Guo Fu Zhang

MRI for differentiating primary fallopian tube carcinoma from epithelial ovarian cancer

To compare potential discriminatory magnetic resonance imaging (MRI) features of primary fallopian tube carcinoma (PFTC) and primary epithelial ovarian cancer (EOC).

MRI appearances of ovarian serous borderline tumor: pathological correlation.

To investigate the spectrum of MRI appearances of ovarian serous borderline tumor (SBT).

MRI appearances of mucinous borderline ovarian tumors: Pathological correlation

The purpose of this study is to evaluate the MRI features of mucinous borderline ovarian tumors (MBOT).

MRI in differentiating ovarian borderline from benign mucinous cystadenoma: pathological correlation.

To investigate MRI in differentiating borderline mucinous cystadenoma (MC) from benign MC of the ovary.

Diffusion-Weighted Imaging for Differentiating Uterine Leiomyosarcoma From Degenerated Leiomyoma.

Purpose The study aimed to investigate magnetic resonance diffusion-weighted imaging (DWI) in the differentiation of uterine leiomyosarcoma (ULMS) from degenerated leiomyoma (DLM). Methods Sixteen patients with ULMSs and 26 patients with DLMs confirmed by surgery and pathology underwent conventional magnetic resonance imaging and DWI. The mean apparent diffusion coefficient (ADC) values of the 2 groups’ tumors were measured and compared using an independent-sample t test (b = 0.1000 s/mm2 [ADC1]; b = 0.800 s/mm2 [ADC2], respectively). A receiver operating characteristic curve was used to evaluate the diagnostic performance of DWI in the differentiation of ULMS from DLM. Intraobserver and interobserver agreements were evaluated using an intraclass correlation coefficient and Bland-Altman analysis. Results The mean ADC value in ULMSs (0.81 ± 0.14 × 10−3mm2/s [ADC1], 0.90 ± 0.11 × 10−3mm2/s [ADC2]) was significantly lower than that in DLMs (1.22 ± 0.22 × 10−3mm2/s [ADC1], 1.50 ± 0.22 × 10−3mm2/s [ADC2]) (P < 0.001, <0.001, respectively). The sensitivity, specificity, accuracy, and positive and negative predictive values for characterizing ULMS were 100%, 90%, 93%, and 83% and 100% [ADC1] and 100%, 93%, 96%, and 90% and 100% [ADC2]; respectively. Intraobserver and interobserver reproducibilities were excellent (intraclass correlation coefficient = 0.967–0.988; small variability and 95% limits of agreement). Conclusions Diffusion-weighted imaging is helpful in differentiating ULMS from DLM.

MR Spectroscopy for Differentiating Benign From Malignant Solid Adnexal Tumors

OBJECTIVE The purpose of this article is to investigate the proton MR spectroscopy ((1)H-MRS) features of solid adnexal tumors and to evaluate the efficacy of (1)H-MRS for differentiating benign from malignant solid adnexal tumors. MATERIALS AND METHODS Sixty-nine patients with surgically and histologically proven solid adnexal tumors (27 benign and 42 malignant) underwent conventional MRI and (1)H-MRS. Single-voxel spectroscopy was performed using the point-resolved spectroscopy localization technique with a voxel size of 2 × 2 × 2 cm(3). Resonance peak integrals of choline, N-acetyl aspartate (NAA), creatine, lactate, and lipid were analyzed, and the choline-tocreatine, NAA-to-creatine, lactate-to-creatine, and lipid-to-creatine ratios were recorded and compared between benign and malignant tumors. RESULTS A choline peak was detected in all 69 cases (100%), NAA peak in 67 cases (97%, 25 benign and 42 malignant), lipid peak in 47 cases (17 benign and 30 malignant), and lactate peak in eight cases (four benign and four malignant). The mean (± SD) choline-tocreatine ratio was 5.13 ± 0.6 in benign tumors versus 8.90 ± 0.5 in malignant solid adnexal tumors, a statistically significant difference (p = 0.000). There were no statistically significant differences between benign and malignant tumors in the NAA-to-creatine and lipid-to-creatine ratios (p = 0.263 and 0.120, respectively). When the choline-to-creatine threshold was 7.46 for differentiating between benign and malignant tumors, the sensitivity, specificity, and accuracy were 94.1%, 97.1%, and 91.2%, respectively. CONCLUSION Our preliminary study shows that the (1)H-MRS patterns of benign and malignant solid adnexal tumors differ. The choline-to-creatine ratio can help clinicians differentiate benign from malignant tumors.

