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Bo J, Sun M, Wei C, Wei L, Fu B, Shi B, Fang X, Dong J. MRI combined with clinical features to differentiate ovarian thecoma-fibroma with cystic degeneration from ovary adenofibroma. Br J Radiol 2024; 97:1057-1065. [PMID: 38402483 DOI: 10.1093/bjr/tqae046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 01/11/2024] [Accepted: 02/21/2024] [Indexed: 02/26/2024] Open
Abstract
OBJECTIVE To explore the value of magnetic resonance imaging (MRI) and clinical features in identifying ovarian thecoma-fibroma (OTF) with cystic degeneration and ovary adenofibroma (OAF). METHODS A total of 40 patients with OTF (OTF group) and 28 patients with OAF (OAF group) were included in this retrospective study. Univariable and multivariable analyses were performed on clinical features and MRI between the two groups, and the receiver operating characteristic (ROC) curve was plotted to estimate the optimal threshold and predictive performance. RESULTS The OTF group had smaller cyst degeneration degree (P < .001), fewer black sponge sign (20% vs. 53.6%, P = .004), lower minimum apparent diffusion coefficient value (ADCmin) (0.986 (0.152) vs. 1.255 (0.370), P < .001), higher age (57.4 ± 14.2 vs. 44.1 ± 15.9, P = .001) and more postmenopausal women (72.5% vs. 28.6%, P < .001) than OAF. The area under the curve of MRI, clinical features and MRI combined with clinical features was 0.870, 0.841, and 0.954, respectively, and MRI combined with clinical features was significantly higher than the other two (P < .05). CONCLUSION The cyst degeneration degree, black sponge sign, ADCmin, age and menopause were independent factors in identifying OTF with cystic degeneration and OAF. The combination of MRI and clinical features has a good effect on the identification of the two. ADVANCES IN KNOWLEDGE This is the first time to distinguish OTF with cystic degeneration from OAF by combining MRI and clinical features. It shows the diagnostic performance of MRI, clinical features, and combination of the two. This will facilitate the discriminability and awareness of these two diseases among radiologists and gynaecologists.
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Affiliation(s)
- Juan Bo
- Department of Radiology, Anhui Provincial Hospital Affiliated to Anhui Medical University, Hefei, Anhui 230001, China
| | - Mingjie Sun
- Faculty of Graduate Studies, Wannan Medical College, Wuhu, Anhui 241002, China
| | - Chao Wei
- Department of Radiology, Western District, First Affiliated Hospital of University of Science and Technology of China, No.107 Huanhu East Road, Shushan District, Hefei, Anhui, 230031, China
| | - Longyu Wei
- Faculty of Graduate Studies, Bengbu Medical College, Bengbu, Anhui 233030, China
| | - Baoyue Fu
- Faculty of Graduate Studies, Bengbu Medical College, Bengbu, Anhui 233030, China
| | - Bin Shi
- Department of Radiology, Western District, First Affiliated Hospital of University of Science and Technology of China, No.107 Huanhu East Road, Shushan District, Hefei, Anhui, 230031, China
| | - Xin Fang
- Department of Radiology, Western District, First Affiliated Hospital of University of Science and Technology of China, No.107 Huanhu East Road, Shushan District, Hefei, Anhui, 230031, China
| | - Jiangning Dong
- Department of Radiology, Anhui Provincial Hospital Affiliated to Anhui Medical University, Hefei, Anhui 230001, China
- Department of Radiology, Western District, First Affiliated Hospital of University of Science and Technology of China, No.107 Huanhu East Road, Shushan District, Hefei, Anhui, 230031, China
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Nagawa K, Kishigami T, Yokoyama F, Murakami S, Yasugi T, Takaki Y, Inoue K, Tsuchihashi S, Seki S, Okada Y, Baba Y, Hasegawa K, Yasuda M, Kozawa E. Diagnostic utility of a conventional MRI-based analysis and texture analysis for discriminating between ovarian thecoma-fibroma groups and ovarian granulosa cell tumors. J Ovarian Res 2022; 15:65. [PMID: 35610706 PMCID: PMC9131674 DOI: 10.1186/s13048-022-00989-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 04/25/2022] [Indexed: 11/24/2022] Open
Abstract
Objective To evaluate the diagnostic utility of conventional magnetic resonance imaging (MRI)-based characteristics and a texture analysis (TA) for discriminating between ovarian thecoma-fibroma groups (OTFGs) and ovarian granulosa cell tumors (OGCTs). Methods This retrospective multicenter study enrolled 52 patients with 32 OGCTs and 21 OTFGs, which were dissected and pathologically diagnosed between January 2008 and December 2019. MRI-based features (MBFs) and texture features (TFs) were evaluated and compared between OTFGs and OGCTs. A least absolute shrinkage and selection operator (LASSO) regression analysis was performed to select features and construct the discriminating model. ROC analyses were conducted on MBFs, TFs, and their combination to discriminate between the two diseases. Results We selected 3 features with the highest absolute value of the LASSO regression coefficient for each model: the apparent diffusion coefficient (ADC), peripheral cystic area, and contrast enhancement in the venous phase (VCE) for the MRI-based model; the 10th percentile, difference variance, and maximal correlation coefficient for the TA-based model; and ADC, VCE, and the difference variance for the combination model. The areas under the curves of the constructed models were 0.938, 0.817, and 0.941, respectively. The diagnostic performance of the MRI-based and combination models was similar (p = 0.38), but significantly better than that of the TA-based model (p < 0.05). Conclusions The conventional MRI-based analysis has potential as a method to differentiate OTFGs from OGCTs. TA did not appear to be of any additional benefit. Further studies are needed on the use of these methods for a preoperative differential diagnosis of these two diseases. Supplementary Information The online version contains supplementary material available at 10.1186/s13048-022-00989-z.
