Sodai Hoshiai

Comparison of MR Imaging of High-grade Serous Carcinomas with and without Homologous Recombination-deficiency

MRI findings of high-grade serous carcinoma (HGSC) with and without homologous recombination deficiency (HRD) were compared to explore the feasibility of using MRI as a genetic predictor. We retrospectively reviewed MRI data from HRD-positive and HRD-negative HGSC and evaluated tumor size, appearance, apparent diffusion coefficient (ADC), time-intensity curve, and several dynamic contrast-enhanced curve descriptors. Age, primary site, tumor stage, bilaterality, presence of lymph node metastasis, presence of peritoneal metastasis, and tumor marker levels were also compared. Forty-eight patients with HRD-positive HGSC (17 patients with BRCA1 variant, 9 patients with BRCA2 variant, and 22 without BRCA variants) and 18 patients with HRD-negative HGSC were included. The HRD-negative patients' mean age was 67 years, which was significantly higher than that of the HRDpositive patients (60 years, P = 0.011). High-risk time-intensity curve (TIC) patterns were more common in HRD-negative tumors (94%) than in HRD-positive tumors (63%; P = 0.047). Tumors without HRD exhibited significantly higher wash-in rates (P = 0.023). Additionally, unresectable lymph node metastases were significantly more frequent in HRD-negative patients (P = 0.013). No significant differences were observed in the other evaluated factors. The comparison between HGSC with and without HRD revealed that HGSC without HRD was significantly associated with older age, a higher likelihood of exhibiting a high-risk TIC pattern, a higher wash-in rate, and a higher frequency of unresectable lymph node metastasis.

Comparison of Benign, Borderline, and Malignant Ovarian Seromucinous Neoplasms on MR Imaging

This study aimed to compare MRI findings among benign, borderline, and malignant ovarian seromucinous neoplasms. We retrospectively analyzed MRI data from 24 patients with ovarian seromucinous neoplasms-seven benign, thirteen borderline, and six malignant. The parameters evaluated included age, tumour size, morphology, number, height, apparent diffusion coefficient (ADC) values, T2 ratios, time-intensity curve (TIC) descriptors, and TIC patterns of the mural nodules. Additionally, we examined the T2 and T1 ratios of the cyst contents, tumour markers, and the presence of endometriosis. We used statistical tests, including the Kruskal-Wallis and Fisher-Freeman-Halton exact tests, to compare these parameters among the three aforementioned groups. The cases showed papillary architecture with internal branching in 57% of benign, 92% of borderline, and 17% of malignant cases. Three or fewer mural nodules were seen in 57% of benign, 8% of borderline, and 17% of malignant cases. Compared to benign and borderline tumours, mural nodules of malignant neoplasms had significantly increased height (P = 0.015 and 0.011, respectively), lower means ADC values (P = 0.003 and 0.035, respectively). The mural nodules in malignant cases also demonstrated significantly lower T2 ratios than those in the benign cases (P = 0.045). Most neoplasms displayed an intermediate-risk TIC pattern, including 80% benign, 83% borderline, and 60% malignant neoplasms, and no significant differences were observed. Most benign and borderline tumours exhibited a papillary architecture with an internal branching pattern, whereas this feature was less common in malignant neoplasms. Additionally, benign tumours had fewer mural nodules compared to borderline tumours. Malignant neoplasms were characterized by mural nodules with increased height and lower ADC values than those in benign and borderline tumours. Interestingly, all three groups predominantly exhibited an intermediate-risk TIC pattern, emphasizing the complexity of diagnosing seromucinous neoplasms using MRI.