MR Diffusion and MR Perfusion in Characterization of Ovarian Tumors; the Problem and the Solution

Objective: To test and compare the sensitivity and accuracy of diffusion weighted imaging (DWI) and MR perfusion in women having ovarian tumors.

Patients and Method:Fifty women with ovarian masses were collected after meeting the inclusion criteria depending on gray scale sonographic findings which suggested the presence of ovarian masses. Conventional MRI, Diffusion weighted imaging (DWI) and MR perfusion (MRP) were done for all patient cohort after the approval of ethical committee of our institution. The sensitivity and accuracy of the techniques were compared.

Results: The surgical and pathological reports of our patients proved non tumorous lesion in three patients. They 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 1x10-3mm2 /sec.

Conclusion: Diffusion weighted imaging and MR perfusion are useful in diagnosis of ovarian tumors with approximately the same sensitivity and positive impact on the operative management.