Diffusion kurtosis imaging for differentiating borderline from malignant epithelial ovarian tumors: A correlation with Ki‐67 expression

To investigate the use of diffusion kurtosis imaging (DKI) in differentiating borderline from malignant epithelial ovarian tumors (MEOTs) and to correlate DKI parameters with Ki‐67 expression.

Primary fallopian tube carcinoma: correlation between magnetic resonance and diffuse weighted imaging characteristics and histopathologic findings.

Objective The aim of this study was to investigate the magnetic resonance (MR) and diffusion-weighted (DW) imaging characteristics of primary fallopian tube carcinoma (PFTC). Methods The clinical, MR, and DW imaging characteristics and pathologic findings of 23 patients with 27 tumors were studied retrospectively. The MR and DW imaging appearance of tumors including laterality, size and shape, architecture, signal intensity, apparent diffusion coefficient (ADC) value, enhancement pattern, hydrosalpinx, and intrauterine fluid collection were evaluated and correlated with pathologic findings. Results Histopathologically, all 27 tumors were serous carcinoma with a unilateral tumor in 19 patients and bilateral tumors in 4 patients. Thirteen patients (57%) with PFTC were misdiagnosed preoperatively, 10 of which as epithelial ovarian carcinoma. The mean (SD) largest diameter was 61 (7) mm. The tumor shape was fusiform, sausagelike, or serpentine in 19 patients (70%) and nodular or irregular in 8 patients (30%). Twenty (74%) of the 27 tumors were solid, and 7 (26%) were cystic-solid. The solid components showed hypointensity to isointensity on T1-weighted imaging, and isointensity to slight hyperintensity on T2-weighted imaging. There were obvious hyperintensity on DW imaging; obvious hypointensity on ADC maps with a mean (SD) ADC value of 0.79 (0.22) × 10−3 mm2; and mild (8/27, 30%), moderate (13/27, 48%), and marked (6/27, 22%) enhancement on contrast-enhanced imaging. Ipsilateral hydrosalpinx, intrauterine fluid collection, and ascites were found in 14 tumors (52%) and 7 (30%) and 5 (22%) patients, respectively. Conclusions The PFTC has some characteristic MR imaging features. The DW imaging, ADC maps, and ADC values are helpful for the detection and differentiation of PFTC from other pelvic masses.

Role of proton MR spectroscopy in the differentiation of borderline from malignant epithelial ovarian tumors: A preliminary study: 1H-MRS and Epithelial Ovarian Tumors

Due to the overlapping imaging appearances between borderline and malignant epithelial ovarian tumors (EOTs), borderline EOTs often represent a diagnostic challenge on conventional MRI. Proton magnetic resonance spectroscopy (1H‐MRS) might have potential to differentiate borderline from malignant tumors.

The value of MR-detectable ipsilateral ovaries in characterizing the origin and malignancy of adnexal tumors

OBJECTIVE To investigate the magnetic resonance (MR) imaging morphological relationship between adnexal tumors and the ipsilateral ovaries to characterize the origin and malignancy of tumors. MATERIAL AND METHODS Clinical and MR imaging data of 496 adnexal tumors confirmed by histology (ovary tumors, n = 400, non-ovarian tumors, n = 96; benign tumors, n = 183, borderline tumors, n = 120, and malignant tumors, n = 193) were retrospectively analyzed. The presence and shape of the ipsilateral ovaries within the context of adnexal tumors of different origins, malignancies and configurations were evaluated. The relationships between the presence of the ipsilateral ovary and patient age, menstrual status and tumor size were also analyzed. RESULT The ipsilateral ovary was detected on MRI in 23% (90/400) of ovarian tumors and in 45% (43/96) of non-ovarian tumors (p < 0.001). A normal ovoid morphology of the ipsilateral ovary was found in only 7% (26/400) of ovarian tumors and in 26% (25/96) of non-ovarian tumors (p < 0.001). The ipsilateral ovary was detectable in 38% (69/183) of benign tumors, 35% (42/120) of borderline tumors, and 11% (22/193) of malignant tumors (p <  0.001); in 24% (24/101) of cystic tumors, 27% (49/179) of mixed cystic-solid tumors and 28% (60/216) of solid tumors (p = 0.737); and in 40% (120/303) of adnexal tumors in premenopausal patients and 7% (13/193) of adnexal tumors in postmenopausal patients (p < 0.001). CONCLUSION Detection of the ipsilateral ovary contributes to the localization and characterization of adnexal tumors. The ipsilateral ovary can be detected more frequently in non-ovarian tumors and in benign or borderline ovarian tumors.