Role of dynamic contrast enhanced magnetic resonance imaging and diffusion weighted imaging in evaluation of ovarian tumors

Abstract

Background: Ovarian cancer has been a leading malignancy endangering women’s health with high rate of worldwide prevalence. For the best possible outcome from treatment, the ovarian tumor must be accurately staged and characterized before surgery. To better characterize female pelvic masses, imaging techniques have developed significantly. Objective: To assess the value of adding dynamic contrast enhanced (DCE) and diffusion weighted images (DWI) to the conventional magnetic resonance imaging (MRI) in the evaluation of ovarian cancer. Patients and Methods: From January 2019 to March 2020, 50 patients with ovarian cancers participated in this prospective trial at Ain Shams university hospital. Results: DWI MRI revealed diffusion restriction in 37 instances (78.7%) and facilitated diffusion in 10 cases (21.3%). the ADC value range (0.5 to 3.2) with a mean of 1.1 0.5. 16 instances (34%) out of the 47 cases displayed type 1 curves, 15 cases (31.9%) displayed type 2 curves, and 16 cases (34%) displayed type 3 curves. On histological diagnosis, type 1 curve cases all presented benign instances. There were statistically significant differences between the three diagnostic techniques and the pathological diagnosis. However, compared to conventional based diagnosis, diffusion-based diagnosis and perfusion-based diagnostic had greater AUC, sensitivity, specificity, and accuracy. Both perfusion- and diffusion-based diagnoses use the same values on the ROC curve. Conclusion: The diagnostic accuracy of conventional MRI has significantly increased with the addition of DWI and DCE-MR sequences.