Generic placeholder image

Current Medical Imaging

Editor-in-Chief

ISSN (Print): 1573-4056
ISSN (Online): 1875-6603

Research Article

MRI Appearances of Stage IA Ovarian Carcinoma

Author(s): Li Wen Cui and Zhi Yong Shen*

Volume 20, 2024

Published on: 28 April, 2023

Article ID: e060323214362 Pages: 12

DOI: 10.2174/1573405619666230306102912

Price: $65

Abstract

Objective: To analyze the MRI findings of stage IA ovarian cancer.

Methods: The data on age distribution, clinical symptoms at onset, CA125 detection, MRI findings, including tumor volume, structure, diffusion-weighted imaging (DWI), apparent diffusion coefficient (ADC) and enhancement, etc., of the patients with stage IA ovarian cancer, who were admitted to Nantong tumor Hospital between 2013 and 2020 were analyzed retrospectively.

Results: Only 11 cases of stage IA ovarian cancer were recorded. The age of patients was 30–67 (average 52) years. The initial symptoms were mostly lower abdominal distension and abdominal pain. CA125 was 90% positive. MRI features 1. Large pelvic mass with a volume range of 23–2,009 cm3 (average 669 cm3). 2. Five cases of cyst type (with plaque-like, papillary, or mural nodule vegetations), two cases of cystic-solid mixed type (with thickened septum or wall), and four cases of solid type. 3. DWI diffusion was limited, and ADC was reduced on all solid components (vegetation, septa, and cyst wall). 4. The solid parts were significantly enhanced on T1-enhanced MRI. 5. There was no metastasis in the pelvic cavity, and a few ascites (negative tumor cells) in three patients.

Conclusion: MRI characteristics of stage IA ovarian carcinomas were large tumors; cystic, cystic-solid, or solid; solid parts limited diffusion on DWI and low ADC; enhancement of the cyst wall, vegetation, and septa; no pelvic metastasis.

