MR imaging findings of ovarian lymphoma: differentiation from other solid ovarian tumors

• Published in: Abdominal imaging 2024-01, Vol.49 (1), p.220-228
• Main Authors: Kim, Taek Min, Ahn, Hyungwoo, Kim, Sang Youn, Hwang, Sung Il, Lee, Myoung Seok, Cho, Jeong Yeon, Moon, Min Hoan
• Format: Article
• Language: English
• Subjects: Follicles; Gastroenterology; Hepatology; Heterogeneity; Image analysis; Image processing; Imaging; Lymphoma; Magnetic resonance imaging; Medical imaging; Medicine; Medicine & Public Health; Ovarian cancer; Ovaries; Pelvis; Radiology; Solid tumors; Tumors
• ISSN: 2366-0058; 2366-004X; 2366-0058
• DOI: 10.1007/s00261-023-04067-w

Purpose To evaluate magnetic resonance imaging (MRI) findings for distinguishing ovarian lymphomas from other solid ovarian tumors. Methods This retrospective multicenter study included 14 women (median age, 46.5 years; range, 26–81 years) with surgically proven ovarian lymphoma and 28 women with solid ovarian tumors other than lymphoma. We conducted a subjective image analysis of factors including laterality, shape, composition, T2 signal intensity (SI), heterogeneity, diffusion restriction, enhancement, and presence of peripheral follicles. A generalized estimating equation was used to identify MRI findings that could be used to distinguish ovarian lymphomas from other solid ovarian tumors. Diagnostic performance of the identified MRI findings was assessed using the area under the receiver-operating characteristic curve (AUC). Results Ovarian lymphoma more frequently showed homogeneous high SI on T2-weighted imaging (81.8% vs. 19.4%, P < 0.001) and peripheral ovarian follicles (40.9% vs. 8.3%, P = 0.01) than other ovarian solid tumors did. Bilaterality, shape, size, diffusion restriction, and enhancement did not differ between the two groups (P > 0.05 for all). Homogeneous high SI on T2-weighted imaging was the only independent MRI finding (OR = 15.19; 95% CI 3.15–73.33; P = 0.001) in the multivariable analysis. Homogeneous high SI on T2-weighted imaging yielded an AUC of 0.82 with a sensitivity of 81.8% and specificity of 80.6% in distinguishing ovarian lymphomas from other solid ovarian tumors. Conclusion Homogeneous high signal intensity on T2-weighted imaging was helpful in distinguishing ovarian lymphomas from other solid ovarian tumors. Peripheral ovarian follicles might be an additional clue that suggests a diagnosis of ovarian lymphoma. Graphical abstract