Primary and metastatic ovarian cancer: Characterization by 3.0T diffusion-weighted MRI.

Lindgren, Auni; Anttila, Maarit; Rautiainen, Suvi; Arponen, Otso; Kivelä, Annukka; Mäkinen, Petri; Härmä, Kirsi Hannele; Hämäläinen, Kirsi; Kosma, Veli-Matti; Ylä-Herttuala, Seppo; Vanninen, Ritva; Sallinen, Hanna (2017). Primary and metastatic ovarian cancer: Characterization by 3.0T diffusion-weighted MRI. European radiology, 27(9), pp. 4002-4012. Springer-Verlag 10.1007/s00330-017-4786-z

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OBJECTIVES We aimed to investigate whether apparent diffusion coefficients (ADCs) measured by 3.0T diffusion-weighted magnetic resonance imaging (DWI) associate with histological aggressiveness of ovarian cancer (OC) or predict the clinical outcome. This prospective study enrolled 40 patients with primary OC, treated 2011-2014. METHODS DWI was performed prior to surgery. Two observers used whole lesion single plane region of interest (WLsp-ROI) and five small ROIs (S-ROI) to analyze ADCs. Samples from tumours and metastases were collected during surgery. Immunohistochemistry and quantitative reverse transcription polymerase chain reaction (qRT-PCR) were used to measure the expression of vascular endothelial growth factor (VEGF) and its receptors. RESULTS The interobserver reliability of ADC measurements was excellent for primary tumours ICC 0.912 (WLsp-ROI). Low ADCs significantly associated with poorly differentiated OC (WLsp-ROI P = 0.035). In primary tumours, lower ADCs significantly associated with high Ki-67 (P = 0.001) and low VEGF (P = 0.001) expression. In metastases, lower ADCs (WLsp-ROI) significantly correlated with low VEGF receptors mRNA levels. ADCs had predictive value; 3-year overall survival was poorer in patients with lower ADCs (WLsp-ROI P = 0.023, S-ROI P = 0.038). CONCLUSION Reduced ADCs are associated with histological severity and worse outcome in OC. ADCs measured with WLsp-ROI may serve as a prognostic biomarker of OC. KEY POINTS • Reduced ADCs correlate with prognostic markers: poor differentiation and high Ki-67 expression • ADCs also significantly correlated with VEGF protein expression in primary tumours • Lower ADC values are associated with poorer survival in ovarian cancer • Whole lesion single plane-ROI ADCs may be used as a prognostic biomarker in OC.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic, Interventional and Paediatric Radiology

UniBE Contributor:

Härmä, Kirsi Hannele


600 Technology > 610 Medicine & health








Nicole Rösch

Date Deposited:

12 Jul 2018 12:06

Last Modified:

12 Jul 2018 12:06

Publisher DOI:


PubMed ID:


Uncontrolled Keywords:

Cell proliferation Diffusion magnetic resonance imaging Neoplasm metastasis Neovascularization pathologic Ovarian neoplasms




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