title: The value of dynamic contrast-enhanced MRI in characterizing complex ovarian tumors.
abstract: BACKGROUND
  The study aimed to investigate the utility of dynamic contrast enhanced MRI (DCE-MRI) in the differentiation of malignant, borderline, and benign complex ovarian tumors.
  
  
  METHODS
  DCE-MRI data of 102 consecutive complex ovarian tumors (benign 15, borderline 16, and malignant 71), confirmed by surgery and histopathology, were analyzed retrospectively. The patterns (I, II, and III) of time-signal intensity curve (TIC) and three semi-quantitative parameters, including enhancement amplitude (EA), maximal slope (MS), and time of half rising (THR), were evaluated and compared among benign, borderline, and malignant ovarian tumors. The types of TIC were compared by Pearson Chi-square χ2between malignant and benign, borderline tumors. The mean values of EA, MS, and THR were compared using one-way ANOVA or nonparametric Kruskal-Wallis test.
  
  
  RESULTS
  Fifty-nine of 71 (83%) malignant tumors showed a type-III TIC; 9 of 16 (56%) borderline tumors showed a type-II TIC, and 10 of 15 (67%) benign tumors showed a type-II TIC, with a statistically significant difference between malignant and benign tumors (P < 0.001) and between malignant and borderline tumors (P < 0.001). MS was significantly higher in malignant tumors than in benign tumors and in borderline than in benign tumors (P < 0.001, P = 0.013, respectively). THR was significantly lower in malignant tumors than in benign tumors and in borderline than in benign tumors (P < 0.001, P = 0.007, respectively). There was no statistically significant difference between malignant and borderline tumors in MS and THR (P = 0.19, 0.153) or among malignant, borderline, and benign tumors in EA (all P > 0.05).
  
  
  CONCLUSIONS
  DCE-MRI is helpful for characterizing complex ovarian tumors; however, semi-quantitative parameters perform poorly when distinguishing malignant from borderline tumors.
authors.affiliation: Department of Radiology, Jinshan Hospital, Shanghai Medical College, Fudan University, 1508 Longhang Road, Shanghai, 201508, China.|Department of Radiology, Nantong Cancer Hospital, Nantong University, Nantong, Jiangsu, 226361, China.
authors.forename: Hai-Ming
authors.initials: HM
authors.lastname: Li
authors.affiliation: Department of Radiology, Jinshan Hospital, Shanghai Medical College, Fudan University, 1508 Longhang Road, Shanghai, 201508, China. dr.jinweiqiang@163.com.
authors.forename: Jin-Wei
authors.initials: JW
authors.lastname: Qiang
authors.affiliation: Department of Radiology, Obstetrics & Gynecology Hospital, Shanghai Medical College, Fudan University, Shanghai, 200011, China.
authors.forename: Feng-Hua
authors.initials: FH
authors.lastname: Ma
authors.affiliation: Department of Radiology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, 1665 Kongjiang Road, Shanghai, 2000092, China.
authors.forename: Shu-Hui
authors.initials: SH
authors.lastname: Zhao
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D005260:Female; D006801:Humans; D007089:Image Enhancement; D008279:Magnetic Resonance Imaging / Q000379:methods; D008875:Middle Aged; D060787:Neoplasm Grading; D010051:Ovarian Neoplasms / Q000175:diagnosis*; D012372:ROC Curve; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D003287:Contrast Media
keywords: Differential diagnosis; Dynamic contrast enhanced; Magnetic resonance imaging; Ovarian tumors