MR diffusion versus MR perfusion in patients with ovarian tumors; how far could we get?
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Abstract Background Ovarian tumors are one of the prevalent gynecological tumors. They are the fifth commonest tumor in women. The therapeutic strategy depends on whether the tumor is benign, borderline or malignant. They always cause nonspecific symptoms at early stages and diagnosed at advanced stages. We tried to test and compare the sensitivity and accuracy of diffusion-weighted imaging (DWI) and MR perfusion in the diagnosis of ovarian tumors among fifty patients with ovarian masses who collected after meeting the inclusion criteria depending on grayscale sonographic findings after the approval of the ethical committee of our institution. The sensitivity and accuracy of the techniques were compared. Results The surgical and pathological reports of our patients proved a non-tumorous lesion in three patients. They also proved benign ovarian tumors in 18/47 (38.3%) patients, borderline tumors in 4/47 (8.5%) patients and malignant ovarian tumors in 25/47 (53.2%) patients. According to conventional MRI, ovarian tumors could be diagnosed with sensitivity 92%, specificity 61.11%, PPV 76.7%, NPV 84.6% and accuracy 79.1%. DWI and MR perfusion showed the same results where they showed sensitivity 98%, specificity 83%, PPV 90%, NPV 98% and accuracy 93% with ADC cut-off value 1 × 10− 3 mm 2 /s. Conclusion Diffusion-weighted imaging and MR perfusion are useful in the diagnosis of ovarian tumors with approximately the same sensitivity and positive impact on operative management.Keywords:
Ovarian tumor
Background: Diffusion Weighted Imaging and Diffusion Tensor Imaging is an advanced technique in MRI that shows the diffusion in brain of ischemic stroke disease. Diffusion Weighted Imaging (DWI) shows the lesions without gadolinium contrast agent and produce Apparent Diffusion Coefficient values. Whereas, Diffusion Tensor Imaging (DTI) shows connectivity’s of central nervous system that cannot be seen by using conventional MRI. Diffusion Tensor Imaging produces Fractional Anisotropy values. Purpose:This study has aim to analyze the Apparent Diffusion Coefficient values and Fractional Anisotropy values in Stroke Ischemic disease. Methods: Total samples used are 14 samples, consist of 7 (50%) man and 7 (50%) woman with ischemic stroke disease. Each sample deals by Diffusion Weighted Imaging and Diffusion Tensor Imaging sequences. The Region of Interest (ROI) is placed in ischemic stroke lesions and contra lateral side of lesions. Results: The result shows that 9 samples of brain tissue lesions located in the right side and 5 samples in the left side. Right lesions have the average ADC stroke: 0.001748; normal ADC: 0.000954; FA stroke: 0.144522; and normal FA: 0.426111. While, left lesions have the average ADC strokes 0.000979; normal ADC: 0.000835; FA stroke: 0.2556; and normal FA 0.4324. Conclusion: So, the conclusion of this study is Apparent Diffusion Coefficient (ADC) values in case of ischemic stroke can decreases or increases depend on the age of stroke. While, the Fractional Anisotropy (FA) values will decrease without being affected by age of stroke.
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This study examined the association of CD44V6 expression in ovarian cancer. We recruited 38 patients with ovarian cancer, 23 with benign ovarian tumor, and 20 with normal ovaries using RT-PCR and western block analysis. Compared with normal ovaries, the expression of CD44V6 mRNA was significantly elevated in benign ovarian tumor and ovarian cancer. At the protein level, we found no significant differences in CD44V6 expression between normal ovarian tissue and benign ovarian tumor. However, the expression of CD44V6 in ovarian cancer was significantly elevated compared to normal ovaries and benign ovarian tumor. These results were supported by ELISA and western blot analysis. Immunohistochemistry showed that CD44V6 protein in ovarian cancer cells accumulated at high levels on the membrane of ovarian cancer cells. CD44V6 expression is closely associated with the tumorous transformation of ovarian tissue, suggesting that CD44V6 can promote the occurrence and progression of ovarian cancer.
Ovarian tumor
Ovarian Tissue Cryopreservation
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OBJECTIVE:To study the application and clinical significance of D-dimer detection in diagnosing and monitoring of ovarian cancer.METHODS: The D-dimer concentration in 45 cases of ovarian cancer and 34 cases of benign ovarian tumor and 42 healthy women(control) were detected by immunoturbidimetric assay.RESULTS: The plasma D-dimer level in ovarian cancer group was significant higher than in ovarian benign tumor group and control group(P0.01),while there were no statistic differences between benign tumor group and control group(P0.05).The D-dimer levels were not significantly different among ovarian cancer patients of different pathological types(P0.05) or among benign ovarian tumor patients of different pathological type(P0.05);however,the D-dimer level in the ovarian cancer patients of stage Ⅱ-Ⅳ was significant higher than in those of stageⅠ(P0.01).The D-dimer level in ovarian cancer patients of different pathological grade increased from G1 to G3 grade in order and the differences were statistically significant(P0.01).CONCLUSION: The detection of D-dimer has very important clinical value for the differential diagnosis of ovarian cancer and the progression and staging evaluation of cancer.D-dimer plays a special role in the laboratory diagnosis of ovarian cancer.
