title: Transverse Relaxation Rate of Cyst Fluid Can Predict Malignant Transformation of Ovarian Endometriosis.
abstract: OBJECTIVE
  Heme and iron accumulation due to repeated hemorrhage in endometriosis may contribute to a pivotal role in carcinogenesis. We evaluate the clinical application of MR relaxometry in a series of ovarian endometriosis (OE) and endometriosis-associated ovarian cancer (EAOC).
  
  
  METHODS
  A prospective study of diagnostic accuracy was conducted among 82 patients (67 OE and 15 EAOC) to compare MR relaxometry and biochemical measurement of cyst fluid total iron concentration. Transverse relaxation rate R2 value was determined using a single-voxel, multi-echo MR sequence (HISTO) by a 3T-MR system. Phantom experiments were also performed to assess the correlation between the ex vivo R2 values and total iron concentrations.
  
  
  RESULTS
  Both the results of phantom experiments and in vivo human data confirmed that in vivo R2 values were highly correlated with total iron concentrations. Compared to OE, EAOC exhibit decreased in vivo R2 values and total iron levels, regardless of their age, menopausal status and cyst size. The use of in vivo R2 values retained excellent accuracy in distinguishing EAOC versus OE (sensitivity and specificity: 86% and 94%).
  
  
  CONCLUSIONS
  We have demonstrated that MR relaxometry provides a noninvasive predictive tool to discriminate between EAOC and OE.
authors.affiliation: Department of Obstetrics and Gynecology, Nara Medical University.
authors.forename: Chiharu
authors.initials: C
authors.lastname: Yoshimoto
authors.forename: Junko
authors.initials: J
authors.lastname: Takahama
authors.forename: Takuya
authors.initials: T
authors.lastname: Iwabuchi
authors.forename: Masato
authors.initials: M
authors.lastname: Uchikoshi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Shigetomi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kobayashi
mesh_terms: D000328:Adult; D000368:Aged; D002471:Cell Transformation, Neoplastic / Q000378:metabolism / Q000473:pathology*; D015331:Cohort Studies; D020420:Cyst Fluid / Q000378:metabolism*; D004715:Endometriosis / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology*; D005260:Female; D006801:Humans; D007501:Iron / Q000378:metabolism; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D055815:Young Adult
chemical_list: D007501:Iron