Can MRI features differentiate ovarian mucinous carcinoma from mucinous borderline tumor?

Our purpose was to determine if MRI could be used to distinguish ovarian mucinous carcinoma (MC) from mucinous borderline tumor (MBT).

This study included 63 consecutive patients with histopathologically proven ovarian mucinous neoplasms (11 MCs and 52 MBTs) who underwent preoperative contrast-enhanced MRI. MRI images were retrospectively reviewed and compared between the 2 pathologies.

The maximum tumor diameters (219.7 ± 80.8 mm vs. 177.4 ± 56.5 mm, p <  0.05) and maximum mural nodule (MN) diameters (41.7 ± 33.8 mm vs. 6.6 ± 8.9 mm, p <  0.01) were significantly larger in MCs than in MBTs. MNs larger than 5 mm (82 % vs. 29 %, p <  0.01) and abnormal ascites (45 % vs. 12 %, p <  0.05) were significantly more frequent in MCs than in MBTs. Apparent diffusion coefficient (ADC) values of MN were significantly lower in MCs than in MBTs (1.20 ± 0.25 × 10^-3 mm²/s vs. 1.61 ± 0.35 × 10^-3 mm²/s, p <  0.05). No significant difference was found in number of loculi, honeycomb sign, stained glass appearance, fluid-fluid level, thickened septa larger than 5 mm, peritoneal dissemination, or T2 hypointense microcysts between MCs and MBTs. T2 hypointense microcysts were observed only in 7 MBTs (13%).

MRI findings of these 2 pathologies overlapped considerably. Compared with MBTs, MCs exhibited larger tumor size, larger MN size, and lower ADC values of MN, and MCs more frequently had MNs larger than 5 mm and abnormal ascites. T2 hypointense microcysts might be a specific MRI finding in MBTs.