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Affiliation(s)
- Keita Nagawa
- Department of Radiology, Saitama Medical University, 38 Morohongou, Moroyama-machi, Iruma-gun, Saitama, Japan.
| | - Tomoki Kishigami
- Department of Radiology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo, Japan
| | - Fumitaka Yokoyama
- Department of Radiology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo, Japan
| | - Sho Murakami
- Department of Radiology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo, Japan
| | - Toshiharu Yasugi
- Department of Gynecology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo, Japan
| | - Yasunobu Takaki
- Department of Radiology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo, Japan
| | - Kaiji Inoue
- Department of Radiology, Saitama Medical University, 38 Morohongou, Moroyama-machi, Iruma-gun, Saitama, Japan
| | - Saki Tsuchihashi
- Department of Radiology, Saitama Medical University, 38 Morohongou, Moroyama-machi, Iruma-gun, Saitama, Japan
| | - Satoshi Seki
- Department of Radiology, Saitama Medical University, 38 Morohongou, Moroyama-machi, Iruma-gun, Saitama, Japan
| | - Yoshitaka Okada
- Department of Diagnostic Imaging, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka city, Saitama, Japan
| | - Yasutaka Baba
- Department of Diagnostic Imaging, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka city, Saitama, Japan
| | - Kosei Hasegawa
- Department of Gynecologic Oncology, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka city, Saitama, Japan
| | - Masanori Yasuda
- Department of Diagnostic Pathology, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka city, Saitama, Japan
| | - Eito Kozawa
- Department of Radiology, Saitama Medical University, 38 Morohongou, Moroyama-machi, Iruma-gun, Saitama, Japan
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Li NY, Shi B, Chen YL, Wang PP, Wang CB, Chen Y, Ge YQ, Dong JN, Wei C. The Value of MRI Findings Combined With Texture Analysis in the Differential Diagnosis of Primary Ovarian Granulosa Cell Tumors and Ovarian Thecoma-Fibrothecoma. Front Oncol 2021; 11:758036. [PMID: 34778075 PMCID: PMC8578857 DOI: 10.3389/fonc.2021.758036] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 10/05/2021] [Indexed: 11/13/2022] Open
Abstract
Objective This study aims to explore the value of magnetic resonance imaging (MRI) and texture analysis (TA) in the differential diagnosis of ovarian granulosa cell tumors (OGCTs) and thecoma-fibrothecoma (OTCA–FTCA). Methods The preoperative MRI data of 32 patients with OTCA–FTCA and 14 patients with OGCTs, confirmed by pathological examination between June 2013 and August 2020, were retrospectively analyzed. The texture data of three-dimensional MRI scans based on T2-weighted imaging and clinical and conventional MRI features were analyzed and compared between tumor types. The Mann–Whitney U-test, χ2 test/Fisher exact test, and multivariate logistic regression analysis were used to identify differences between the OTCA–FTCA and OGCTs groups. A regression model was established by using binary logistic regression analysis, and receiver operating characteristic curve analysis was carried out to evaluate diagnostic efficiency. Results A multivariate analysis of the imaging-based features combined with TA revealed that intratumoral hemorrhage (OR = 0.037), log-sigma-20mm-3D_glszm_SmallAreaEmphasis (OR = 4.40), and log-sigma-2-0mm-3D_glszm_SmallAreaHighGrayLevelEmphasis (OR = 1.034) were independent features for discriminating between OGCTs and OTCA–FTCA (P < 0.05). An imaging-based diagnosis model, TA-based model, and combination model were established. The areas under the curve of the three models in predicting OGCTs and OTCA–FTCA were 0.935, 0.944, and 0.969, respectively; the sensitivities were 93.75, 93.75, and 96.87%, respectively; and the specificities were 85.71, 92.86, and 92.86%, respectively. The DeLong test indicated that the combination model had the highest predictive efficiency (P < 0.05), with no significant difference among the three models in differentiating between OGCTs and OTCA–FTCA (P > 0.05). Conclusions Compared with OTCA–FTCA, intratumoral hemorrhage may be characteristic MR imaging features with OGCTs. Texture features can reflect the microheterogeneity of OGCTs and OTCA–FTCA. MRI signs and texture features can help differentiate between OGCTs and OTCA–FTCA and provide a more comprehensive and accurate basis for clinical treatment.
