Differentiation between endometriosis-associated ovarian cancers and non- endometriosis-associated ovarian cancers based on magnetic resonance imaging

• Published in: British journal of radiology 2021-09, Vol.94 (1125), p.20201441-20201441
• Main Authors: Zhang, Ximing, Li, Min, Tang, Zhuopeng, Li, Xinyi, Song, Ting
• Format: Article
• Language: English
• Subjects: Adult; Age Factors; Carcinoma, Ovarian Epithelial - complications; Carcinoma, Ovarian Epithelial - diagnostic imaging; Carcinoma, Ovarian Epithelial - pathology; Diagnosis, Differential; Endometriosis - complications; Endometriosis - diagnostic imaging; Endometriosis - pathology; Female; Female genitourinary oncology special feature: Full Paper; Humans; Magnetic Resonance Imaging - methods; Middle Aged; Neoplasm Staging; Ovarian Neoplasms - complications; Ovarian Neoplasms - diagnostic imaging; Ovarian Neoplasms - pathology; Ovary - diagnostic imaging; Ovary - pathology; Retrospective Studies
• ISSN: 0007-1285; 1748-880X
• DOI: 10.1259/bjr.20201441

Endometriosis-associated ovarian cancer (EAOC) patients show different clinical characteristics compared with non-EAOC patients. However, a few studies are focused on the imaging characteristics of EAOC until now. We assessed MRI characteristics in differentiating EAOC and non-EAOC. We retrospectively analyzed clinical and MRI characteristics from 54 patients with 67 lesions diagnosed with primary epithelial ovarian carcinoma at the Third Affiliated Hospital of Guangzhou Medical University between January 2012 and October 2020. We studied MRI findings such as maximum diameter, morphology, configuration, locularity, features of mural nodules, lymphadenopathy, peritoneal implants, the presence of hyperintensity on T1WI, and hypointensity on T2WI. We also studied the clinical characteristics. Significant MRI variables in univariate analysis were selected for subsequent multivariate regression analysis. This study evaluated the diagnostic performance of the significant MRI variables in univariate analysis. We found that the patients with EAOC, compared with those with non-EAOC, were younger, more unilateral, and had earlier FIGO stage. Univariate analysis revealed that morphology, locularity, growth pattern of mural nodules, and hypointensity on T2WI were factors that significantly differed between EAOC and non-EAOC. In the multivariate logistic regression analysis, locularity and hypointensity on T2WI were independent predictors to distinguish EAOC from non-EAOC. EAOC typically presented as a unilocular mass with hypointensity on T2WI in cystic components. MRI could help distinguish EAOC from non-EAOC. MRI is a promising tool for preoperative diagnosis of EAOC.