Limits...
The Value of Diffusion-Weighted Imaging in the Differential Diagnosis of Ovarian Lesions: A Meta-Analysis.

Kim HJ, Lee SY, Shin YR, Park CS, Kim K - PLoS ONE (2016)

Bottom Line: Subgroup analysis by mass property revealed higher ADC values in cystic tumor types than in solid types for both benign and malignant tumors.Significant study heterogeneity was observed.There was no notable publication bias.

View Article: PubMed Central - PubMed

Affiliation: Department of Preventive Medicine, College of Medicine, Korea University, Seoul, Korea.

ABSTRACT

Objectives: The ability of contrast-enhanced MRI to distinguish between malignant and benign ovarian masses is limited. The aim of this meta-analysis is to evaluate the diagnostic performance of diffusion-weighted imaging (DWI) in differentiating malignant from benign ovarian masses.

Methods: A comprehensive literature search was performed in several authoritative databases to identify relevant articles. The weighted mean difference (WMD) and corresponding 95% confidence interval (95% CI) were calculated. We also used subgroup analysis to analyze study heterogeneity, and evaluated publication bias.

Results: The meta-analysis is based on 21 studies, which reported the findings for 731 malignant and 918 benign ovarian masses. There was no significant difference in apparent diffusion coefficient (ADC) values for DWI between benign and malignant lesions (WMD = 0.22, 95% CI = -0.02-0.47, p = 0.08). Subgroup analysis by benign tumor type revealed higher ADC values (or a trend toward higher values) for cysts, cystadenomas and other benign tumors compared to malignant masses (cyst: WMD = 0.54, 95% CI = -0.05-1.12, p = 0.07; cystadenoma: WMD = 0.73, 95% CI = 0.38-1.07, p < 0.0001; other benign tumor: WMD = 0.16, 95% CI = -0.13-0.46, p = 0.28). On the other hand, lower ADC values (or a trend toward lower values) were observed for endometrioma and teratoma compared to malignant masses (endometrioma: WMD = -0.09, 95% CI = -0.47-0.29, p = 0.64; teratoma: WMD = -0.49, 95% CI = -0.85-0.12, p = 0.009). Subgroup analysis by mass property revealed higher ADC values in cystic tumor types than in solid types for both benign and malignant tumors. Significant study heterogeneity was observed. There was no notable publication bias.

Conclusions: Quantitative DWI is not a reliable diagnostic method for differentiation between benign and malignant ovarian masses. This knowledge is essential in avoiding misdiagnosis of ovarian masses.

Show MeSH

Related in: MedlinePlus

Flow chart describing the study selection process.From: www.prisma-statement.org. Used with permission.
© Copyright Policy
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4764370&req=5

pone.0149465.g001: Flow chart describing the study selection process.From: www.prisma-statement.org. Used with permission.

Mentions: The systematic database search returned 261 articles. Of these, 218 were excluded as their titles and abstracts indicated that they did not fulfill the selection criteria. Full manuscripts were obtained for the remaining 43 articles; following scrutiny of these, 22 publications were excluded as they were not cohort studies (n = 1), were not in the field of interest (n = 5), were not relevant to DWI (n = 2), or had insufficient data (n = 13) or patient overlap (n = 1). Therefore, a total of 21 studies were included in the review [8–13, 21–35]. The study selection process is presented with a flow chart in Fig 1.


The Value of Diffusion-Weighted Imaging in the Differential Diagnosis of Ovarian Lesions: A Meta-Analysis.

Kim HJ, Lee SY, Shin YR, Park CS, Kim K - PLoS ONE (2016)

Flow chart describing the study selection process.From: www.prisma-statement.org. Used with permission.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4764370&req=5

pone.0149465.g001: Flow chart describing the study selection process.From: www.prisma-statement.org. Used with permission.
Mentions: The systematic database search returned 261 articles. Of these, 218 were excluded as their titles and abstracts indicated that they did not fulfill the selection criteria. Full manuscripts were obtained for the remaining 43 articles; following scrutiny of these, 22 publications were excluded as they were not cohort studies (n = 1), were not in the field of interest (n = 5), were not relevant to DWI (n = 2), or had insufficient data (n = 13) or patient overlap (n = 1). Therefore, a total of 21 studies were included in the review [8–13, 21–35]. The study selection process is presented with a flow chart in Fig 1.

Bottom Line: Subgroup analysis by mass property revealed higher ADC values in cystic tumor types than in solid types for both benign and malignant tumors.Significant study heterogeneity was observed.There was no notable publication bias.

View Article: PubMed Central - PubMed

Affiliation: Department of Preventive Medicine, College of Medicine, Korea University, Seoul, Korea.

ABSTRACT

Objectives: The ability of contrast-enhanced MRI to distinguish between malignant and benign ovarian masses is limited. The aim of this meta-analysis is to evaluate the diagnostic performance of diffusion-weighted imaging (DWI) in differentiating malignant from benign ovarian masses.

Methods: A comprehensive literature search was performed in several authoritative databases to identify relevant articles. The weighted mean difference (WMD) and corresponding 95% confidence interval (95% CI) were calculated. We also used subgroup analysis to analyze study heterogeneity, and evaluated publication bias.

Results: The meta-analysis is based on 21 studies, which reported the findings for 731 malignant and 918 benign ovarian masses. There was no significant difference in apparent diffusion coefficient (ADC) values for DWI between benign and malignant lesions (WMD = 0.22, 95% CI = -0.02-0.47, p = 0.08). Subgroup analysis by benign tumor type revealed higher ADC values (or a trend toward higher values) for cysts, cystadenomas and other benign tumors compared to malignant masses (cyst: WMD = 0.54, 95% CI = -0.05-1.12, p = 0.07; cystadenoma: WMD = 0.73, 95% CI = 0.38-1.07, p < 0.0001; other benign tumor: WMD = 0.16, 95% CI = -0.13-0.46, p = 0.28). On the other hand, lower ADC values (or a trend toward lower values) were observed for endometrioma and teratoma compared to malignant masses (endometrioma: WMD = -0.09, 95% CI = -0.47-0.29, p = 0.64; teratoma: WMD = -0.49, 95% CI = -0.85-0.12, p = 0.009). Subgroup analysis by mass property revealed higher ADC values in cystic tumor types than in solid types for both benign and malignant tumors. Significant study heterogeneity was observed. There was no notable publication bias.

Conclusions: Quantitative DWI is not a reliable diagnostic method for differentiation between benign and malignant ovarian masses. This knowledge is essential in avoiding misdiagnosis of ovarian masses.

Show MeSH
Related in: MedlinePlus