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Affiliation(s)
- Nai-Yu Li
- The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Bin Shi
- The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Yu-Lan Chen
- The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Pei-Pei Wang
- The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Chuan-Bin Wang
- The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Yao Chen
- The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Ya-Qiong Ge
- Department of the Healthcare, GE of China, Shanghai, China
| | - Jiang-Ning Dong
- The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Chao Wei
- The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
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Tng EL, Tan JMM. Dexamethasone suppression test versus selective ovarian and adrenal vein catheterization in identifying virilizing tumors in postmenopausal hyperandrogenism - a systematic review and meta-analysis. Gynecol Endocrinol 2021; 37:600-608. [PMID: 33660585 DOI: 10.1080/09513590.2021.1897099] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
OBJECTIVE The diagnostic accuracy of tests in identifying virilizing tumors in postmenopausal hyperandrogenism is limited. This systematic review compares the dexamethasone suppression test against selective ovarian and adrenal vein sampling of androgens in distinguishing neoplastic from non-neoplastic causes of postmenopausal hyperandrogenism. METHODS Diagnostic test accuracy studies on these index tests in postmenopausal women were selected based on pre-established criteria. The true positive, false positive, false negative, and true negative values were extracted and meta-analysis was conducted using the hierarchical summary receiver operator characteristics curve method. RESULTS The summary sensitivity of the dexamethasone suppression test is 100% (95% CI 0-100%) and that for selective venous sampling is 100% (95% CI 0-100%). The summary specificity of the dexamethasone suppression test is 89.2% (95% CI 85.3-92.2%) and that for selective venous sampling is 100% (95% CI 0.3-100%). CONCLUSION There is limited evidence for the use of dexamethasone suppression test or selective venous sampling in identifying virilizing tumors in postmenopausal hyperandrogenism.
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Affiliation(s)
- Eng-Loon Tng
- Department of Medicine, Ng Teng Fong General Hospital, Singapore
| | - Jeanne May-May Tan
- Department of Neurology, National Neuroscience Institute, Tan Tock Seng Hospital, Singapore
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Tng EL, Tan JMM. Gonadotropin-Releasing Hormone Analogue Stimulation Test Versus Venous Sampling in Postmenopausal Hyperandrogenism. J Endocr Soc 2021; 5:bvaa172. [PMID: 33324863 PMCID: PMC7724751 DOI: 10.1210/jendso/bvaa172] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Indexed: 11/19/2022] Open
Abstract
Postmenopausal hyperandrogenism can be due to excessive androgen secretion from adrenal or ovarian virilizing tumors or nonneoplastic conditions. The etiology of postmenopausal hyperandrogenism can be difficult to discern because of limited accuracy of current diagnostic tests. This systematic review compares the diagnostic accuracy of the gonadotropin-releasing hormone (GnRH) analogue stimulation test against selective ovarian and adrenal vein sampling of androgens in distinguishing neoplastic from nonneoplastic causes of postmenopausal hyperandrogenism. Diagnostic test accuracy studies on these index tests in postmenopausal women were selected based on preestablished criteria. The true positive, false positive, false negative, and true negative values were extracted and meta-analysis was conducted using the hierarchical summary receiver operator characteristics curve method. The summary sensitivity of the GnRH analogue stimulation test is 10% (95% confidence interval [CI], 1.1%-46.7%) and that for selective venous sampling is 100% (95% CI, 0%-100%). Both tests have 100% specificity. There is limited evidence for the use of either test in identifying virilizing tumors in postmenopausal hyperandrogenism.
