The role of dynamic contrast enhanced MR imaging in the assessment of inconclusive ovarian masses

Objectives: To evaluate the diagnostic accuracy of dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) in characterization of inconclusive ovarian tumors, with histologic findings as the reference standard. Patients & methods: DCE-MRI was done in 30 patients with 32 complex ovarian masses, prior to surgical excision. We analyzed the following kinetic parameters: enhancement amplitude (EA) in the form of MRE%, time to peak in the form of T max and maximal slope (MS) and correlated them with histopathology. Results: DCE-MRI showed higher overall accuracy (96%) and specificity (100%) than conventional MRI. Malignant masses showed higher MRE% than benign (p = .004) or borderline masses (p = .036). A shorter T max was found in malignant compared to benign (p = .0002) and borderline (p = .049) masses. MS was best at discrimination between benign, borderline and malignant tumors. Finally, Type III curve showed 100% specificity for invasive malignant tumors. Conclusion: DCE-MRI sequence is a helpful adjunct to conventional MRI for discrimination of inconclusive ovarian masses into benign, borderline and invasive malignant tumors