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Background and purpose:Bleeding or thrombotic diseases are easily to be found in ovarian cancer patients,because the balance of their coagulation system are being undermined due to tumor burden or surgery.We studied the value of plasma D-dimer monitoring before and after ovarian cancer surgery.Methods:The plasma concentration of D-dimer levels were measured in 161 ovarian cancer patients and 41 benign ovarian tumor patients,and then we followed up to analyze the change of D-dimer concentration of 23 postoperative patients.Results: The plasma levels of D-dimer in ovarian cancer patients were found to be significantly higher than those in ovarian benign tumor(P0.01).Significantly differences of D-dimer levels were found among different ovarian cancer stages(χ2=78.894,P0.01),which suggested that ovarian cancer patients’ coagulation and fibrinolysis dysfunction become more serious during the progression of disease.The D-dimer amount kept at a high level or raised suddenly after a transient decrease in 9 patients who were seized with thrombotic diseases after operation.Conclusion:Monitoring the plasma D-dimer level before and after ovarian cancer operation could help finding out those who have high probability of thrombotic diseases and preventing deep venous thrombosis after operation.It also helps us to strive for early prevention,early diagnosis,early treatment,and to improve the prognosis of the patients.
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This study aimed to elucidate the difference in diffusion-weighted magnetic resonance imaging (DWI) and diffusion tensor imaging (DTI) parameters between endometrioid endometrial adenocarcinoma (EEA) and uterine serous adenocarcinoma (SA).Methods
Data of patients with pathologically confirmed EEA or SA who underwent DWI and DTI scanning between May 2013 and July 2016 were retrospectively analyzed. Apparent diffusion coefficient (ADC) value from DWI and ADC from DTI (ADCT) map and fractional anisotropy (FA) values from DTI were analyzed and compared statistically. The correlation between ADC and ADCT was analyzed by Pearson correlation analysis. Apparent diffusion coefficient, ADCT, and FA between the 2 groups were compared using independent t test. The effect of ADC, ADCT, and FA in distinguishing EEA and SA was evaluated by receiver operator characteristic curve.Result
Thirty-three patients were enrolled into the study, including 13 cases of SA and 20 cases of EEA. Pearson correlation analysis suggested that the value of ADC was highly related with ADCT in both the SA group (r = 0.812, P = 0.001) and the EEA group (r = 0.858, P < 0.001). The value of ADC and ADCT in the SA group was significantly lower than that in the EEA group; FA was significantly higher than that in the EEA group. Receiver operator characteristic curve analysis showed that ADC and ADCT have high sensitivity and specificity; FA has low sensitivity and high specificity.Conclusions
We suggest that both DWI and DTI could be used in distinguishing EEA from SA. Apparent diffusion coefficient and ADCT possess potential diagnostic value with high sensitivity and specificity.Cite
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Background: Diffusion Weighted Imaging and Diffusion Tensor Imaging is an advanced technique in MRI that shows the diffusion in brain of ischemic stroke disease. Diffusion Weighted Imaging (DWI) shows the lesions without gadolinium contrast agent and produce Apparent Diffusion Coefficient values. Whereas, Diffusion Tensor Imaging (DTI) shows connectivity’s of central nervous system that cannot be seen by using conventional MRI. Diffusion Tensor Imaging produces Fractional Anisotropy values. Purpose:This study has aim to analyze the Apparent Diffusion Coefficient values and Fractional Anisotropy values in Stroke Ischemic disease. Methods: Total samples used are 14 samples, consist of 7 (50%) man and 7 (50%) woman with ischemic stroke disease. Each sample deals by Diffusion Weighted Imaging and Diffusion Tensor Imaging sequences. The Region of Interest (ROI) is placed in ischemic stroke lesions and contra lateral side of lesions. Results: The result shows that 9 samples of brain tissue lesions located in the right side and 5 samples in the left side. Right lesions have the average ADC stroke: 0.001748; normal ADC: 0.000954; FA stroke: 0.144522; and normal FA: 0.426111. While, left lesions have the average ADC strokes 0.000979; normal ADC: 0.000835; FA stroke: 0.2556; and normal FA 0.4324. Conclusion: So, the conclusion of this study is Apparent Diffusion Coefficient (ADC) values in case of ischemic stroke can decreases or increases depend on the age of stroke. While, the Fractional Anisotropy (FA) values will decrease without being affected by age of stroke.
