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کاربرد نوع شرط:
- جایگاه : پژوهشی
- مجله: Asian Pacific Journal of Cancer Prevention
- نوع مقاله: Journal Article
- کلمات کلیدی: qualitative,Adnexal mass,DCE-MRI,semi-quantitative,quantitative
- چکیده:
- چکیده انگلیسی: Objective: The present study aimed to compare the qualitative (time intensity curve analysis), the semi-quantitative
and the quantitative multiphase 3T dynamic contrast-enhanced (DCE) MRI parameters as predictors of malignancy
in adnexal masses. Materials and Methods: In this prospective study, women with an adnexal mass who were
scheduled for surgical resection or were followed for more than one year period to confirm the benignity of their
lesions, underwent multiphase 3T DCE-MRI. The qualitative (time intensity curve), semi-quantitative (SImax, SIrel,
WIR) and quantitative (Ktrans, Kep, Vb) analyses were performed on DCE-MRI sequences and their predictive values
were compared. Results: A total of 17 benign and 14 malignant lesions were included. According to the qualitative
analysis, none of the lesions with Type I time intensity curves (TIC) were malignant and none of the masses with Type
III TICs were benign. The accuracy of the quantitative parameters in detection of malignancy was found to be higher
than that of semi-quantitative variables, particularly when calculated for a small ROI within the high signal area of the
mass (sROI) rather than the largest ROI including the whole mass (lROI), and when inter-MRI variations were omitted
using ratios. The Kep(tumor)/Kep(myometrium) ratio measured from sROI was the best parameter for differentiating
a malignant lesion with a sensitivity of 100% and a specificity of 92.3%. Conclusion: We concluded that a Type I TIC
confirms a benign lesion, and a type III TIC confirms the malignancy and further evaluation is not recommended for
these lesions. So complementary quantitative analysis is only recommended for adnexal masses with type II TICs.- انتشار مقاله: 17-02-1396
- نویسندگان: Mehrooz Malek,Zeynab Oghabian,Elnaz Tabibian,Maryam Rahmani,Seyedeh Nooshin Miratashi Yazdi,Mohammad Ali Oghabian,Sara Parviz
- مشاهده
- جایگاه : پژوهشی
- مجله: Asian Pacific Journal of Cancer Prevention
- نوع مقاله: Journal Article
- کلمات کلیدی: Complex adnexal mass,dynamic contrast-enhanced MRI,Pharmacokinetic modeling,Semi-quantitative analysis
- چکیده:
- چکیده انگلیسی: Background: To evaluate the utility of the pharmacokinetic modeling derived from dynamic contrast-enhanced
magnetic resonance imaging (DCE-MRI) in differentiating benign from malignant adnexal masses. Methods: A total of
43 patients with 49 complex adnexal masses (27 benign, 3 borderline, and 19 malignant lesions) underwent preoperative
DCE-MRI examinations on a 3 Tesla MRI. Using extended Tofts’ model, quantitative analysis was performed in the
solid components of all tumors. Three pharmacokinetic parameters were defined as volume transfer coefficient (Ktrans),
the rate constant (Kep), and the plasma volume (Vp). Semi-quantitative analysis was also performed and the values
of relative signal intensity (SI rel) wash-in-rate (WIR), the initial area under the curve (iAUC60), time-to-peak (TTP)
and wash-out-rate (WOR) were calculated. Receiver operating characteristic (ROC) curve analysis was performed to
evaluate diagnostic characteristics of each DCE-MRI parameter in differentiating borderline/malignant tumors from
benign lesions and to provide the optimal cutoff values for these variables. Results: SI rel had the highest diagnostic value
(AUC=0.872; p<0.001; cut-off=121.4 associated with an overall accuracy=79.6%, sensitivity=95.5%, specificity=66.7%,
NPV=94.8% and PPV=70.0%). Ktrans had the second highest AUC=0.836 (p<0.001; cut-off=0.034 associated with an
overall accuracy=79.6%, sensitivity=86.4%, specificity=74.1%, NPV=87.0% and PPV=73.1%). The other factors found
to be acceptable diagnostic parameters for borderline/malignant lesions included WIR (AUC=0.816; p<0.001), iAUC60
(AUC=0.808; p<0.001), Vp (AUC=0.795; p<0.001), SI max (AUC=0.737, p=0.005), SI peak (AUC=0.737; p=0.005)
and Kep (AUC=0.681; p=0.031). Conclusion: Quantitative DCE-MRI is a relevant tool for differentiating benign from
malignant adnexal masses. Among all the DCE parameters, SI rel and Ktrans are the most accurate discriminators.- انتشار مقاله: 23-04-1397
- نویسندگان: Masoumeh Gity,Sara Parviz,Hamidreza Saligheh Rad,Anahita Fathi Kazerooni,Elham Shirali,Madjid Shakiba,Masoud Baikpour
- مشاهده