiation from stage I disease. AJR Am J Roentgenol. 2005;184:999–1003.

    Article  PubMed  Google Scholar 

  34. Bazot M, Lafont C, Roussel A, Jarboui L, Nassar-Slaba J, Thomassin-Naggara I. Soft tissue characterization of the female pelvis with MRI. J Radiol. 2010;91:453–64.

    Article  CAS  PubMed  Google Scholar 

  35. Siegelman ES, Outwater EK. Tissue characterization in the female pelvis by means of MR imaging. Radiology. 1999;212:5–18.

    Article  CAS  PubMed  Google Scholar 

  36. Bazot M, Haouy D, Darai E, Cortez A, Dechoux-Vodovar S, Thomassin-Naggara I. Is MRI a useful tool to distinguish between serous and mucinous borderline ovarian tumours? Clin Radiol. 2013;1:47–54.

    Google Scholar 

  37. Kim SH, Yang DM. Borderline serous surface papillary tumor of the ovary: MRI characteristics. AJR Am J Roentgenol. 2005;184:1898–900.

    Article  PubMed  Google Scholar 

  38. Tanaka YO, Okada S, Satoh T, Matsumoto K, Oki A, Nishida M, et al. Ovarian serous surface papillary borderline tumors form sea anemone-like masses. J Magn Reson Imaging. 2011;33:643–40.

    Google Scholar 

  39. Wagner BJ, Buck JL, Seidman JD, McCabe KM. From the archives of the AFIP. Ovarian epithelial neoplasms: radiologic- pathologic correlation. Radiographics. 1994;14:1351–74. quiz 75–6.

    Article  CAS  PubMed  Google Scholar 

  40. Kawamoto S, Urban BA, Fishman EK. CT of epithelial ovarian tumors. Radiographics. 1999;19 Spec No:S85–102; quiz S263-4.

    Article  CAS  PubMed  Google Scholar 

  41. Okada S, Ohaki Y, Inoue K, Kawamura T, Hayashi T, Kato T, et al. Calcifications in mucinous and serous cystic ovarian tumors. J Nippon Med Sch. 2005;72:29–33.

    Article  PubMed  Google Scholar 

  42. Burkill GJ, Allen SD, A’Hern RP, Gore ME, King DM. Significance of tumour calcification in ovarian carcinoma. Br J Radiol. 2009;82:640–4.

    Article  CAS  PubMed  Google Scholar 

  43. Okamoto Y, Tanaka YO, Tsunoda H, Yoshikawa H, Minami M. Malignant or borderline mucinous cystic neoplasms have a larger number of loculi than mucinous cystadenoma: a retrospective study with MR. J Magn Reson Imaging. 2007;26:94–9.

    Article  PubMed  Google Scholar 

  44. Matsuki M, Kaji Y, Matsuo M, Kobashi Y. Struma ovarii: MRI findings. Br J Radiol. 2000;73:87–90.

    CAS  PubMed  Google Scholar 

  45. Scully RE, Young RH, Clement PB. Germ cell tumors. In: Rosai J, editor. Tumors of the ovary and maldeveloped gonads, fallopian tube, and broad ligament. Washington, D.C.: Armed Forces Institute of Pathology; 1998. p. 226–99.

    Google Scholar 

  46. Jung SE, Rha SE, Lee JM, Park SY, Oh SN, Cho KS, et al. CT and MRI findings of sex cord-stromal tumor of the ovary. AJR Am J Roentgenol. 2005;185:207–15.

    Article  PubMed  Google Scholar 

  47. Jung SE, Lee JM, Rha SE, Byun JY, Jung JI, Hahn ST. CT and MR imaging of ovarian tumors with emphasis on differential diagnosis. Radiographics. 2002;22:1305–25.

    Article  PubMed  Google Scholar 

  48. Outwater EK, Siegelman ES, Kim B, Chiowanich P, Blasbalg R, Kilger A. Ovarian Brenner tumors: MR imaging characteristics. Magn Reson Imaging. 1998;16:1147–53.

    Article  CAS  PubMed  Google Scholar 

  49. Moon WJ, Koh BH, Kim SK, Kim YS, Rhim HC, Cho OK, et al. Brenner tumor of the ovary: CT and MR findings. J Comput Assist Tomogr. 2000;24:72–6.

    Article  CAS  PubMed  Google Scholar 

  50. Tanaka YO, Yoshizako T, Nishida M, Yamaguchi M, Sugimura K, Itai Y. Ovarian carcinoma in patients with endometriosis: MR imaging findings. AJR Am J Roentgenol. 2000;175:1423–30.

    Article  CAS  PubMed  Google Scholar 

  51. Young RH, Scully RE. Metastatic tumors of the ovary. In: Kurman R, editor. Blaustein’s pathology of the female genital tract. New York: Springer; 1995. p. 939–74.

    Google Scholar 

  52. Kurtz AB, Tsimikas JV, Tempany CM, Hamper UM, Arger PH, Bree RL, et al. Diagnosis and staging of ovarian cancer: comparative values of Doppler and conventional US, CT, and MR imaging correlated with surgery and histopathologic analysis – report of the Radiology Diagnostic Oncology Group. Radiology. 1999;212:19–27.

    Article  CAS  PubMed  Google Scholar 

  53. Brown DL, Zou KH, Tempany CM, Frates MC, Silverman SG, McNeil BJ, et al. Primary versus secondary ovarian malignancy: imaging findings of adnexal masses in the Radiology Diagnostic Oncology Group Study. Radiology. 2001;219:213–8.

