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- Title
Role of proton MR spectroscopy in the differentiation of borderline from malignant epithelial ovarian tumors: A preliminary study.
- Authors
Ma, Feng Hua; Li, Yong Ai; Liu, Jia; Li, Hai Ming; Zhang, Guo Fu; Qiang, Jin Wei
- Abstract
<bold>Background: </bold>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.<bold>Purpose: </bold>To investigate the ability of 1 H-MRS to differentiate borderline from malignant EOTs.<bold>Study Type: </bold>Prospective.<bold>Population: </bold>In all, 278 patients with adnexal masses.<bold>Field Strength/sequence: </bold>1.5 T Siemens Avanto MRI system and 1 H-MRS using a point-resolved spectroscopy sequence (PRESS).<bold>Assessment: </bold>Resonance peak integrals of the most common metabolites were analyzed and compared between the two groups.<bold>Statistical Tests: </bold>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.<bold>Results: </bold>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.<bold>Data Conclusion: </bold>The NAA/Cho ratio is a reliable biomarker for differentiating borderline from malignant EOTs.<bold>Level Of Evidence: </bold>2 Technical Efficacy: Stage 3 J. Magn. Reson. Imaging 2019;49:1684-1693.
- Subjects
EPITHELIAL cell tumors; OVARIAN tumors; PROTON magnetic resonance spectroscopy; PHARMACOKINETICS; DIFFERENTIAL diagnosis; DIAGNOSTIC imaging; RESEARCH funding; TUMORS; RESEARCH bias; RECEIVER operating characteristic curves; LONGITUDINAL method
- Publication
Journal of Magnetic Resonance Imaging, 2019, Vol 49, Issue 6, p1684
- ISSN
1053-1807
- Publication type
journal article
- DOI
10.1002/jmri.26541