Purpose. To assess if there is a significant difference in enhancement of high grade serous carcinoma of the ovary compared with other ovarian malignancies on clinically performed contrast enhanced MRI studies. Methods. In this institutional-review–board-approved study, two radiologists reviewed contrast enhanced MRI scans in 37 patients with ovarian cancer. Readers measured the signal intensity (SI) of ovarian mass and gluteal fat pre- and postcontrast administration. Percentage enhancement (PE) was calculated as [(post-pre)/precontrast SI] × 100. Results. Pathology revealed 19 patients with unilateral and 18 patients with bilateral malignancies for a total of 55 malignant ovaries-high grade serous carcinoma in 25/55 ovaries (45%), other epithelial carcinomas in 12 ovaries (22%), nonepithelial cancers in 8 ovaries (14%), and borderline tumors in 10 ovaries (18%). Enhancement of high grade serous carcinoma was not significantly different from other invasive ovarian malignancies (Reader 1 ; Reader 2 ). Enhancement of invasive ovarian malignancies was more than borderline tumors but did not reach statistical significance (Reader 1 ; Reader 2 ). Conclusion. On clinically performed contrast enhanced MRI studies, enhancement of high grade serous ovarian carcinoma is not significantly different from other ovarian malignancies. 1. Introduction Epithelial ovarian carcinoma is no longer felt to be a uniform disease, both in the pathology and oncology literature. It is now divided into two categories in pathology articles, tumors arising from a precursor lesion with a better prognosis versus tumors arising de novo with a worse prognosis [1]. The most common type of epithelial ovarian carcinoma, high grade serous carcinoma, is in the second category [2]. These two categories are based on differences in genetic mutations with clinical implications for targeted chemotherapy [1, 3]. Cytotoxic and antiangiogenesis medications targeting various cellular receptors and pathways have the potential to improve response rates in patients [3]. Angiogenesis or tumor vascularity can be indirectly assessed on imaging by the degree of enhancement of the mass. Although ovarian carcinomas are now viewed as two distinct groups in the pathology literature, little is known about whether there are imaging differences between the groups. Thus far, most imaging studies of ovarian tumors, including those using dynamic contrast enhanced (DCE) MRI, have not evaluated the enhancement of the subtypes of ovarian cancer and only a minority of patients in these reports have had serous carcinoma
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