[1]
Torre LA, Trabert B, DeSantis CE, et al. Ovarian cancer statistics, 2018. CA Cancer J Clin 2018; 68(4): 284-96.
[http://dx.doi.org/10.3322/caac.21456] [PMID: 29809280]
[2]
Shaaban A, Rezvani M. Ovarian cancer: detection and radiologic staging. Clin Obstet Gynecol 2009; 52(1): 73-93.
[http://dx.doi.org/10.1097/GRF.0b013e3181961625] [PMID: 19179862]
[3]
Javadi S, Ganeshan DM, Qayyum A, Iyer RB, Bhosale P. Ovarian cancer, the revised FIGO staging system, and the role of imaging. AJR Am J Roentgenol 2016; 206(6): 1351-60.
[http://dx.doi.org/10.2214/AJR.15.15199] [PMID: 27042752]
[4]
Smith RA, Andrews KS, Brooks D, et al. Cancer screening in the United States, 2018: A review of current American Cancer Society guidelines and current issues in cancer screening. CA Cancer J Clin 2018; 68(4): 297-316.
[http://dx.doi.org/10.3322/caac.21446] [PMID: 29846940]
[5]
Park SB, Lee JB. MRI features of ovarian cystic lesions. J Magn Reson Imaging 2014; 40(3): 503-15.
[http://dx.doi.org/10.1002/jmri.24579] [PMID: 24474469]
[6]
Li S, Liu J, Xiong Y, et al. A radiomics approach for automated diagnosis of ovarian neoplasm malignancy in computed tomography. Sci Rep 2021; 11(1): 8730.
[http://dx.doi.org/10.1038/s41598-021-87775-x] [PMID: 33888749]
[7]
Jeong YY, Outwater EK, Kang HK. Imaging evaluation of ovarian masses. Radiographics 2000; 20(5): 1445-70.
[http://dx.doi.org/10.1148/radiographics.20.5.g00se101445] [PMID: 10992033]
[8]
Castellani F, Nganga EC, Dumas L, Banerjee S, Rockall AG. Imaging in the pre-operative staging of ovarian cancer. Abdom Radiol (NY) 2019; 44(2): 685-96.
[http://dx.doi.org/10.1007/s00261-018-1779-6] [PMID: 30229424]
[9]
Forstner R. Early detection of ovarian cancer. Eur Radiol 2020; 30(10): 5370-3.
[http://dx.doi.org/10.1007/s00330-020-06937-z] [PMID: 32468105]
[10]
Shen ZY, Shen AJ, Yang SL, Wu MF. Combination of sonographic morphology score and tumor markers for detecting postoperative recurrent pelvic ovarian carcinoma. Ultrasound Q 2019; 35(1): 45-53.
[http://dx.doi.org/10.1097/RUQ.0000000000000394] [PMID: 30672869]
[11]
Hricak H, Chen M, Coakley FV, et al. Complex adnexal masses: Detection and characterization with MR imaging--multivariate analysis. Radiology 2000; 214(1): 39-46.
[http://dx.doi.org/10.1148/radiology.214.1.r00ja3939] [PMID: 10644099]
[12]
Armstrong DK, Alvarez RD, Backes FJ, et al. NCCN Guidelines® insights: Ovarian cancer, version 3.2022. J Natl Compr Canc Netw 2022; 20(9): 972-80.
[http://dx.doi.org/10.6004/jnccn.2022.0047] [PMID: 36075393]
[13]
Morgan RJ Jr, Alvarez RD, Armstrong DK, et al. Ovarian cancer, version 2.2013. J Natl Compr Canc Netw 2013; 11(10): 1199-209.
[http://dx.doi.org/10.6004/jnccn.2013.0142] [PMID: 24142821]
[14]
Morgan RJ Jr, Armstrong DK, Alvarez RD, et al. Ovarian Cancer, Version 1.2016, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw 2016; 14(9): 1134-63.
[http://dx.doi.org/10.6004/jnccn.2016.0122] [PMID: 27587625]
[15]
Billmire DF, Cullen JW, Rescorla FJ, et al. Surveillance after initial surgery for pediatric and adolescent girls with stage I ovarian germ cell tumors: Report from the Children’s Oncology Group. J Clin Oncol 2014; 32(5): 465-70.
[http://dx.doi.org/10.1200/JCO.2013.51.1006] [PMID: 24395845]
[16]
Armstrong DK, Alvarez RD, Bakkum-Gamez JN, et al. Ovarian Cancer, Version 2.2020, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw 2021; 19(2): 191-226.
[http://dx.doi.org/10.6004/jnccn.2021.0007] [PMID: 33545690]
[17]
Matulonis UA, Sood AK, Fallowfield L, Howitt BE, Sehouli J, Karlan BY. Ovarian cancer. Nat Rev Dis Primers 2016; 2(1): 16061.
[http://dx.doi.org/10.1038/nrdp.2016.61] [PMID: 27558151]
[18]
Olt GJ, Berchuck A, Bast RC Jr. Gynecologic tumor markers. Semin Surg Oncol 1990; 6(6): 305-13.
[http://dx.doi.org/10.1002/ssu.2980060604] [PMID: 2263805]
[19]
Türkoğlu S, Kayan M. Differentiation between benign and malignant ovarian masses using multiparametric MRI. Diagn Interv Imaging 2020; 101(3): 147-55.
[http://dx.doi.org/10.1016/j.diii.2020.01.006] [PMID: 31987805]
[20]
Zhang S, Yu S, Hou W, et al. Diagnostic extended usefulness of RMI: comparison of four risk of malignancy index in preoperative differentiation of borderline ovarian tumors and benign ovarian tumors. J Ovarian Res 2019; 12(1): 87.
[http://dx.doi.org/10.1186/s13048-019-0568-3] [PMID: 31526390]
[21]
Stein EB, Roseland ME, Shampain KL, Wasnik AP, Maturen KE. Contemporary Guidelines for Adnexal Mass Imaging: A 2020 Update. Abdom Radiol (NY) 2021; 46(5): 2127-39.
[http://dx.doi.org/10.1007/s00261-020-02812-z] [PMID: 33079254]
[22]
Taylor EC, Irshaid L, Mathur M. Multimodality imaging approach to ovarian neoplasms with pathologic correlation. Radiographics 2021; 41(1): 289-315.
