The Enhanced T2 Star Weighted Angiography (ESWAN) value for Differentiating Borderline from Malignant Epithelial Ovarian Tumors

Abstract Purpose To investigate the potential of ESWAN in differentiating borderline epithelial ovarian tumors (BEOTs) from malignant epithelial ovarian tumors (MEOTs). Method Thirty-four patients with 37 lesions were enrolled, including 14 BEOTs and 23 MEOTs. The magnitude, phase, R 2 * and T 2 * maps were analyzed by two observers. The regions of interest were drawn along the boundaries of tumors on the slice with maximal solid area, according to fat suppression T 2 WI and T 1 WI. The consistency among the three measurements taken by two observers was tested by intra-class correlation coefficients. Agreement of average values measured by two observers was evaluated by Bland-Altman plots. All the data of BEOTs and MEOTs were compared using the independent-sample t test. The receiver operating characteristic curve was used to evaluate the diagnostic performance. Results No statistical differences were observed in the magnitude and phase values between two tumor groups. The R 2 * value of BEOTs was lower than that of MEOTs ( P ＜0.001), whereas the T 2 * value of BEOTs was higher than that of MEOTs ( P ＝0.01). The area under the curve of R 2 * values was 0.894 and the corresponding cutoff value was 7.50 Hz, with the sensitivity, specificity and accuracy of 85.7%, 82.6% and 86.5%, respectively. The AUC of T 2 * values was 0.776 and the corresponding cutoff value was 143.73 ms with the sensitivity, specificity and accuracy of 71.4%, 82.6% and 78.4%, respectively. Conclusions R 2 * and T 2 * values can be used for quantificationally differentiating BEOTs from MEOTs and the R 2 * has better diagnostic performance.