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Affiliation(s)
- Eng-Loon Tng
- Department of Medicine, Ng Teng Fong General Hospital, Singapore
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Kilinc YB, Sari L, Toprak H, Gultekin MA, Karabulut UE, Sahin N. Ovarian Granulosa Cell Tumor: A Clinicoradiologic Series with Literature Review. Curr Med Imaging 2020; 17:790-797. [PMID: 33371855 DOI: 10.2174/1573405616666201228153755] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 09/21/2020] [Accepted: 10/15/2020] [Indexed: 01/17/2023]
Abstract
BACKGROUND Ovarian granulosa cell tumors that originate from the sex cord-stromal cells represent 2% to 5% of all ovarian cancers. These tumors constitute two subgroups according to their clinical and histopathological features: juvenile granulosa cell tumors (JGCT) and adult granulosa cell tumors (AGCT). Granulosa cell tumor (GCT) is considered to be a low-grade malignancy with a favorable prognosis. METHODS This case series includes four patients who were admitted to our university hospital and had an MRI examination within 5 years. RESULTS The histopathological subtype of granulosa tumor was the adult type in 3 patients and juvenile type in 1 patient. Even though it is extremely rare, bone metastases were present in one of our patients. Liver metastases were also detected in one patient. The MRI examination of tumors revealed a heterogeneous solid mass that contained cystic components in 3 patients. In one of our patients, the tumor had a multiseptated cystic feature, and all of the tumors were ovoid or round with smooth margins. T1 signal hyperintensity, not suppressed on fat saturation sequences, was observed in 3 patients, which represents its hemorrhagic content. CONCLUSION Even though granulosa cell tumor shows a wide spectrum in terms of tumor appearance, some common findings have been shown and especially a hemorrhagic content could be a clue for us. The tumor is known to have a good prognosis, but it may have an unpredictable clinical course, so close follow-up is greatly important.
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Affiliation(s)
- Yagmur Basak Kilinc
- Department of Radiology, Medical Faculty, Bezmialem Faundatiton Vakif University Hospital, Istanbul, Turkey
| | - Lutfullah Sari
- Department of Radiology, Medical Faculty, Bezmialem Faundatiton Vakif University Hospital, Istanbul, Turkey
| | - Huseyin Toprak
- Department of Radiology, Medical Faculty, Bezmialem Faundatiton Vakif University Hospital, Istanbul, Turkey
| | - Mehmet Ali Gultekin
- Department of Radiology, Medical Faculty, Bezmialem Faundatiton Vakif University Hospital, Istanbul, Turkey
| | - Ummuhan Ebru Karabulut
- Department of Radiology, Medical Faculty, Bezmialem Faundatiton Vakif University Hospital, Istanbul, Turkey
| | - Nurhan Sahin
- Department of Pathology, Medical Faculty, Bezmialem Vakif University, Istanbul, Turkey
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Qian L, Ren J, Liu A, Gao Y, Hao F, Zhao L, Wu H, Niu G. MR imaging of epithelial ovarian cancer: a combined model to predict histologic subtypes. Eur Radiol 2020; 30:5815-5825. [PMID: 32535738 DOI: 10.1007/s00330-020-06993-5] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 04/15/2020] [Accepted: 05/28/2020] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To compare the performance of clinical features, conventional MR image features, ADC value, T2WI, DWI, DCE-MRI radiomics, and a combined multiple features model in predicting the type of epithelial ovarian cancer (EOC). METHODS In this retrospective analysis, 61 EOC patients were confirmed by histology. Significant features (p < 0.05) by multivariate logistic regression were retained to establish a clinical model, conventional MRI morphological model, ADC model, and traditional model. The radiomics model included FS-T2WI, DWI, and DCE-MRI, and also, a multisequence model was established. A total of 1070 radiomics features of each sequence were extracted; then, univariate analysis and LASSO were used to select important features. Traditional models were combined with a combined radiomics model to establish a mixed model. The predictive performance was validated by receiver operating characteristic curve (ROC) analysis, calibration curve, and decision curve analysis (DCA). A stratified analysis was conducted to compare the differences between the combined radiomics model and the traditional model in identifying early- and late-stage EOC. RESULTS Traditional models showed the highest performance (AUC = 0.96). The performance of the mixed model (AUC = 0.97) was not significantly different from that of the traditional model. The calibration curve showed that the traditional model had the highest reliability. Stratified analysis showed the potential of the combined radiomics model in the early distinction of the two tumor types. CONCLUSION The traditional model is an effective tool to distinguish EOC type I/II. Combined radiomics models have the potential to better distinguish EOC types in early FIGO stage disease. KEY POINTS • The combined radiomics model resulted in a better predictive model than that from a single sequence model. • The traditional model showed higher classification accuracy than the combined radiomics model. • Combined radiomics models have the potential to better distinguish EOC types in early FIGO stage disease.
