Comparison of MR Imaging of High-grade Serous Carcinomas with and without Homologous Recombination-deficiency

MRI findings of high-grade serous carcinoma (HGSC) with and without homologous recombination deficiency (HRD) were compared to explore the feasibility of using MRI as a genetic predictor.

We retrospectively reviewed MRI data from HRD-positive and HRD-negative HGSC and evaluated tumor size, appearance, apparent diffusion coefficient (ADC), time-intensity curve, and several dynamic contrast-enhanced curve descriptors. Age, primary site, tumor stage, bilaterality, presence of lymph node metastasis, presence of peritoneal metastasis, and tumor marker levels were also compared.

Forty-eight patients with HRD-positive HGSC (17 patients with BRCA1 variant, 9 patients with BRCA2 variant, and 22 without BRCA variants) and 18 patients with HRD-negative HGSC were included. The HRD-negative patients' mean age was 67 years, which was significantly higher than that of the HRDpositive patients (60 years, P = 0.011). High-risk time-intensity curve (TIC) patterns were more common in HRD-negative tumors (94%) than in HRD-positive tumors (63%; P = 0.047). Tumors without HRD exhibited significantly higher wash-in rates (P = 0.023). Additionally, unresectable lymph node metastases were significantly more frequent in HRD-negative patients (P = 0.013). No significant differences were observed in the other evaluated factors.

The comparison between HGSC with and without HRD revealed that HGSC without HRD was significantly associated with older age, a higher likelihood of exhibiting a high-risk TIC pattern, a higher wash-in rate, and a higher frequency of unresectable lymph node metastasis.