    Article  CAS  PubMed  Google Scholar 

  54. Tempany CM, Zou KH, Silverman SG, Brown DL, Kurtz AB, McNeil BJ. Staging of advanced ovarian cancer: comparison of imaging modalities – report from the Radiological Diagnostic Oncology Group. Radiology. 2000;215:761–7.

    Article  CAS  PubMed  Google Scholar 

  55. Kyriazi S, Collins DJ, Morgan VA, Giles SL, deSouza NM. Diffusion-weighted imaging of peritoneal disease for noninvasive staging of advanced ovarian cancer. Radiographics. 2010;30:1269–85.

    Article  PubMed  Google Scholar 

  56. Dromain C, Leboulleux S, Auperin A, Goere D, Malka D, Lumbroso J, et al. Staging of peritoneal carcinomatosis: enhanced CT vs. PET/CT. Abdom Imaging. 2008;33:87–93.

    Article  PubMed  Google Scholar 

  57. Buy JN, Moss AA, Ghossain MA, Sciot C, Malbec L, Vadrot D, et al. Peritoneal implants from ovarian tumors: CT findings. Radiology. 1988;169:691–4.

    CAS  PubMed  Google Scholar 

  58. Mitchell DG, Hill MC, Hill S, Zaloudek C. Serous carcinoma of the ovary: CT identification of metastatic calcified implants. Radiology. 1986;158:649–52.

    CAS  PubMed  Google Scholar 

  59. Choi CH, Kim TJ, Kim WY, Ahn GH, Lee JW, Kim BG, et al. Papillary serous carcinoma in ovaries of normal size: a clinicopathologic study of 20 cases and comparison with extraovarian peritoneal papillary serous carcinoma. Gynecol Oncol. 2007;105:762–8.

    Article  PubMed  Google Scholar 

  60. Hiromura T, Tanaka YO, Nishioka T, Tomita K. Serous psammocarcinoma of the ovary: CT and MR findings. J Comput Assist Tomogr. 2007;31:490–2.

    Article  PubMed  Google Scholar 

  61. Fujii S, Matsusue E, Kanasaki Y, Kanamori Y, Nakanishi J, Sugihara S, et al. Detection of peritoneal dissemination in gynecological malignancy: evaluation by diffusion-weighted MR imaging. Eur Radiol. 2008;18:18–23.

    Article  PubMed  Google Scholar 

  62. Low RN, Sebrechts CP, Barone RM, Muller W. Diffusion-weighted MRI of peritoneal tumors: comparison with conventional MRI and surgical and histopathologic findings – a feasibility study. AJR Am J Roentgenol. 2009;193:461–70.

    Article  PubMed  Google Scholar 

  63. Vergote I, Trope CG, Amant F, Kristensen GB, Ehlen T, Johnson N, et al. Neoadjuvant chemotherapy or primary surgery in stage IIIC or IV ovarian cancer. N Engl J Med. 2010;363:943–53.

    Article  CAS  PubMed  Google Scholar 

  64. Chi DS, Liao JB, Leon LF, Venkatraman ES, Hensley ML, Bhaskaran D, et al. Identification of prognostic factors in advanced epithelial ovarian carcinoma. Gynecol Oncol. 2001;82:532–7.

    Article  CAS  PubMed  Google Scholar 

  65. Chereau E, Ballester M, Selle F, Cortez A, Darai E, Rouzier R. Comparison of peritoneal carcinomatosis scoring methods in predicting resectability and prognosis in advanced ovarian cancer. Am J Obstet Gynecol. 2010;202:178.e1–10.

    Article  Google Scholar 

  66. Sala E, Kataoka MY, Priest AN, Gill AB, McLean MA, Joubert I, et al. Advanced ovarian cancer: multiparametric MR imaging demonstrates response- and metastasis-specific effects. Radiology. 2012;263:149–59.

    Article  PubMed  Google Scholar 

  67. Woodward PJ, Hosseinzadeh K, Saenger JS. From the archives of the AFIP: radiologic staging of ovarian carcinoma with pathologic correlation. Radiographics. 2004;24:225–46.

    Article  PubMed  Google Scholar 

  68. Walensky RP, Venbrux AC, Prescott CA, Osterman Jr FA. Pseudomyxoma peritonei. AJR Am J Roentgenol. 1996;167:471–4.

    Article  CAS  PubMed  Google Scholar 

  69. Seshul MB, Coulam CM. Pseudomyxoma peritonei: computed tomography and sonography. AJR Am J Roentgenol. 1981;136:803–6.

    Article  CAS  PubMed  Google Scholar 

  70. Yeh HC, Shafir MK, Slater G, Meyer RJ, Cohen BA, Geller SA. Ultrasonography and computed tomography in pseudomyxoma peritonei. Radiology. 1984;153:507–10.

    CAS  PubMed  Google Scholar 

  71. Buy JN, Malbec L, Ghossain MA, Guinet C, Ecoiffier J. Magnetic resonance imaging of pseudomyxoma peritonei. Eur J Radiol. 1989;9:115–8.

    CAS  PubMed  Google Scholar 

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Bazot, M., Thomassin-Naggara, I., Daraï, E. (2013). CT and MR Imaging of Ovarian Adenocarcinoma (Serous/Mucinous/Endometrioid). In: Saba, L., Acharya, U., Guerriero, S., Suri, J. (eds) Ovarian Neoplasm Imaging. Springer, Boston, MA. https://doi.org/10.1007/978-1-4614-8633-6_15

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