Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-745bb68f8f-d8cs5 Total loading time: 0 Render date: 2025-01-30T13:25:51.605Z Has data issue: false hasContentIssue false

7 - MR Imaging in Ovarian Cancer

Published online by Cambridge University Press:  11 September 2009

By
Aslam Sohaib  and
Rodney Reznek
Edited by
Rodney Reznek
Aslam Sohaib
Affiliation:
Department of Radiology, Royal Marsden Hospital, London, UK
Rodney Reznek
Affiliation:
Department of Radiology, Royal Marsden Hospital, London, UK
Rodney Reznek
Affiliation:
St. Bartholomew's Hospital, London
Get access

Summary

Introduction

MR imaging is increasingly being used in gynaecological and pelvic imaging due to its high contrast resolution compared to CT and ultrasound. As MR imaging techniques continue to improve, its role continues to evolve. Consequently, MRI is proving useful in characterising adnexal masses and may have a role in defining the extent of disease in ovarian cancer.

Technique

Optimal imaging in ovarian cancer requires a high-field system with good gradients in order to obtain rapid and high-resolution images. Imaging acquisition is further enhanced by the use of phased-array coils that are compatible with parallel imaging techniques. These techniques use some of the spatial information contained in the individual elements of a radiofrequency (RF) receiver coil array to increase imaging speed [1].

For characterisation of adnexal masses, images should be obtained in at least two planes to assist in determining the organ of origin of the mass. Both T1- and T2-weighted images are important for pelvic anatomy and in tissue characterisation. The use of small field of view high-resolution images improves the delineation of small structures such as papillary projections. Fat-suppression sequences help to distinguish fatty from haemorrhagic masses. Fat-saturated chemical shift techniques are preferable to STIR sequences. This is to avoid confusion between fat and haemorrhagic lesions, as haemorrhagic lesions may have the same T1 relaxation time as fat on the STIR sequence. Gadolinium-enhanced fat-suppressed T1-weighted images improve lesion characterisation by increasing the conspicuity of nodules and septa in complex adnexal masses [2–5].

Type
Chapter
Information
Cancer of the Ovary , pp. 112 - 131
Publisher: Cambridge University Press
Print publication year: 2006

