title: Diffusion-weighted MR imaging for differentiating borderline from malignant epithelial tumours of the ovary: pathological correlation.
abstract: OBJECTIVE
  To investigate diffusion-weighted (DW) magnetic resonance (MR) imaging for differentiating borderline from malignant epithelial tumours of the ovary.
  
  
  METHODS
  This retrospective study included 60 borderline epithelial ovarian tumours (BEOTs) in 48 patients and 65 malignant epithelial ovarian tumours (MEOTs) in 54 patients. DW imaging as well as conventional MR imaging was performed. Signal intensity on DW imaging was assessed and apparent diffusion coefficient (ADC) value was measured. The results were correlated with histopathology and cell density.
  
  
  RESULTS
  The majority of MEOTs showed high signal intensity on DW imaging, whereas most BEOTs showed low or moderate signal intensity (P = 0.000). The mean ADC value of the solid components in BEOTs (1.562 ± 0.346 × 10(-3) mm(2)/s) was significantly higher than in MEOTs (0.841 ± 0.209 × 10(-3) mm(2)/s). A threshold value of 1.039 × 10(-3) mm(2)/s permitted the distinction with a sensitivity of 97.0%, a specificity of 92.2% and an accuracy of 96.4%. There was an inverse correlation between ADC value and cell density (r = -0.609; P = 0.0000) which was significantly lower in BEOTs than in MEOTs.
  
  
  CONCLUSIONS
  DW imaging is useful for differentiating borderline from malignant epithelial tumours of the ovary.
  
  
  CONCLUSIONS
  DW MR imaging is useful for differentiating BEOTs from MEOTs. Patients with BEOTs are treated differently from patients with MEOTs. Conservative fertility-sparing laparoscopic surgery can be performed in patients with BEOTs. BEOTs often affect young women of childbearing age.
authors.affiliation: Department of Radiology, Jinshan Hospital, Fudan University, 1508 Longhang Road, Shanghai, 201508, China.
authors.forename: Shu Hui
authors.initials: SH
authors.lastname: Zhao
authors.forename: Jin Wei
authors.initials: JW
authors.lastname: Qiang
authors.forename: Guo Fu
authors.initials: GF
authors.lastname: Zhang
authors.forename: Feng Hua
authors.initials: FH
authors.lastname: Ma
authors.forename: Song Qi
authors.initials: SQ
authors.lastname: Cai
authors.forename: Hai Ming
authors.initials: HM
authors.lastname: Li
authors.forename: Li
authors.initials: L
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy; D003937:Diagnosis, Differential; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods*; D010051:Ovarian Neoplasms / Q000175:diagnosis*; D010053:Ovary / Q000473:pathology*; D015203:Reproducibility of Results; D012189:Retrospective Studies