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Differentiation between borderline and benign ovarian tumors: combined analysis of MRI with tumor markers for large cystic masses (≥5 cm).

 Sung Yoon Park  ;  Young Taik Oh  ;  Dae Chul Jung 
 Acta Radiologica, Vol.57(5) : 633-639, 2016 
Journal Title
 Acta Radiologica 
Issue Date
Adult ; Biomarkers, Tumor/analysis* ; CA-125 Antigen/analysis* ; CA-19-9 Antigen/analysis* ; Contrast Media ; Diagnosis, Differential ; Female ; Humans ; Magnetic Resonance Imaging/methods* ; Meglumine ; Organometallic Compounds ; Ovarian Neoplasms/pathology* ; Predictive Value of Tests ; Retrospective Studies ; Sensitivity and Specificity
Borderline tumor ; CA 125 ; magnetic resonance imaging (MRI) ; ovary ; tumor marker
BACKGROUND: There is overlap in imaging features between borderline and benign ovarian tumors. PURPOSE: To analyze diagnostic performance of magnetic resonance imaging (MRI) combined with tumor markers for differentiating borderline from benign ovarian tumor. MATERIAL AND METHODS: Ninety-nine patient with MRI and surgically confirmed ovarian tumors 5 cm or larger (borderline, n = 37; benign, n = 62) were included. On MRI, tumor size, septal number (0; 1-4; 5 or more), and presence of solid portion such as papillary projection or septal thickening 0.5 cm or larger were investigated. Serum tumor markers (carbohydrate antigen 125 [CA 125] and CA 19-9) were recorded. Multivariate analysis was conducted for assessing whether combined MRI with tumor markers could differentiate borderline from benign tumor. The diagnostic performance was also analyzed. RESULTS: Incidence of solid portion was 67.6% (25/37) in borderline and 3.2% (2/62) in benign tumors (P < 0.05). In all patients, without combined analysis of MRI with tumor markers, multivariate analysis revealed solid portion (P < 0.001) and CA 125 (P = 0.039) were significant for predicting borderline tumors. When combined analysis of MRI with CA 125 ((i) the presence of solid portion or (ii) CA 125 > 44.1 U/mL with septal number ≥5 for borderline tumor) is incorporated to multivariate analysis, it was only significant (P = 0.001). The sensitivity, specificity, PPV, NPV, and accuracy of combined analysis of MRI with CA 125 were 89.1%, 91.9%, 86.8%, 93.4, and 90.9%, respectively. CONCLUSION: Combined analysis of MRI with CA 125 may allow better differentiation between borderline and benign ovarian tumor compared with MRI alone.
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1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
박성윤(Park, Sung Yoon)
오영택(Oh, Young Taik) ORCID logo https://orcid.org/0000-0002-4438-8890
정대철(Jung, Dae Chul) ORCID logo https://orcid.org/0000-0001-5769-5083
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