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Affiliation(s)
- LuoDan Qian
- Department of Radiology, Affiliated Hospital of Inner Mongolia Medical University, Hohhot, 010000, China
| | - JiaLiang Ren
- GE Healthcare (Shanghai) Co., Ltd., Shanghai, 210000, China
| | - AiShi Liu
- Department of Radiology, Affiliated Hospital of Inner Mongolia Medical University, Hohhot, 010000, China
| | - Yang Gao
- Department of Radiology, Affiliated Hospital of Inner Mongolia Medical University, Hohhot, 010000, China
| | - FenE Hao
- Department of Radiology, Affiliated Hospital of Inner Mongolia Medical University, Hohhot, 010000, China
| | - Lei Zhao
- Department of Radiology, Affiliated Hospital of Inner Mongolia Medical University, Hohhot, 010000, China
| | - Hui Wu
- Department of Radiology, Affiliated Hospital of Inner Mongolia Medical University, Hohhot, 010000, China.
| | - GuangMing Niu
- Department of Radiology, Affiliated Hospital of Inner Mongolia Medical University, Hohhot, 010000, China.
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Petrone M, Bergamini A, Tateo S, Castellano LM, Pella F, Rabaiotti E, Bocciolone L, Mereu L, Candiani M, Mangili G. Transvaginal ultrasound in evaluation and follow-up of ovarian granulosa cell tumors. Int J Gynecol Cancer 2020; 30:1384-1389. [PMID: 32474449 DOI: 10.1136/ijgc-2020-001276] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 04/24/2020] [Accepted: 04/30/2020] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE Ultrasound features of granulosa cell tumors of the ovary are still poorly defined. The aim of this study is to widen current knowledge on the role of sonographic gray scale and pattern recognition in the characterization of these tumors and to compare the ultrasound characteristics of primary diagnosis and recurrences. METHODS Transvaginal ultrasound images of primary diagnosis or recurrences of histologically-confirmed granulosa cell tumors of the ovary were retrospectively retrieved from a dedicated database designed for the collection of clinical and ultrasound data from January 2001 to January 2019. All patients included were treated at San Raffaele and Santa Chiara Hospitals. Women with a concomitant diagnosis of another malignancy other than endometrial carcinoma were excluded from the study. All ultrasound images were described according to International Ovarian Tumor Analysis terminology and examined by experienced ultrasound examiners. RESULTS A total of 27 patients were included: 24 with adult and 3 with juvenile ovarian granulosa cell tumors. At primary diagnosis, mean ovarian mass size was 103.8 mm (range 30-200). On ultrasound evaluation at primary diagnosis, 12 patients presented with a multilocular solid lesion (48%), 9 with a solid lesion (36%), and 4 with a multilocular lesion(16%). The echogenicity of the cyst was low level or anechoic, mixed, or hemorrhagic in 56.3%, 31.2%, and 12.5% of cases, respectively. Most tumors (45.1%), including first diagnosis and relapses, had a moderate to high color score on doppler evaluation. CONCLUSIONS Our study showed that sonographic features and pattern recognition of relapses were comparable to those of tumors at primary diagnosis. In order to highlight the importance of transvaginal ultrasound evaluation during follow-up, further studies based on a standardized ultrasound characterization of ovarian masses are recommended.
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Affiliation(s)
- Micaela Petrone
- Department of Obstetrics and Gynecology, IRCCS Ospedale San Raffaele, Milano, Italy
| | - Alice Bergamini
- Department of Obstetrics and Gynecology, IRCCS Ospedale San Raffaele, Milano, Italy .,Università Vita Salute San Raffaele, Milano, Italy
| | | | | | - Francesca Pella
- Department of Obstetrics and Gynecology, IRCCS Ospedale San Raffaele, Milano, Italy
| | - Emanuela Rabaiotti
- Department of Obstetrics and Gynecology, IRCCS Ospedale San Raffaele, Milano, Italy
| | - Luca Bocciolone
- Department of Obstetrics and Gynecology, IRCCS Ospedale San Raffaele, Milano, Italy
| | | | - Massimo Candiani
- Department of Obstetrics and Gynecology, IRCCS Ospedale San Raffaele, Milano, Italy.,Università Vita Salute San Raffaele, Milano, Italy
| | - Giorgia Mangili
- Department of Obstetrics and Gynecology, IRCCS Ospedale San Raffaele, Milano, Italy
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