Solid Over Kitlelerinde Difüzyon Ağırlıklı Görüntüleme: Benign-Malign Ayrımında Faydalı Mı?

Amaç: Apparent diffusion coefficient (ADC) değerlerinin benign-malign solid over kitlelerinin ayrımında faydalı olup olmadığını araştırmak.Araçlar ve Yöntem: Çalışmamıza geriye dönük olarak 50 hastanın 62 solid over kitlesi dahil edildi. Hastalar benign ve malign olmak üzere 2 gruba ayrıldı. On üç hastanın 13 over kitlesi benign tanı alırken, 37 hastanın 49 over kitlesi malign tanı aldı. Lezyon boyutları ve solid over kitlelerinin ADC değerlerinin karşılaştırılmasında Mann-Whitney U testi kullanıldı. Malign-benign ayrımında bir cut-offADC değeri hesaplamak için receiver-operating characteristic (ROC) eğrisi kullanıldı.Bulgular: Gruplar arasında yaş (p=0.06), tüm lezyon boyutu (p= 0.647) ve solid komponent boyutu (p=0.066) arasında istatistiksel anlamlı farklılık yoktu. İki grup arasında ADC değerlerinde anlamlı farklılık saptandı (p=0.015). ADC değerleri istatistiksel anlamlı olarak malign grupta daha düşüktü. ROC analizi ile eğri altında kalan alan 0.722 ve cut-off ADC değeri 0.886 x 10-3 mm2/s olarakhesaplandı.Sonuç: Difüzyon ağırlıklı görüntüleme solid over kitlelerinin ayırıcı tanısında kullanışlı bir tekniktir. Solid over kitlelerinde düşük ADC değerleri benign lezyondan ziyade malign bir lezyona işaret etmektedir.

Anahtar Kelimeler:

Solid over kitlesi, Apparent diffusion coefficient, Difüzyon ağırlıklı görüntüleme

Diffusion-Weighted Imaging of Solid Ovarian Masses: Is it Useful to Differentiate Benign From Malignant?

Purpose: To research whether apparent diffusion coefficient (ADC) values of solid ovarian masses are beneficial for differentiation between benign and malignant.Materials and Methods: We analyzed 50 patients with 62 solid ovarian masses retrospectively. We divided the ovarian masses into two groups as benign and malignant. Thirteen patients with 13 solid ovarian masses were identified to have benign masses, while 37 patients with 49 solid ovarian masses were diagnosed with malignancy. The Mann-Whitney U test was used for the comparisons of the sizes and the ADC values of solid ovarian mass. Receiver-operating characteristic (ROC) curves were analyzed to determine a cutoff value for ADC to differentiate benign from malignant.Results: No significant differences were found between the two groups in terms of age (p=0.06), whole lesion size (p= 0.647), and solid component size (p=0.066). ADC values of the two groups were significantly different (p=0.015). Malignant solid ovarian lesions showed significantly lower ADC values than benign lesions. The ROC curves showed an area under the curve rate of 0.722 and a cutoff value of 886 x 10-6 mm2/s.Conclusion: Diffusion-weighted imaging is a useful method for differential diagnosis of solid ovarian masses. Lower ADC values of solid ovarian lesions indicate malignancy rather than benign lesions.

Keywords:

Solid ovarian mass, Apparent diffusion coefficient, Diffusion weighted imaging,

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1. Mironov S, Akin O, Pandit Taskar N, Hann LE. Ovarian cancer. Radiol Clin North Am. 2007;45(1):149-166.
2. Kim HJ, Lee SY, Shin YR, Park CS, Kim K. The value of diffusion-weighted imaging in the differential diagnosis of ovarian lesions: a meta-analysis. PLoS One. 2016;11(2):e0149465.
3. Mukuda N, Ishibashi M, Murakami A, Fukunaga T, Fujii S. Ovarian solid tumors: MR imaging features with radiologic-pathologic correlation. Jpn J Radiol. 2020;38(8):719-730.
4. Li W, Chu C, Cui Y, Zhang P, Zhu M. Diffusionweighted MRI: a useful technique to discriminate benign versus malignant ovarian surface epithelial tumors with solid and cystic components. Abdom Imaging. 2012;37(5):897-903.
5. Türkoğlu S, Kayan M. Differentiation between benign and malignant ovarian masses using multiparametric MRI. Diagn Interv Imaging. 2020;101(3):147-155.
6. Yin B, Li W, Cui Y, et al. Value of diffusion-weighted imaging combined with conventional magnetic resonance imaging in the diagnosis of thecomas/fibrothecomas and their differential diagnosis with malignant pelvic solid tumors. World J Surg Oncol. 2016;14(1):5.
7. Chung BM, Park SB, Lee JB, Park HJ, Kim YS, Oh YJ. Magnetic resonance imaging features of ovarian fibroma, fibrothecoma, and thecoma. Abdom Imaging. 2015;40(5):1263-1272.
8. Takeuchi M, Matsuzaki K, Nishitani H. Diffusionweighted magnetic resonance imaging of ovarian tumors: differentiation of benign and malignant solid components of ovarian masses. J Comput Assist Tomogr. 2010;34(2):173-176.
9. Wang YX, Yuan MZ, Wen ZX. Application of apparent diffusion coefficient and exponent apparent diffusion coefficient values in magnetic resonance imaging diffusion-weighted imaging to differentiate benign and malignant ovarian epithelial tumors. J Cancer Res Ther. 2016;12(1):401-405.
10. Fujii S, Kakite S, Nishihara K, et al. Diagnostic accuracy of diffusion-weighted imaging in differentiating benign from malignant ovarian lesions. J Magn Reson Imaging. 2008;28(5):1149-1156.
11. Bakir B, Bakan S, Tunaci M, et al. Diffusion-weighted imaging of solid or predominantly solid gynaecological adnexial masses: is it useful in the differential diagnosis? Br J Radiol.2011;84(1003):600-611.
12. Kierans AS, Bennett GL, Mussi TC, et al. Characterization of malignancy of adnexal lesions using ADC entropy: comparison with mean ADC and qualitative DWI assessment. J Magn Reson Imaging. 2013;37(1):164-171.
13. Thomassin Naggara I, Toussaint I, Perrot N, et al. Characterization of complex adnexal masses: value of adding perfusion- and diffusion-weighted MR imaging to conventional MR imaging. Radiology. 2011;258(3):793-803.