Value of magnetic resonance imaging in differentiating serous from non – serous epithelial ovarian carcinomas
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Abstract
This retrospective cross-sectional study included 80 patients with primary epithelial ovarian carcinoma (EOC) treated at Vietnam National Cancer Hospital between January 2022 and December 2025. The study aimed to identify magnetic resonance imaging (MRI) features that distinguish serous ovarian carcinoma from other EOC subtypes. MRI findings associated with serous ovarian carcinoma included bilateral involvement, smaller tumor size with a predominant solid component, and the presence of peritoneal carcinomatosis and ascites. Notably, an apparent diffusion coefficient (ADC) threshold of 0.860 × 10-3 mm2/s (AUC = 0.842, p < 0.001) enabled differentiation between serous ovarian carcinoma and other subtypes with a sensitivity of 87.2% and a specificity of 67.7%. Multivariate regression analysis identified two independent predictors: an ADC value ≤ 0.860 × 10-3 mm2/s (OR = 11.6, p < 0.001) and tumor size ≤ 122 mm (OR = 3.7, p = 0.038). MRI is a useful modality for differentiating serous ovarian carcinoma from other EOC subtypes through morphological assessment and quantitative ADC measurement.
Article Details
Keywords
epithelial ovarian carcinoma, serous carcinoma, magnetic resonance imaging
References
2. Höhn AK, Brambs CE, Hiller GGR, May D, Schmoeckel E, Horn LC. 2020 WHO Classification of Female Genital Tumors. Geburtshilfe Frauenheilkd. 2021;81(10):1145-1153. doi:10.1055/a-1545-4279
3. Dong S, Yu F, Liu Y, et al. Comparison of the clinical characteristics and prognosis between clear cell carcinomas and high-grade serous ovarian carcinomas. Ginekol Pol. 2023;94(10):792-798. doi:10.5603/GP.a2022.0123
4. Rauh-Hain JA, Rodriguez N, Growdon WB, et al. Primary debulking surgery versus neoadjuvant chemotherapy in stage IV ovarian cancer. Ann Surg Oncol. 2012;19(3):959-965. doi:10.1245/s10434-011-2100-x
5. Reinhold C, Rockall A, Sadowski EA, et al. Ovarian-Adnexal Reporting Lexicon for MRI: A White Paper of the ACR Ovarian-Adnexal Reporting and Data Systems MRI Committee. Journal of the American College of Radiology. 2021;18(5):713-729. doi:10.1016/j.jacr.2020.12.022
6. Forstner R, Thomassin-Naggara I, Cunha TM, et al. ESUR recommendations for MR imaging of the sonographically indeterminate adnexal mass: an update. Eur Radiol. 2017;27(6):2248-2257. doi:10.1007/s00330-016-4600-3
7. Thomassin-Naggara I, Daraï E, Cuenod CA, et al. Contribution of diffusion-weighted MR imaging for predicting benignity of complex adnexal masses. Eur Radiol. 2009;19(6):1544-1552. doi:10.1007/s00330-009-1299-4
8. Forstner R, Sala E, Kinkel K, Spencer JA, European Society of Urogenital Radiology. ESUR guidelines: ovarian cancer staging and follow-up. Eur Radiol. 2010;20(12):2773-2780. doi:10.1007/s00330-010-1886-4
9. Armstrong DK, Alvarez RD, Backes FJ, et al. NCCN Guidelines® Insights: Ovarian Cancer, Version 3.2022: Featured Updates to the NCCN Guidelines. Journal of the National Comprehensive Cancer Network. 2022;20(9):972-980. doi:10.6004/jnccn.2022.0047
10. González-Martín A, Harter P, Leary A, et al. Newly diagnosed and relapsed epithelial ovarian cancer: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up. Annals of Oncology. 2023;34(10):833-848. doi:10.1016/j.annonc.2023.07.011
11. Kurman RJ, Shih IM. The Dualistic Model of Ovarian Carcinogenesis: Revisited, Revised, and Expanded. Am J Pathol. 2016;186(4):733-747. doi:10.1016/j.ajpath.2015.11.011
12. Ono T, Kishimoto K, Tajima S, et al. Apparent diffusion coefficient (ADC) values of serous, endometrioid, and clear cell carcinoma of the ovary: pathological correlation. Acta Radiol. 2020;61(7):992-1000. doi:10.1177/0284185119883392