Cystic-solid ADC difference on MRI for differentiating seromucinous borderline tumor from endometriosis-associated ovarian cancer.

Authors

Masanori Ishida, Akihiko Hayakawa, Shigehiro Hayashi, Yoichi Araki, Elly Arizono, Akitoshi Kanagawa, Yukari Wakabayashi, Motoki Nakai, Hirotaka Nishi, Kazuhiro Saito

Published in

Acta radiologica (Stockholm, Sweden : 1987). Pages 2841851261495789. Oct 12, 2026. Epub Oct 12, 2026.

Abstract

BackgroundSeromucinous borderline tumor (SMBT) and endometriosis-associated ovarian cancer (EAOC) may show overlapping magnetic resonance imaging (MRI) features. Quantitative diffusion-weighted imaging may improve their preoperative differentiation.PurposeTo evaluate the diagnostic performance of the cystic-solid apparent diffusion coefficient difference (ΔADC) for differentiating SMBT from EAOC.Material and MethodsThis retrospective single-center study included 49 patients with pathologically confirmed SMBT (n = 14) or EAOC (n = 35) who underwent preoperative pelvic MRI. Apparent diffusion coefficient (ADC) values were measured in the cystic and solid components, and ΔADC was calculated as cystic ADC minus solid ADC. Receiver operating characteristic (ROC) analysis was performed with EAOC as the positive outcome.ResultsSMBT showed lower cystic ADC values and higher solid ADC values than EAOC, resulting in a smaller ΔADC. ΔADC and solid ADC yielded areas under the ROC curve of 0.924 (95% confidence interval (CI) 0.817-1.000) and 0.918 (95% CI 0.837-1.000), respectively. The difference was not statistically significant (P = 0.862). At the internally derived ΔADC cutoff of 0.529 ×10^-3 mm²/s, sensitivity was 94.3% (95% CI 80.8-99.3) and specificity was 92.9% (95% CI 66.1-99.8); because the cutoff was derived and evaluated in the same cohort, these performance estimates may be optimistic.ConclusionΔADC showed high diagnostic performance for differentiating SMBT from EAOC, but incremental diagnostic performance over solid ADC was not demonstrated. The internally derived cutoff and associated performance estimates require independent multicenter validation before clinical application.

PMID:
42862744
Bibliographic data and abstract were imported from PubMed on 13 Oct 2026.

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