Biparametric Magnetic Resonance Imaging as an Adjunct to CA125 and HE4 to Improve Characterization of Large Ovarian Masses.
OBJECTIVE
Aim of the present study was to assess the diagnostic value of unenhanced biparametric magnetic resonance imaging (Bp-MRI) as adjunct to CA125 and human epididymis protein 4 (HE4) in the characterization of large ovarian masses.


METHODS
Bp-MRI and dynamic contrast-enhanced (DCE) imaging of 53 patients with large ovarian masses were retrospectively analyzed and compared to histological diagnosis. The results of Bp-MRI and DCE were assessed by two readers in consensus for each technique individually compared to each other and then with HE4 and CA125.


RESULTS
Sensitivity, specificity, negative predictive values and positive predictive values for Bp-MRI and DCE were 92.3%, 91.4%, 94.1%, 88.9% and 84.6%, 94.3%, 89.2%, 91.7%, respectively. Both Bp-MRI and DCE were significant predictors of outcome. Among biomarkers, HE4 was significant. Considering the area under receiver operating characteristic curve the model including Bp-MRI and HE4 was not significantly different from the model including DCE and HE4.


CONCLUSIONS
Bp-MRI in addition to HE4, especially in women of pre-menopausal age, could improve the characterization of large ovarian masses.
Department of Radiological, Oncological and Anatomopathological Sciences, Sapienza University of Rome, Rome, Italy lucia.manganaro@uniroma1.it.
Lucia
L
Manganaro
Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy.
Emanuela
E
Anastasi
Department of Obstetrics, Gynecology and Urologic Sciences, Sapienza University of Rome, Rome, Italy.
Maria Grazia
MG
Porpora
Department of Radiological, Oncological and Anatomopathological Sciences, Sapienza University of Rome, Rome, Italy.
Valeria
V
Vinci
Department of Radiological, Oncological and Anatomopathological Sciences, Sapienza University of Rome, Rome, Italy.
Matteo
M
Saldari
Department of Radiological, Oncological and Anatomopathological Sciences, Sapienza University of Rome, Rome, Italy.
Silvia
S
Bernardo
Department of Radiological, Oncological and Anatomopathological Sciences, Sapienza University of Rome, Rome, Italy.
Laura
L
Ballesio
Department of Radiological, Oncological and Anatomopathological Sciences, Sapienza University of Rome, Rome, Italy.
Paolo
P
Sollazzo
Department of Radiological, Oncological and Anatomopathological Sciences, Sapienza University of Rome, Rome, Italy.
Irene
I
Pecorella
Division of Radiology, Department of Surgical and Biomedical Sciences, Perugia University, S. Maria della Misericordia Hospital, Perugia, Italy.
Nicola
N
Recchia
Division of Hygiene and Public Health, Department of Experimental Medicine, Perugia University, S. Maria della Misericordia Hospital, Perugia, Italy.
Fabrizio
F
Stracci
Department of Obstetrics, Gynecology and Urologic Sciences, Sapienza University of Rome, Rome, Italy.
Pierluigi Benedetti
PB
Panici
Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy.
Antonio
A
Angeloni
Department of Radiological, Oncological and Anatomopathological Sciences, Sapienza University of Rome, Rome, Italy.
Carlo
C
Catalano
Division of Radiology, Department of Surgical and Biomedical Sciences, Perugia University, S. Maria della Misericordia Hospital, Perugia, Italy.
Michele
M
Scialpi
D002288:Adenocarcinoma, Mucinous / Q000378:metabolism / Q000473:pathology*; D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis*; D018394:CA-125 Antigen / Q000378:metabolism*; D018284:Cystadenocarcinoma, Serous / Q000378:metabolism / Q000473:pathology*; D016889:Endometrial Neoplasms / Q000378:metabolism / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000378:metabolism / Q000473:pathology*; D011379:Prognosis; D011506:Proteins / Q000378:metabolism*; D012372:ROC Curve; D012189:Retrospective Studies; D000081102:WAP Four-Disulfide Core Domain Protein 2
D014408:Biomarkers, Tumor; D018394:CA-125 Antigen; D011506:Proteins; D000081102:WAP Four-Disulfide Core Domain Protein 2; C569698:WFDC2 protein, human
CA125; HE4; Magnetic resonance imaging (MRI); biparameric MRI (Bp-MRI); diffusion-weighted imaging (DWI); ovarian tumors characterization; pelvic mass; tumor markers