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Bammer, R. and Schoenberg, S. O.. Current concepts and advances in clinical parallel magnetic resonance imaging. Top Magn Reson Imaging (2004), 15:129–58.CrossRefGoogle ScholarPubMed
Forstner, R., Hricak, H., Occhipinti, K. A., et al. Ovarian cancer: staging with CT and MR imaging. Radiology (1995), 197:619–26.CrossRefGoogle ScholarPubMed
Low, R. N. and Signeti, J. S.. MR imaging of peritoneal disease. AJR Am J Roentgenol (1994), 163:1131–40.CrossRefGoogle ScholarPubMed
Ghossain, M. A., Buy, J. N., Ligneres, C., et al. Epithelial tumors of the ovary: comparison of MR and CT findings. Radiology (1991), 181:863–70.CrossRefGoogle ScholarPubMed
Thurnher, S., Hodler, J., Baer, S., et al. Gadolinium-DOTA enhanced MR imaging of adnexal tumors. J Comput Assist Tomogr (1990), 14:939–49.CrossRefGoogle ScholarPubMed
Sohaib, S. A., Sahdev, A., Trappen, P. O., et al. Characterization of adnexal mass lesions on MR imaging. AJR Am J Roentgenol (2003), 180:1297–304.CrossRef
Katayama, M., Masui, T., Kobayashi, S., et al. Diffusion-weighted echo planar imaging of ovarian tumors: is it useful to measure apparent diffusion coefficients?J Comput Assist Tomogr (2002), 26:250–6.CrossRefGoogle ScholarPubMed
Kinkel, K., Hricak, H., Lu, Y., et al. US characterization of ovarian masses: a meta-analysis. Radiology (2000), 217:803–11.CrossRefGoogle ScholarPubMed
Koonings, P. P., Campbell, K., Mishell, D. R. Jr, et al. Relative frequency of primary ovarian neoplasms: a 10-year review. Obstet Gynecol (1989), 74:921–6.Google ScholarPubMed
Sohaib, S. A., Mills, T. D., Sahdev, A., et al. The role of magnetic resonance imaging and ultrasound in patients with adnexal masses. Clin Radiol (2005), 60:340–8.CrossRefGoogle ScholarPubMed
Yamashita, Y., Torashima, M., Hatanaka, Y., et al. Adnexal masses: accuracy of characterization with transvaginal US and precontrast and postcontrast MR imaging. Radiology (1995), 194:557–65.CrossRefGoogle ScholarPubMed
Komatsu, T., Konishi, I., Mandai, M., et al. Adnexal masses: transvaginal US and gadolinium-enhanced MR imaging assessment of intratumoral structure. Radiology (1996), 198:109–15.CrossRefGoogle ScholarPubMed
Rieber, A., Nussle, K., Stohr, I., et al. Preoperative diagnosis of ovarian tumors with MR imaging: comparison with transvaginal sonography, positron emission tomography, and histologic findings. AJR Am J Roentgenol (2001), 177:123–9.CrossRefGoogle ScholarPubMed
Kinkel, K., Lu, Y., Mehdizade, A., et al. Indeterminate ovarian mass at US: incremental value of second imaging test for characterization–meta-analysis and Bayesian analysis. Radiology (2005), 236:85–94.CrossRefGoogle ScholarPubMed
Stevens, S. K., Hricak, H. and Stern, J. L.. Ovarian lesions: detection and characterization with gadolinium-enhanced MR imaging at 1.5 T. Radiology (1991), 181:481–8.CrossRefGoogle ScholarPubMed
Semelka, R. C., Lawrence, P. H., Shoenut, J. P., et al. Primary ovarian cancer: prospective comparison of contrast-enhanced CT and pre- and post-contrast, fat-suppressed MR imaging, with histologic correlation. J Magn Reson Imaging (1993), 3:99–106.CrossRefGoogle Scholar
Hricak, H., Chen, M., Coakley, F. V., et al. Complex adnexal masses: detection and characterization with MR imaging – multivariate analysis. Radiology (2000), 214:39–46.CrossRefGoogle ScholarPubMed
Forstner, R., Hricak, H. and White, S.. CT and MRI of ovarian cancer. Review. Abdom Imaging (1995), 20:2–8.CrossRefGoogle Scholar
Buy, J. N., Ghossain, M. A., Sciot, C., et al. Epithelial tumors of the ovary: CT findings and correlation with US. Radiology (1991), 178:811–8.CrossRefGoogle ScholarPubMed
