title: Comparison between borderline ovarian tumors and carcinomas using semi-automated histogram analysis of diffusion-weighted imaging: focusing on solid components.
abstract: OBJECTIVE
  This study aimed to evaluate whether histogram analysis of the apparent diffusion coefficient (ADC) of a solid tumor component could distinguish borderline ovarian tumors from ovarian carcinoma.
  
  
  METHODS
  Sixteen pathologically proven borderline tumors and 21 carcinomas were retrospectively examined. Magnetic resonance (1.5-T) image data sets were coregistered, and the solid components of each tumor were semiautomatically segmented. ADC histograms of the solid components were extracted; modes, minimums, means, and 10th, 25th, 50th, 75th, and 90th percentiles of the histograms were compared between the two tumor types, and receiver-operating characteristic (ROC) analysis was performed.
  
  
  RESULTS
  The mode, minimum, mean, 10th, 25th, 50th, and 75th percentile ADC values of solid components of borderline tumors were significantly larger than those of carcinomas. Among these, the 10th percentile values had the lowest p value (p = 0.0003). At ROC analysis, the area under the curve (AUC) in the 10th percentile was the greatest (0.854), and the best cutoff value in the 10th percentile provided the highest specificity (93.8 %).
  
  
  CONCLUSIONS
  ADC histograms of solid tumor components facilitated the distinction between borderline ovarian tumors and carcinoma. The 10th percentile ADC values had the best diagnostic performance.
authors.affiliation: Department of Radiation Medicine, Hokkaido University Graduate School of Medicine, N15, W7, Kita-ku, Sapporo, 060-8638, Japan.
authors.forename: Rie
authors.initials: R
authors.lastname: Mimura
authors.affiliation: Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, N14, W5, Kita-ku, Sapporo, 060-8648, Japan. fumikato@med.hokudai.ac.jp.
authors.forename: Fumi
authors.initials: F
authors.lastname: Kato
authors.affiliation: Department of Radiation Medicine, Hokkaido University Graduate School of Medicine, N15, W7, Kita-ku, Sapporo, 060-8638, Japan.
authors.forename: Khin Khin
authors.initials: KK
authors.lastname: Tha
authors.affiliation: Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, N14, W5, Kita-ku, Sapporo, 060-8648, Japan.
authors.forename: Kohsuke
authors.initials: K
authors.lastname: Kudo
authors.affiliation: Department of Obstetrics and Gynecology, Hokkaido University Graduate School of Medicine, N14, W5, Sapporo, 060-8648, Japan.
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Konno
authors.affiliation: Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, N14, W5, Kita-ku, Sapporo, 060-8648, Japan.
authors.forename: Noriko
authors.initials: N
authors.lastname: Oyama-Manabe
authors.affiliation: Department of Obstetrics and Gynecology, Hokkaido University Graduate School of Medicine, N14, W5, Sapporo, 060-8648, Japan.
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Kato
authors.affiliation: Department of Obstetrics and Gynecology, Hokkaido University Graduate School of Medicine, N14, W5, Sapporo, 060-8648, Japan.
authors.forename: Hidemichi
authors.initials: H
authors.lastname: Watari
authors.affiliation: Department of Obstetrics and Gynecology, Hokkaido University Graduate School of Medicine, N14, W5, Sapporo, 060-8648, Japan.
authors.forename: Noriaki
authors.initials: N
authors.lastname: Sakuragi
authors.affiliation: Department of Radiation Medicine, Hokkaido University Graduate School of Medicine, N15, W7, Kita-ku, Sapporo, 060-8638, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Shirato
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D002277:Carcinoma / Q000000981:diagnostic imaging*; D003937:Diagnosis, Differential; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000000981:diagnostic imaging*; D010053:Ovary / Q000000981:diagnostic imaging; D012372:ROC Curve; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D055815:Young Adult
keywords: Apparent diffusion coefficient; Borderline ovarian tumor; Histogram analysis; Ovarian carcinoma; Semiautomated segmentation