Value of normalized apparent diffusion coefficients in differentiating between borderline and malignant epithelial ovarian tumors

• Published in: European journal of radiology Vol. 118; pp. 44 - 50
• Main Authors: Lu, Jing, Pi, Shan, Ma, Feng Hua, Zhao, Shu Hui, Li, Hai Ming, Cai, Shu Lei, Qiang, Jin Wei
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier B.V 01-09-2019
• Subjects: Adolescent; Adult; Aged; Apparent diffusion coefficient; Borderline; Diagnosis, Differential; Diffusion Magnetic Resonance Imaging - methods; Female; Humans; Magnetic resonance imaging; Magnetic Resonance Imaging - methods; Malignant; Middle Aged; Ovarian Neoplasms - diagnostic imaging; Ovarian Neoplasms - pathology; Ovarian tumor; Ovary - diagnostic imaging; Ovary - pathology; Reproducibility of Results; Retrospective Studies; Young Adult; Borderline; Malignant; Magnetic resonance imaging; Ovarian tumor; Apparent diffusion coefficient
• ISSN: 0720-048X; 1872-7727
• DOI: 10.1016/j.ejrad.2019.06.020

•ADC and normalized ADCs can differentiate borderline from malignant ovarian tumors.•ADCtumor is lower but diagnostic performance is better at b = 1000 than 800 s/mm2.•Normalized ADCurine is the best of all normalized ADC values.•Normalized ADCurine is superior to ADCtumor.
To compare the diagnostic performance of normalized apparent diffusion coefficients (nADCs) of different references with that of ADCs at differentb factors in differentiating borderline epithelial ovarian tumors (BEOTs) from malignant epithelial ovarian tumors (MEOTs).
This retrospective study included 53 BEOTs and 148 MEOTs. Conventional magnetic resonance and diffusion-weighted imaging withb factors of 800 and 1000s/mm2 were performed. ADC was measured three times at solid components of tumors, gluteus maximus muscle (GMM), iliopsoas muscle (IM) and urine and then averaged. ADCtumor, nADCs were then obtained. Differences and the diagnostic performance of ADCtumor and nADCs between BEOTs and MEOTs with different b factors were compared.
ADCtumor, nADCs regardless of b factors were significantly higher in BEOTs than MEOTs. The diagnostic performance of nADCurine regardless of b factors was significantly larger than that of nADCGMM and nADCIM. There was no significant difference in the diagnostic performance between ADCtumor and nADCurine regardless of b factors. A significantly lower ADCtumor and a larger diagnostic performance for ADCtumor was found with a b factor of 1000s/mm2 than 800 s/mm2. There were no significant differences in nADCurine of BEOTs or MEOTs or in the diagnostic performance of nADCurine with b factors between 800 and 1000s/mm2.
ADCtumor and nADCs were both capable of differentiating BEOTs from MEOTs. nADCurine was the best of all nADCs and was superior to ADCtumor because of its stable performance in differentiating BEOTs from MEOTs, regardless of b factors.