Preoperative Differentiation of Epithelial Ovarian Cancer Subtypes Using Synthetic
MRI
Combined With Clinico‐Morphological Features: A Pilot Study
Xiaoli Song, Limei Guo, Yawei Ma, Jialiang Ren, Runmei Zhang, Jinliang Niu ABSTRACT
Background
Epithelial ovarian cancer (EOC) can be broadly classified into type I and type II tumours, which exhibit distinct biological behaviours. Accurate preoperative differentiation between these subtypes is important for guiding treatment decisions and optimizing patient outcomes.
Purpose
To evaluate the diagnostic value of quantitative parameters derived from synthetic magnetic resonance imaging (SyMRI) alone and in combination with clinico‐morphological features for differentiating type I from type II EOCs.
Materials and Methods
This retrospective study included 92 patients with pathologically confirmed EOC, including 32 type I and 60 type II tumours, who underwent preoperative MRI. Quantitative parameters derived from SyMRI, including T1, T2, and proton density (PD), and DWI‐derived apparent diffusion coefficient (ADC) values were measured from the solid components of the tumours. Clinico‐morphological characteristics were also recorded. Differences between type I and type II EOCs were assessed using the independent Student's t, Mann–Whitney U test, or chi‐squared tests. Multivariable logistic regression analysis was used to identify independent predictors and construct a combined model. The model's performance was evaluated using receiver operating characteristic (ROC) curve analysis.
Results
Type I EOCs exhibited significantly higher T1, T2, and ADC values than type II EOCs (all p < 0.05), whereas PD values did not differ significantly between the two groups ( p = 0.746). Significant differences were also observed in patient age, serum CA125 levels, maximum tumour diameter, MRI enhancement characteristics, and texture (all p < 0.05). A multivariable analysis identified T1 value, CA125 level, maximum tumour diameter, and enhancement characteristics served as independent predictors. The combined model incorporating these variables achieved an AUC of 0.936, which was significantly higher than that of any individual parameter (all p < 0.05).
Conclusions
SyMRI‐derived quantitative parameters, particularly T1 values, may provide valuable biomarkers for differentiating EOC subtypes. A combined model integrating T1 values with clinico‐morphological features showed high diagnostic performance and may support preoperative risk stratification and individualized treatment planning in patients with EOC.