title: MRI for discriminating metastatic ovarian tumors from primary epithelial ovarian cancers.
abstract: OBJECTIVE
  To find specific magnetic resonance imaging (MRI) features to differentiate metastatic ovarian tumors from primary epithelial ovarian cancers.
  
  
  METHODS
  Eleven cases with metastatic ovarian tumors and 26 cases with primary malignant epithelial ovarian cancers were retrospectively studied. All features such as patient characteristics, MRI findings and biomarkers were evaluated. The differences including laterality, configuration, uniformity of locules, diffusion weighted imaging (DWI) signal of solid components and enhancement of solid portions between metastatic ovarian tumors and primary epithelial ovarian cancers were compared by Fisher's exact test. Median age of patients, the maximum diameter of lesions and biomarkers were compared by the Mann-Whitney test.
  
  
  RESULTS
  Patients with metastatic ovarian tumors were younger than patients with primary epithelial ovarian cancers in the median age (P = 0.015). Patients with bilateral tumors in metastatic ovarian tumors were more than those of primary epithelial ovarian cancers (P = 0.032). The maximum diameter of lesions in metastatic ovarian tumors was smaller than that of primary epithelial ovarian cancers (P = 0.005). The locules in metastatic ovarian tumors were more uniform than those of primary epithelial ovarian cancers (P = 0.024). The enhancement of solid portions in metastatic ovarian tumors showed more moderate than that of primary epithelial ovarian cancers (P = 0.037). There was no statistically significant difference between the two groups in configuration, DWI signal of solid components and ascites. Biomarkers such as CA125 and human epididymis protein 4 (HE4) in metastatic ovarian tumors showed less elevated than that of primary epithelial ovarian cancers.
  
  
  CONCLUSIONS
  Significant differences between metastatic ovarian tumors and primary epithelial ovarian cancers were found in the median age of patients, laterality, the maximum diameter of lesions, uniformity of locules, enhancement patterns of solid portions and biomarkers. Metastatic ovarian tumors usually presented in the younger patients, smaller-sized, more bilateral lesions, more uniform of locules, more moderate enhancement of solid portions, and less elevated levels of CA125 and HE4 than those of primary epithelial ovarian cancers.
authors: Department of Radiology, Shanghai First People's Hospital, Shanghai Jiaotong University School of Medicine, 100 Haining Road, Shanghai, 200080, People's Republic of China.
authors: Yanhong
authors: Y
authors: Xu
authors: Department of Radiology, Shanghai First People's Hospital, Shanghai Jiaotong University School of Medicine, 100 Haining Road, Shanghai, 200080, People's Republic of China.
authors: Jia
authors: J
authors: Yang
authors: Department of Radiology, Shanghai First People's Hospital, Shanghai Jiaotong University School of Medicine, 100 Haining Road, Shanghai, 200080, People's Republic of China.
authors: Zaixian
authors: Z
authors: Zhang
authors: Department of Radiology, Shanghai First People's Hospital, Shanghai Jiaotong University School of Medicine, 100 Haining Road, Shanghai, 200080, People's Republic of China. guixiangzhang@sina.com.
authors: Guixiang
authors: G
authors: Zhang
mesh_terms: D000328:Adult; D018394:CA-125 Antigen / Q000235:genetics; D000077216:Carcinoma, Ovarian Epithelial; D003937:Diagnosis, Differential; D005260:Female; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008565:Membrane Proteins / Q000235:genetics; D008875:Middle Aged; D009362:Neoplasm Metastasis / Q000000981:diagnostic imaging* / Q000473:pathology; D009375:Neoplasms, Glandular and Epithelial / Q000000981:diagnostic imaging* / Q000473:pathology; D010051:Ovarian Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D011506:Proteins / Q000235:genetics; D011859:Radiography; D000081102:WAP Four-Disulfide Core Domain Protein 2
chemical_list: D018394:CA-125 Antigen; C451759:MUC16 protein, human; D008565:Membrane Proteins; D011506:Proteins; D000081102:WAP Four-Disulfide Core Domain Protein 2; C569698:WFDC2 protein, human