Troiano, R. N., Lazzarini, K. M., Scoutt, L. M., et al. Fibroma and fibrothecoma of the ovary: MR imaging findings. Radiology (1997), 204:795–8.CrossRefGoogle ScholarPubMed
Outwater, E. K., Siegelman, E. S., Talerman, A., et al. Ovarian fibromas and cystadenofibromas: MRI features of the fibrous component. J Magn Reson Imaging (1997), 7:465–71.CrossRefGoogle ScholarPubMed
Togashi, K., Nishimura, K., Kimura, I., et al. Endometrial cysts: diagnosis with MR imaging. Radiology (1991), 180:73–8.CrossRefGoogle ScholarPubMed
Tanaka, Y. O., Yoshizako, T., Nishida, M., et al. Ovarian carcinoma in patients with endometriosis: MR imaging findings. AJR Am J Roentgenol (2000), 175:1423–30.CrossRefGoogle ScholarPubMed
Heaps, J. M., Nieberg, R. K. and Berek, J. S.. Malignant neoplasms arising in endometriosis. Obstet Gynecol (1990), 75:1023–8.Google ScholarPubMed
McMeekin, D. S., Burger, R. A., Manetta, A., et al. Endometrioid adenocarcinoma of the ovary and its relationship to endometriosis. Gynecol Oncol (1995), 59:81–6.CrossRefGoogle ScholarPubMed
Souza, N. M., O'Neill, R., McIndoe, G. A., et al. Borderline tumors of the ovary: CT and MRI features and tumor markers in differentiation from stage I disease. AJR Am J Roentgenol (2005), 184:999–1003.Google Scholar
Stevens, S. K., Hricak, H. and Campos, Z.. Teratomas versus cystic hemorrhagic adnexal lesions: differentiation with proton-selective fat-saturation MR imaging. Radiology (1993), 186:481–8.CrossRefGoogle ScholarPubMed
Kim, S. H., Kim, Y. J., Park, B. K., et al. Collision tumors of the ovary associated with teratoma: clues to the correct preoperative diagnosis. J Comput Assist Tomogr (1999), 23:929–33.CrossRefGoogle ScholarPubMed
Rha, S. E., Byun, J. Y., Jung, S. E., et al. Atypical CT and MRI manifestations of mature ovarian cystic teratomas. AJR Am J Roentgenol (2004), 183:743–50.CrossRefGoogle ScholarPubMed
Comerci, J. T. Jr, Licciardi, F., Bergh, P. A., et al. Mature cystic teratoma: a clinicopathologic evaluation of 517 cases and review of the literature. Obstet Gynecol (1994), 84:22–8.Google ScholarPubMed
Kido, A., Togashi, K., Konishi, I., et al. Dermoid cysts of the ovary with malignant transformation: MR appearance. AJR Am J Roentgenol (1999), 172:445–9.CrossRefGoogle ScholarPubMed
Tanaka, Y. O., Kurosaki, Y., Nishida, M., et al. Ovarian dysgerminoma: MR and CT appearance. J Comput Assist Tomogr (1994), 18:443–8.CrossRefGoogle ScholarPubMed
Kim, S. H. and Kang, S. B.. Ovarian dysgerminoma: color Doppler ultrasonographic findings and comparison with CT and MR imaging findings. J Ultrasound Med (1995), 14:843–8.CrossRefGoogle ScholarPubMed
Jung, S. E., Rha, S. E., Lee, J. M., et al. CT and MRI findings of sex cord-stromal tumor of the ovary. AJR Am J Roentgenol (2005), 185:207–15.CrossRefGoogle ScholarPubMed
MacSweeney, J. E. and King, D. M.. Computed tomography, diagnosis, staging and follow-up of pure granulosa cell tumour of the ovary. Clin Radiol (1994), 49:241–5.CrossRefGoogle ScholarPubMed
Schwartz, R. K., Levine, D., Hatabu, H., et al. Ovarian fibroma: findings by contrast-enhanced MRI. Abdom Imaging (1997), 22:535–7.CrossRefGoogle ScholarPubMed
Stevens, S. K.. The adnexa. In: Higgins, C. B., Hricak, H., Helms, C. A. eds., Magnetic Resonance Imaging of the Body, 2nd edn. (New York: Raven Press Ltd, 1992), pp. 865–89.Google Scholar
Brown, D. L., Zou, K. H., Tempany, C. M., et al. Primary versus secondary ovarian malignancy: imaging findings of adnexal masses in the Radiology Diagnostic Oncology Group Study. Radiology (2001), 219:213–8.CrossRefGoogle ScholarPubMed
Outwater, E. K. and Dunton, C. J.. Imaging of the ovary and adnexa: clinical issues and applications of MR imaging. Radiology (1995), 194:1–18.CrossRefGoogle ScholarPubMed