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Objective To detect the level of serum human epididymis protein 4(HE4) in the patients with ovarian cancer and approach the significance of serum HE4 in the diagnosis of ovarian cancer.Methods ELISA mothod was used to detect the levels of serum HE4 in ovarian cancer group,benign ovarian tumor group,other malignant gynecology tumor group and malignant tumor of other organs group.The changes of the serum HE4 level in ovarian cancer group before and after operation were detected.The effects of the serum HE4 level and CA215 level in ovarian cancer group in the diagnois of ovarian cancer were compared.Results The serum HE4 levels ovarian cancer group was (242.76±113.40)pmol·L-1 and the positive rate was 70.59%,they were higher than those in benign ovarian tumor group(85.57 pmol·L-1±63.40 pmol·L-1,7.02%),other malignant gynecology tumor group (73.16 pmol·L-1±12.27 pmol·L-1,0.00%),malignant tumor of other organs group(80.65 pmol·L-1±16.24 pmol·L-1,0.00%)and control group(43.95 pmol·L-1±18.16 pmol·L-1,0.00%)(P0.01);the serum HE4 level in ovarian cancer group after operation(134.83 pmol·L-1±56.20 pmol·L-1) was lower than before operation(242.76 pmol·L-1±113.40 pmol·L-1)(P0.05).The positive rate of serum HE4 in the early ovarian cancer was higher than that of seum CA125.The sensitiveity of HE4 combined with CA125 was higher than each of them,the specificity of HE4 combined with CA125 was lower than each of them(P0.05).Conclusion The HE4 serum has important significance in the diagnosis of ovarian cancer,especially,its sensitivity and specificity are all better than CA125 in the diagnosis of early ovarian cancer,the detection of HE4 combined with CA125 can elevate the early diagnosis rate of ovarian cancer.
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CT Findings of Stage IA Ovarian Cancer: Comparison with Borderline Tumor and Stage IC Ovarian Cancer
Ovarian cancer is a common gynecological malignant tumor in women. Most patients have reached the advanced stage when they visit the hospital. In order to diagnose ovarian cancer at an early stage, treat it at an early stage, and improve the survival rate of patients, this study has used the imaging computed tomography (CT) method to diagnose stage IA ovarian cancer.The purpose of this work was to study CT features of stage IA ovarian cancer, and compare the borderline tumor and stage IC ovarian cancer at the same time so as to improve the CT diagnosis of early ovarian cancer.We retrospectively collected clinical and CT data of patients with stage I ovarian cancer and borderline ovarian tumor admitted to Nantong Tumor Hospital from 2013 to 2021. Altogether, 23 cases of patients (borderline ovarian tumor, 9 cases; stage IA ovarian cancer, 5 cases; stage IC ovarian cancer, 9 cases) were involved. CT characteristics of these patients were analyzed in terms of the tumor diameter, cystic solid structure, solid component, septation, enhancement, peritoneal thickening, ascites, and abdominal lymph nodes.CT features of stage IA ovarian cancer included large tumor size (average diameter: 15 cm), cystic solid structure (4/5; 80%), septation (4/5; 80%), and enhanced cystic wall, septum, or solid components of the tumor on contrast-enhanced CT (5/5; 100%) no peritoneal thickening (0/5; 0%), no ascites (0/5; 0%), and no abdominal lymph node enlargement (0/5; 0%). The tumor structure did not differ significantly between stage IA and IC ovarian cancers (p > 0.05), while intraperitoneal ascites did (χ2 = 0.031; p < 0.05). Stage IA and borderline ovarian tumors did not differ significantly in ovarian tumor structure (p > 0.05).CT features of stage IA ovarian cancer included large tumor size, cystic solid structure, septation, and enhanced cystic wall and solid parts in the tumors. No pelvic or abdominal metastasis was observed.
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Diffusion weighted magnetic resonance imaging (DWI) is a powerful tool for evaluation of microstructural anomalies in numerous central nervous system pathologies. Diffusion tensor imaging (DTI) allows for the magnitude and direction of water self diffusion to be estimated by sampling the apparent diffusion coefficient (ADC) in various directions. Clinical DWI and DTI performed at a single level of diffusion weighting, however, does not allow for multiple diffusion compartments to be elicited. Furthermore, assumptions made regarding the precise number of diffusion compartments intrinsic to the tissue of interest have resulted in a lack of consensus between investigations. To overcome these challenges, a stretched-exponential model of diffusion was applied to examine the diffusion coefficient and "heterogeneity index" within highly compartmentalized brain tumors. The purpose of the current study is to expand on the stretched-exponential model of diffusion to include directionality of both diffusion heterogeneity and apparent diffusion coefficient. This study develops the mathematics of this new technique along with an initial application in quantifying spinal cord regeneration following acute injection of epidermal neural crest stem cell (EPI-NCSC) grafts.
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Intravoxel incoherent motion
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Objective To investigate the relationship between the mRNA expression of HE4 and clincopathological features in ovarian cancer and it's clinical Significance.Methods We examined the mRNA expression of HE4 and serum levels of CA125 in control group(n=21),ovarian borderline tumor(n=21) and epithelial ovarian cancer(n=51) by RT-PCR and electrochemiluminescence method.Results The mRNA expression of HE4 and Serum levels of CA125 were significantly higher in ovarian borderline tumor and ovarian cancer than that in control group(P0.01,P0.05).The specificity and sensitivity of the mRNA expression of HE4 in ovarian borderline tumor and the sensitivity in earlier ovarian cancer and the specificity in ovarian cancer were significantly higher than serum level of CA125 respectively(P0.05).Conclusion Increased mRNA expression of HE4 were closely associated with tumorigenesis and pathobiological behaviors of ovarian cancer,therefore may be used as specific tumor markers for the detection of the benign and borderline tumor and l ovarian cancer.
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Clinical Significance
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