1 Service de Radiologie, Institut Régional du Cancer de Montpellier, 208 Avenue des Apothicaires, Montpellier, Herault 34298, France.
2 Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY.
AJR Am J Roentgenol. 2018 Apr;210(4):918-926. doi: 10.2214/AJR.17.18254. Epub 2018 Feb 28.
The objective of our study was to investigate whether the CT features of serous borderline tumors (SBTs) differ from those of low-grade serous carcinomas (LGSCs) and to evaluate if mutation status is associated with distinct CT phenotypes.
This retrospective study included 59 women, 37 with SBT and 22 with LGSC, who underwent CT before primary surgical resection. Thirty of 59 patients were genetically profiled. Two radiologists (readers 1 and 2) independently and retrospectively reviewed CT examinations for qualitative features and quantified total tumor volumes (TTVs), solid tumor volumes (STVs), and solid proportion of ovarian masses. Univariate and multivariate associations of the CT features with histopathologic diagnoses and mutations were evaluated, and interreader agreement was determined.
At multivariate analysis, the presence of bilateral ovarian masses (p = 0.03), the presence of peritoneal disease (PD) (p = 0.002), and higher STV of ovarian masses (p = 0.002) were associated with LGSC. The presence of nodular PD pattern (p < 0.001 each reader) and the presence of PD calcifications (reader 1, p = 0.02; reader 2, p = 0.003) were associated with invasive peritoneal lesions (i.e., LGSC). The presence of bilateral ovarian masses (p = 0.04 each reader), PD (reader 1, p = 0.01; reader 2, p = 0.004), and higher STV (p = 0.03 for each reader) were associated with the absence of BRAF mutation (i.e., wild type [wt]-BRAF).
The CT features of LGSCs were distinct from those of SBTs. The CT manifestations of LGSC and the wt-BRAF phenotype were similar.
本研究旨在探讨浆液性交界性肿瘤（SBT）的 CT 特征是否与低级别浆液性癌（LGSC）不同，并评估突变状态是否与不同的 CT 表型相关。
本回顾性研究纳入了 59 名女性患者，其中 37 名为 SBT 患者，22 名为 LGSC 患者，均在初次手术切除前接受了 CT 检查。59 例患者中有 30 例进行了基因分析。两名放射科医生（读者 1 和 2）独立且回顾性地对 CT 检查进行定性特征分析，并对卵巢肿块的总肿瘤体积（TTV）、实性肿瘤体积（STV）和实性比例进行定量评估。评估 CT 特征与组织病理学诊断和突变的单变量和多变量关联，并确定读者间的一致性。
多变量分析显示，双侧卵巢肿块（p = 0.03）、腹膜疾病（PD）存在（p = 0.002）和卵巢肿块的 STV 较高（p = 0.002）与 LGSC 相关。存在结节性 PD 模式（每个读者均为 p < 0.001）和 PD 钙化（读者 1，p = 0.02；读者 2，p = 0.003）与侵袭性腹膜病变（即 LGSC）相关。双侧卵巢肿块（每个读者均为 p = 0.04）、PD（读者 1，p = 0.01；读者 2，p = 0.004）和较高的 STV（每个读者均为 p = 0.03）与 BRAF 突变缺失（即 wt-BRAF）相关。
LGSC 的 CT 特征与 SBT 不同。LGSC 的 CT 表现与 wt-BRAF 表型相似。
