The Value of MRI Findings Combined With Texture Analysis in the Differential Diagnosis of Primary Ovarian Granulosa Cell Tumors and Ovarian Thecoma-Fibrothecoma

Nai-Yu Li; Bin Shi; Yu-Lan Chen; Pei-Pei Wang; Chuan-Bin Wang; Yao Chen; Ya-Qiong Ge; Jiang-Ning Dong; Chao Wei

doi:10.3389/fonc.2021.758036

The Value of MRI Findings Combined With Texture Analysis in the Differential Diagnosis of Primary Ovarian Granulosa Cell Tumors and Ovarian Thecoma-Fibrothecoma

Front Oncol. 2021 Oct 27:11:758036. doi: 10.3389/fonc.2021.758036. eCollection 2021.

Authors

Nai-Yu Li¹, Bin Shi¹, Yu-Lan Chen¹, Pei-Pei Wang¹, Chuan-Bin Wang¹, Yao Chen¹, Ya-Qiong Ge², Jiang-Ning Dong¹, Chao Wei¹

Affiliations

¹ The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China.
² Department of the Healthcare, GE of China, Shanghai, China.

Abstract

Objective: This study aims to explore the value of magnetic resonance imaging (MRI) and texture analysis (TA) in the differential diagnosis of ovarian granulosa cell tumors (OGCTs) and thecoma-fibrothecoma (OTCA-FTCA).

Methods: The preoperative MRI data of 32 patients with OTCA-FTCA and 14 patients with OGCTs, confirmed by pathological examination between June 2013 and August 2020, were retrospectively analyzed. The texture data of three-dimensional MRI scans based on T2-weighted imaging and clinical and conventional MRI features were analyzed and compared between tumor types. The Mann-Whitney U-test, χ ² test/Fisher exact test, and multivariate logistic regression analysis were used to identify differences between the OTCA-FTCA and OGCTs groups. A regression model was established by using binary logistic regression analysis, and receiver operating characteristic curve analysis was carried out to evaluate diagnostic efficiency.

Results: A multivariate analysis of the imaging-based features combined with TA revealed that intratumoral hemorrhage (OR = 0.037), log-sigma-20mm-3D_glszm_SmallAreaEmphasis (OR = 4.40), and log-sigma-2-0mm-3D_glszm_SmallAreaHighGrayLevelEmphasis (OR = 1.034) were independent features for discriminating between OGCTs and OTCA-FTCA (P < 0.05). An imaging-based diagnosis model, TA-based model, and combination model were established. The areas under the curve of the three models in predicting OGCTs and OTCA-FTCA were 0.935, 0.944, and 0.969, respectively; the sensitivities were 93.75, 93.75, and 96.87%, respectively; and the specificities were 85.71, 92.86, and 92.86%, respectively. The DeLong test indicated that the combination model had the highest predictive efficiency (P < 0.05), with no significant difference among the three models in differentiating between OGCTs and OTCA-FTCA (P > 0.05).

Conclusions: Compared with OTCA-FTCA, intratumoral hemorrhage may be characteristic MR imaging features with OGCTs. Texture features can reflect the microheterogeneity of OGCTs and OTCA-FTCA. MRI signs and texture features can help differentiate between OGCTs and OTCA-FTCA and provide a more comprehensive and accurate basis for clinical treatment.

Keywords: fibrothecoma; granulosa cell tumor; magnetic resonance imaging; sex cord stromal tumors; texture analysis; thecoma.