[http://dx.doi.org/10.1148/rg.2021200086] [PMID: 33186060]
[23]
Park SY, Oh YT, Jung DC. Differentiation between borderline and benign ovarian tumors: combined analysis of MRI with tumor markers for large cystic masses (≥5 cm). Acta Radiol 2016; 57(5): 633-9.
[http://dx.doi.org/10.1177/0284185115597266] [PMID: 26231948]
[24]
Zhuang Y, Wang T, Zhang G. Diffusion-Weighted Magnetic Resonance Imaging (DWI) parameters in benign and malignant ovarian tumors with solid and cystic components. J Coll Physicians Surg Pak 2019; 29(2): 105-8.
[http://dx.doi.org/10.29271/jcpsp.2019.02.105] [PMID: 30700345]
[25]
Bent CL, Sahdev A, Rockall AG, Singh N, Sohaib SA, Reznek RH. MRI appearances of borderline ovarian tumours. Clin Radiol 2009; 64(4): 430-8.
[http://dx.doi.org/10.1016/j.crad.2008.09.011] [PMID: 19264189]
[26]
Zilliox M, Lecointre L, Azais H, et al. Management of borderline ovarian tumours during pregnancy: Results of a French multi-centre study. Eur J Obstet Gynecol Reprod Biol 2021; 256: 412-8.
[http://dx.doi.org/10.1016/j.ejogrb.2020.11.033] [PMID: 33296755]
[27]
Günakan E, Tohma YA, Karakaş LA, Akıllı H, Haberal AN, Ayhan A. Prognostic impact of p16 and p53 gene expressions in stage 1a epithelial ovarian cancer. Obstet Gynecol Sci 2020; 63(4): 464-9.
[http://dx.doi.org/10.5468/ogs.19204] [PMID: 32550735]
[28]
Eymerit-Morin C, Brun JL, Vabret O, Devouassoux-Shisheboran M. Borderline ovarian tumours: CNGOF Guidelines for clinical practice-Biopathology of ovarian borderline tumors. Gynécol Obstét Fertil Sénol 2020; 48(9): 629-45.
[http://dx.doi.org/10.1016/j.gofs.2020.05.007] [PMID: 32422414]
[29]
Lee KR, Castrillon DH, Nucci MR. Pathologic findings in eight cases of ovarian serous borderline tumors, three with foci of serous carcinoma, that preceded death or morbidity from invasive carcinoma. Int J Gynecol Pathol 2001; 20(4): 329-34.
[http://dx.doi.org/10.1097/00004347-200110000-00003] [PMID: 11603215]
[30]
Jung HJ, Park JY, Kim DY, et al. Low value of staging in detecting extraovarian occult metastasis in mucinous borderline ovarian tumors. Int J Gynecol Cancer 2020; 30(11): 1780-3.
[http://dx.doi.org/10.1136/ijgc-2020-001355] [PMID: 32928923]
[31]
Gammon R, Hameed A, Keyhani-Rofagha S. Peritoneal washing in borderline epithelial ovarian tumors in women under 25: The use of cell block preparations. Diagn Cytopathol 1998; 18(3): 212-4.
[http://dx.doi.org/10.1002/(SICI)1097-0339(199803)18:3<212::AID-DC10>3.0.CO;2-N] [PMID: 9523141]
[32]
Wong HF, Low JJH, Chua Y, Busmanis I, Tay EH, Ho TH. Ovarian tumors of borderline malignancy: A review of 247 patients from 1991 to 2004. Int J Gynecol Cancer 2007; 17(2): 342-9.
[http://dx.doi.org/10.1111/j.1525-1438.2007.00864.x] [PMID: 17343573]
[33]
Daraï E, Tulpin L, Prugnolle H, Cortez A, Dubernard G. Laparoscopic restaging of borderline ovarian tumors. Surg Endosc 2007; 21(11): 2039-43.
[http://dx.doi.org/10.1007/s00464-007-9286-9] [PMID: 17514402]
[34]
deSouza NM, O’Neill R, McIndoe GA, Dina R, Soutter WP. Borderline tumors of the ovary: CT and MRI features and tumor markers in differentiation from stage I disease. AJR Am J Roentgenol 2005; 184(3): 999-1003.
[http://dx.doi.org/10.2214/ajr.184.3.01840999] [PMID: 15728632]
[35]
Stein EB, Wasnik AP, Sciallis AP, Kamaya A, Maturen KE. MR imaging–pathologic correlation in ovarian cancer. Magn Reson Imaging Clin N Am 2017; 25(3): 545-62.
[http://dx.doi.org/10.1016/j.mric.2017.03.004] [PMID: 28668159]
[36]
Bolis G, Scarfone G, Raspagliesi F, et al. Paclitaxel/carboplatin versus topotecan/paclitaxel/carboplatin in patients with FIGO suboptimally resected stage III–IV epithelial ovarian cancer a multicenter, randomized study. Eur J Cancer 2010; 46(16): 2905-12.
[http://dx.doi.org/10.1016/j.ejca.2010.06.124] [PMID: 20673626]
[37]
Flicek KT, VanBuren W, Dudiak K, et al. Borderline epithelial ovarian tumors: What the radiologist should know. Abdom Radiol (NY) 2021; 46(6): 2350-66.
[http://dx.doi.org/10.1007/s00261-020-02688-z] [PMID: 32860524]
[38]
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): 719-30.
[http://dx.doi.org/10.1007/s11604-020-00976-8] [PMID: 32342277]
[39]
Tomao F, Di Pinto A, Sassu CM, et al. Fertility preservation in ovarian tumours. Ecancermedicalscience 2018; 12: 885.
[http://dx.doi.org/10.3332/ecancer.2018.885] [PMID: 30679952]
[40]
Trimbos JB. Surgical treatment of early-stage ovarian cancer. Best Pract Res Clin Obstet Gynaecol 2017; 41: 60-70.
[http://dx.doi.org/10.1016/j.bpobgyn.2016.10.001] [PMID: 27894705]
[41]
Crane EK, Brown J. Early stage mucinous ovarian cancer: A review. Gynecol Oncol 2018; 149(3): 598-604.
[http://dx.doi.org/10.1016/j.ygyno.2018.01.035] [PMID: 29429591]

Rights & Permissions Print Cite
© 2024 Bentham Science Publishers | Privacy Policy