Mitchell, D. G., Hill, M. C., Hill, S., et al. Serous carcinoma of the ovary: CT identification of metastatic calcified implants. Radiology (1986), 158:649–52.CrossRefGoogle ScholarPubMed
Low, R. N., Carter, W. D., Saleh, F., et al. Ovarian cancer: comparison of findings with perfluorocarbon-enhanced MR imaging, In-111-CYT-103 immunoscintigraphy, and CT. Radiology (1995), 195:391–400.CrossRefGoogle ScholarPubMed
Payer, L. M., Stiglbauer, R., Kramer, J., et al. Superparamagnetic particles as oral contrast medium in MRI of patients with treated ovarian cancer – comparison with plain MRI. Br J Radiol (1993), 66:415–9.CrossRefGoogle Scholar
Potter, M. E., Partridge, E. E., Hatch, K. D., et al. Primary surgical therapy of ovarian cancer: how much and when. Gynecol Oncol (1991), 40:195–200.CrossRefGoogle ScholarPubMed
Walsh, J. W.. Computed tomography of gynaecologic neoplasms. Radiol Clin North Am (1992), 30:817–30.Google Scholar
Coakley, F. V.. Staging ovarian cancer: role of imaging. Radiol Clin North Am (2002), 40:609–36.CrossRefGoogle ScholarPubMed
Fleischer, A. C.. Transabdominal and transvaginal songraphy of ovarian masses. Clin Obstet Gynecol (1991), 34:433–42.CrossRefGoogle Scholar
Sanders, R. C., McNeil, B. J., Finberg, H. J., et al. A prospective study of computed tomography and ultrasound in the detection and staging of pelvic masses. Radiology (1983), 146:439–42.CrossRefGoogle ScholarPubMed
Shiels, R. A., Peel, K. R., MacDonald, H. N., et al. A prospective trial of CT in staging of ovarian malignancy. Br J Obstet Gynaecol (1985), 92:407–12.CrossRefGoogle ScholarPubMed
Johnson, R. J., Blackledge, G., Eddleston, B., et al. Abdomino-pelvic computed tomography in the management of ovarian carcinoma. Radiology (1983), 146:447–52.CrossRefGoogle ScholarPubMed
Blaquiere, R. M. and Husband, J. E.. Conventional radiology and computed tomography in ovarian cancer: discussion paper. J R Soc Med (1983), 76:574–9.CrossRefGoogle ScholarPubMed
Meyer, J. I., Kennedy, A. W., Friedman, R., et al. Ovarian carcinoma: value of CT in predicting success of debulking surgery. AJR Am J Roentgenol (1995), 165:875–8.CrossRefGoogle ScholarPubMed
Nelson, B. E., Rosenfield, A. T. and Schwartz, P. E.. Preoperative abdominopelvic computed tomographic prediction of optimal cytoreduction in epithelial ovarian carcinoma. J Clin Oncol (1993), 11:166–72.CrossRefGoogle ScholarPubMed
Low, R. N., Duggan, B., Barone, R. M., et al. Treated ovarian cancer: MR imaging, laparotomy reassessment, and serum CA-125 values compared with clinical outcome at 1 year. Radiology (2005), 235:918–26.CrossRefGoogle ScholarPubMed
Prayer, L., Kainz, C., Kramer, J., et al. CT and MR accuracy in the detection of tumor recurrence in patients treated for ovarian cancer. J Comput Assist Tomogr (1993), 17:626–32.CrossRefGoogle Scholar
Goldhirsch, A., Triller, J. K., Greiner, R., et al. Computed tomography prior to second-look operation in advanced ovarian cancer. Obstet Gynecol (1983), 62:630–4.Google ScholarPubMed
Moskovic, E., Fernando, I., Blake, P., et al. Lymphography - current role in oncology. Br J Radiol (1991), 64:422–7.CrossRefGoogle Scholar
Silverman, P. M., Osborne, M., Dunnick, N. R., et al. CT prior to second-look operation in ovarian cancer. AJR Am J Roentgenol (1988), 150:829–32.CrossRefGoogle ScholarPubMed
Forstner, R., Hricak, H., Powell, C. B., et al. Ovarian cancer recurrence: value of MR imaging. Radiology (1995), 196:715–20.CrossRefGoogle ScholarPubMed
Low, R. N., Saleh, F., Song, S. Y., et al. Treated ovarian cancer: comparison of MR imaging with serum CA-125 level and physical examination – a longitudinal study. Radiology (1999), 211:519–28.CrossRefGoogle ScholarPubMed

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×