Role of proton MR spectroscopy in the differentiation of borderline from malignant epithelial ovarian tumors: A preliminary study.
J Magn Reson Imaging
; 49(6): 1684-1693, 2019 06.
Article
in En
| MEDLINE
| ID: mdl-30353967
ABSTRACT
BACKGROUND:
Due to the overlapping imaging appearances between borderline and malignant epithelial ovarian tumors (EOTs), borderline EOTs often represent a diagnostic challenge on conventional MRI. Proton magnetic resonance spectroscopy (1 H-MRS) might have potential to differentiate borderline from malignant tumors.PURPOSE:
To investigate the ability of 1 H-MRS to differentiate borderline from malignant EOTs. STUDY TYPE Prospective. POPULATION In all, 278 patients with adnexal masses. FIELD STRENGTH/SEQUENCE 1.5 T Siemens Avanto MRI system and 1 H-MRS using a point-resolved spectroscopy sequence (PRESS). ASSESSMENT Resonance peak integrals of the most common metabolites were analyzed and compared between the two groups. STATISTICAL TESTS The ratios of metabolites between borderline and malignant EOTs were compared with the Mann-Whitney U-test. A receiver operating characteristic (ROC) curve was used to determine their differential diagnosis performances.RESULTS:
In the solid components of borderline and malignant EOTs, the mean Cho/Cr, NAA/Cr, and NAA/Cho ratios were 4.4 ± 1.1 and 9.9 ± 2.8; 10.4 ± 3.0 and 2.2 ± 1.0; and 2.4 ± 0.7 and 0.3 ± 0.1, respectively (all P < 0.001). The sensitivity, specificity, and area under the curve (AUC) were 91%, 100%, and 0.98 for the Cho/Cr ratio; 100%, 98%, and 0.99 for the NAA/Cr ratio; and 100%, 100%, and 1.00 for the NAA/Cho ratio, respectively. In the cystic components, the mean Cho/Cr, NAA/Cr, and NAA/Cho ratios were 3.2 ± 0.8 and 5.1 ± 1.2; 9.1 ± 3.4 and 2.3 ± 1.4; and 2.9 ± 1.2 and 0.5 ± 0.4, respectively (all P < 0.001). The sensitivity, specificity, and AUC were 84%, 82%, and 0.89 for the Cho/Cr ratio; 94%, 97%, and 0.99 for the NAA/Cr ratio; and 94%, 97%, and 0.99 for the NAA/Cho ratio, respectively. DATACONCLUSION:
The NAA/Cho ratio is a reliable biomarker for differentiating borderline from malignant EOTs. LEVEL OF EVIDENCE 2 Technical Efficacy Stage 3 J. Magn. Reson. Imaging 2019;491684-1693.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Ovarian Neoplasms
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Neoplasms, Glandular and Epithelial
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Proton Magnetic Resonance Spectroscopy
/
Neoplasms
Type of study:
Diagnostic_studies
/
Observational_studies
/
Prognostic_studies
Limits:
Adult
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Female
/
Humans
/
Middle aged
Language:
En
Journal:
J Magn Reson Imaging
Journal subject:
DIAGNOSTICO POR IMAGEM
Year:
2019
Type:
Article