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European Radiology

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01-04-2012 | Magnetic Resonance

Effectiveness of semi-quantitative multiphase dynamic contrast-enhanced MRI as a predictor of malignancy in complex adnexal masses: radiological and pathological correlation

Authors: Livia Bernardin, Philip Dilks, Sidath Liyanage, Marc E. Miquel, Anju Sahdev, Andrea Rockall

Published in: European Radiology | Issue 4/2012

Abstract

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

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Title: Effectiveness of semi-quantitative multiphase dynamic contrast-enhanced MRI as a predictor of malignancy in complex adnexal masses: radiological and pathological correlation
Authors: Livia Bernardin
Philip Dilks
Sidath Liyanage
Marc E. Miquel
Anju Sahdev
Andrea Rockall
Publication date: 01-04-2012
Publisher: Springer-Verlag
Published in: European Radiology / Issue 4/2012
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-011-2331-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Effectiveness of semi-quantitative multiphase dynamic contrast-enhanced MRI as a predictor of malignancy in complex adnexal masses: radiological and pathological correlation

Abstract

Objectives

Methods

Results

Conclusion

Key Points

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusion

Key Points

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