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Diffusion-weighted magnetic resonance sequence and CA125/CEA ratio can be used as add-on tools to ultrasound for the differentiation of ovarian from non-ovarian pelvic masses.
PLoS One. 2023; 18(3):e0283212.Plos

Abstract

OBJECTIVE

To provide a straightforward approach to the sequential use of ultrasound (US), magnetic resonance (MR) and serum biomarkers in order to differentiate the origin of pelvic masses, making the most efficient use of these diagnostic resources.

STUDY DESIGN

This is a cross-sectional study with 159 patients (133 with ovarian and 26 with non-ovarian tumors) who underwent surgery/biopsy for an adnexal mass. Preoperative CA125 and CEA serum measurements were obtained and a pelvic/abdominal ultrasound was performed. Preoperative pelvic MR studies were performed for all patients. Morphological and advanced MR sequences were obtained. Using a recursive partitioning algorithm to predict tumor origin, we devised a roadmap to determine the probability of non-ovarian origin using only statistically significant US, laboratory and MR parameters.

RESULTS

Upfront US classification as ovarian versus non-ovarian and CA125/CEA ratio were significantly associated with non-ovarian tumors. Signal diffusion (absent/low versus high) was the only MR parameter significantly associated with non-ovarian tumors. When upfront US designated a tumor as being of ovarian origin, further MR signal diffusion and CA125/CEA ratio were corrected nearly all US errors: patients with MR signal diffusion low/absent and those with signal high but CA125/CEA ratio ≥25 had an extremely low chance (<1%) of being of non-ovarian origin. However, for women whose ovarian tumors were incorrectly rendered as non-ovarian by upfront US, neither MR nor CA125/CEA ratio were able to determine tumor origin precisely.

CONCLUSION

MR signal diffusion is an extremely useful MR parameter to help determine adnexal mass origin when US and laboratory findings are inconclusive.

Authors+Show Affiliations

Faculty of Medical Sciences, Department of Obstetrics and Gynecology, State University of Campinas-Unicamp, Campinas, São Paulo, Brazil. Section of Imaging, Sumaré State Hospital, State University of Campinas, Sumaré, São Paulo, Brazil.Faculty of Medical Sciences, Department of Obstetrics and Gynecology, State University of Campinas-Unicamp, Campinas, São Paulo, Brazil.Faculty of Medical Sciences, Department of Obstetrics and Gynecology, State University of Campinas-Unicamp, Campinas, São Paulo, Brazil.Section of Imaging, Sumaré State Hospital, State University of Campinas, Sumaré, São Paulo, Brazil.Faculty of Medical Sciences, Department of Obstetrics and Gynecology, State University of Campinas-Unicamp, Campinas, São Paulo, Brazil.Faculty of Medical Sciences, Department of Obstetrics and Gynecology, State University of Campinas-Unicamp, Campinas, São Paulo, Brazil.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

36928256

Citation

Nunes Pereira, Patrick, et al. "Diffusion-weighted Magnetic Resonance Sequence and CA125/CEA Ratio Can Be Used as Add-on Tools to Ultrasound for the Differentiation of Ovarian From Non-ovarian Pelvic Masses." PloS One, vol. 18, no. 3, 2023, pp. e0283212.
Nunes Pereira P, Françoise Derchain S, Yoshida A, et al. Diffusion-weighted magnetic resonance sequence and CA125/CEA ratio can be used as add-on tools to ultrasound for the differentiation of ovarian from non-ovarian pelvic masses. PLoS One. 2023;18(3):e0283212.
Nunes Pereira, P., Françoise Derchain, S., Yoshida, A., Hoelz de Oliveira Barros, R., Menezes Jales, R., & Sarian, L. O. (2023). Diffusion-weighted magnetic resonance sequence and CA125/CEA ratio can be used as add-on tools to ultrasound for the differentiation of ovarian from non-ovarian pelvic masses. PloS One, 18(3), e0283212. https://doi.org/10.1371/journal.pone.0283212
Nunes Pereira P, et al. Diffusion-weighted Magnetic Resonance Sequence and CA125/CEA Ratio Can Be Used as Add-on Tools to Ultrasound for the Differentiation of Ovarian From Non-ovarian Pelvic Masses. PLoS One. 2023;18(3):e0283212. PubMed PMID: 36928256.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Diffusion-weighted magnetic resonance sequence and CA125/CEA ratio can be used as add-on tools to ultrasound for the differentiation of ovarian from non-ovarian pelvic masses. AU - Nunes Pereira,Patrick, AU - Françoise Derchain,Sophie, AU - Yoshida,Adriana, AU - Hoelz de Oliveira Barros,Ricardo, AU - Menezes Jales,Rodrigo, AU - Sarian,Luís Otávio, Y1 - 2023/03/16/ PY - 2022/04/23/received PY - 2023/03/04/accepted PY - 2023/3/17/entrez PY - 2023/3/18/pubmed PY - 2023/3/22/medline SP - e0283212 EP - e0283212 JF - PloS one JO - PLoS One VL - 18 IS - 3 N2 - OBJECTIVE: To provide a straightforward approach to the sequential use of ultrasound (US), magnetic resonance (MR) and serum biomarkers in order to differentiate the origin of pelvic masses, making the most efficient use of these diagnostic resources. STUDY DESIGN: This is a cross-sectional study with 159 patients (133 with ovarian and 26 with non-ovarian tumors) who underwent surgery/biopsy for an adnexal mass. Preoperative CA125 and CEA serum measurements were obtained and a pelvic/abdominal ultrasound was performed. Preoperative pelvic MR studies were performed for all patients. Morphological and advanced MR sequences were obtained. Using a recursive partitioning algorithm to predict tumor origin, we devised a roadmap to determine the probability of non-ovarian origin using only statistically significant US, laboratory and MR parameters. RESULTS: Upfront US classification as ovarian versus non-ovarian and CA125/CEA ratio were significantly associated with non-ovarian tumors. Signal diffusion (absent/low versus high) was the only MR parameter significantly associated with non-ovarian tumors. When upfront US designated a tumor as being of ovarian origin, further MR signal diffusion and CA125/CEA ratio were corrected nearly all US errors: patients with MR signal diffusion low/absent and those with signal high but CA125/CEA ratio ≥25 had an extremely low chance (<1%) of being of non-ovarian origin. However, for women whose ovarian tumors were incorrectly rendered as non-ovarian by upfront US, neither MR nor CA125/CEA ratio were able to determine tumor origin precisely. CONCLUSION: MR signal diffusion is an extremely useful MR parameter to help determine adnexal mass origin when US and laboratory findings are inconclusive. SN - 1932-6203 UR - https://www.unboundmedicine.com/medline/citation/36928256/Diffusion_weighted_magnetic_resonance_sequence_and_CA125/CEA_ratio_can_be_used_as_add_on_tools_to_ultrasound_for_the_differentiation_of_ovarian_from_non_ovarian_pelvic_masses_ DB - PRIME DP - Unbound Medicine ER -