PMID- 22095438
OWN - NLM
STAT- MEDLINE
DCOM- 20120716
LR  - 20211021
IS  - 1432-1084 (Electronic)
IS  - 0938-7994 (Linking)
VI  - 22
IP  - 4
DP  - 2012 Apr
TI  - Effectiveness of semi-quantitative multiphase dynamic contrast-enhanced MRI as a 
      predictor of malignancy in complex adnexal masses: radiological and pathological 
      correlation.
PG  - 880-90
LID - 10.1007/s00330-011-2331-z [doi]
AB  - OBJECTIVES: To determine whether threshold criteria using semi-quantitative 
      multiphase-dynamic contrast-enhanced magnetic resonance imaging (DCE- MRI) can 
      improve prediction of malignancy in complex adnexal masses. METHODS: MRI features 
      of 70 complex adnexal masses with enhancing components in 63 patients were 
      reviewed and correlated with histopathology (n = 67) or radiological follow-up (n 
      = 3). Masses were categorised as benign (n = 34) or borderline/invasive malignant 
      (n = 36). Borderline lesions (n = 6) were also analysed separately. Using the 
      semi-quantitative breast analysis software, regions of interest were drawn around 
      the most avidly enhancing component of each lesion. Maximum absolute enhancement 
      of signal intensities (SI(max)), maximum relative enhancement (SI(rel)) and 
      wash-in rate (WIR) were recorded. Optimal threshold criteria were established to 
      predict borderline/invasive malignancy. RESULTS: There was a significant 
      difference in mean SI(max) (P < 0.05), SI(rel) (P < 0.01) and WIR (P < 0.001) 
      between benign and borderline/invasive malignant groups. A cut-off WIR >/= 9.5 l/s 
      had a specificity of 88% and positive predictive value of 86% for predicting 
      malignancy, significantly better than conventional MRI (62%, P < 0.01). WIR <8.2 
      l/s had a negative predictive value of 94%. CONCLUSION: Threshold criteria using 
      semi-quantitative multiphase DCE-MRI improves specificity in the prediction of 
      malignancy in complex adnexal masses with enhancing components and is 
      complementary to standard qualitative assessment. KEY POINTS: Semi-quantitative 
      DCE-MRI threshold criteria are effective for predicting ovarian malignancy. The 
      surgical approach may be altered depending on DCE-MRI threshold criteria 
      analysis. Borderline tumours demonstrate significant overlap with benign lesions 
      using DCE-MRI threshold criteria.
FAU - Bernardin, Livia
AU  - Bernardin L
AD  - Policlinico GB Rossi, P.le L.A. Scuro, 37134, Verona, Italy. 
      liviabernardin@yahoo.it
FAU - Dilks, Philip
AU  - Dilks P
FAU - Liyanage, Sidath
AU  - Liyanage S
FAU - Miquel, Marc E
AU  - Miquel ME
FAU - Sahdev, Anju
AU  - Sahdev A
FAU - Rockall, Andrea
AU  - Rockall A
LA  - eng
PT  - Journal Article
DEP - 20111118
PL  - Germany
TA  - Eur Radiol
JT  - European radiology
JID - 9114774
RN  - 0 (Contrast Media)
RN  - 0 (Organometallic Compounds)
RN  - 6HG8UB2MUY (Meglumine)
RN  - L0ND3981AG (gadoterate meglumine)
SB  - IM
MH  - Adnexal Diseases/*diagnosis
MH  - Contrast Media
MH  - Diagnosis, Differential
MH  - Female
MH  - Humans
MH  - Image Enhancement/methods
MH  - Image Interpretation, Computer-Assisted/*methods
MH  - Magnetic Resonance Imaging/*methods
MH  - *Meglumine
MH  - *Organometallic Compounds
MH  - Ovarian Neoplasms/*diagnosis
MH  - Reproducibility of Results
MH  - Sensitivity and Specificity
MH  - Statistics as Topic
EDAT- 2011/11/19 06:00
MHDA- 2012/07/17 06:00
CRDT- 2011/11/19 06:00
PHST- 2011/08/11 00:00 [received]
PHST- 2011/10/27 00:00 [accepted]
PHST- 2011/10/14 00:00 [revised]
PHST- 2011/11/19 06:00 [entrez]
PHST- 2011/11/19 06:00 [pubmed]
PHST- 2012/07/17 06:00 [medline]
AID - 10.1007/s00330-011-2331-z [doi]
PST - ppublish
SO  - Eur Radiol. 2012 Apr;22(4):880-90. doi: 10.1007/s00330-011-2331-z. Epub 2011 Nov 
      18.