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Luca Saba · U. Rajendra Acharya Stefano Guerriero · Jasjit Suri Editors Ovarian Neoplasm Imaging Ovarian Neoplasm Imaging Luca Saba (cid:129) U. Rajendra Acharya Stefano Guerriero (cid:129) Jasjit Suri Editors Ovarian Neoplasm Imaging Editors Luca Saba Jasjit S. Suri Department of Radiology Department of Biomedical Engineering University of Cagliari CTO, Global Biomedical Technologies Cagliari Roseville , CA Italy USA U. Rajendra Acharya Department of Biomedical Engineering Ngee Ann Polytechnic Idaho State University (Aff.) Singapore Pocatello , ID USA Stefano Guerriero University of Cagliari Cagliari Italy ISBN 978-1-4614-8632-9 ISBN 978-1-4614-8633-6 (eBook) DOI 10.1007/978-1-4614-8633-6 Springer New York Heidelberg Dordrecht London Library of Congress Control Number: 2013957808 © Springer Science+Business Media New York 2013 T his work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifi cally the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfi lms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. Exempted from this legal reservation are brief excerpts in connection with reviews or scholarly analysis or material supplied specifi cally for the purpose of being entered and executed on a computer system, for exclusive use by the purchaser of the work. Duplication of this publication or parts thereof is permitted only under the provisions of the Copyright Law of the Publisher's location, in its current version, and permission for use must always be obtained from Springer. Permissions for use may be obtained through RightsLink at the Copyright Clearance Center. Violations are liable to prosecution under the respective Copyright Law. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specifi c statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. While the advice and information in this book are believed to be true and accurate at the date of publication, neither the authors nor the editors nor the publisher can accept any legal responsibility for any errors or omissions that may be made. The publisher makes no warranty, express or implied, with respect to the material contained herein. Printed on acid-free paper Springer is part of Springer Science+Business Media (www.springer.com) Contents Part I General Concepts Epidemiology of Epithelial Ovarian Carcinoma. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Anna Maria Paoletti, Bruno Piras, Monica Pilloni, Maria Francesca Marotto, Marisa Orrù, Valentina Corda, and Gian Benedetto Melis Histopathology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 Giuseppina Parodo, Clara Gerosa, and Silvia Soddu Part II Non Neoplastic Lesions of the Ovary Cysts of Follicular Origin and Pregnancy Luteoma. . . . . . . . . . . . . . . . . . . . . . . . . . . 43 Bianka K. Freiwald-Chilla, Nik Hauser, and Rahel A. Kubik-Huch The Ovarian Endometrioma: Clinical Setting and Ultrasound Findings. . . . . . . . . . 55 Stefano Guerriero, Silvia Ajossa, Cristina Peddes, Maura Perniciano, Bruna Soggiu, Jasjit S. Suri, Luca Saba, and Gian Benedetto Melis Endometrioma: Computed Tomography and Magnetic Resonance Imaging . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71 Luca Saba, Rosa Sulcis, Sara Spiga, Mario Piga, Jasjit S. Suri, Silvia Ajossa, and Stefano Guerriero Part III Benign Tumors Epithelial Stromal Tumors: Serous and Mucinous (Clinical Setting and Ultrasound). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 93 Maria Àngela Pascual Benign Surface Stromal Tumors of the Ovary: Computed Tomography and Magnetic Resonance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 115 Takashi Koyama Ovarian Benign Sex Cord-Stromal Tumors: Clinical and Ultrasound Features. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 121 Juan José Hidalgo-Mora and Juan Luis Alcázar Sex Cord-Stromal Tumors: Computed Tomography and Magnetic Resonance. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 133 Takashi Koyama Ovarian Teratomas: Clinical Setting and Ultrasound Findings . . . . . . . . . . . . . . . . 145 Tom Holland and Davor Jurkovic v vi Contents CT and MR of Benign Ovarian Germ Cell Tumours. . . . . . . . . . . . . . . . . . . . . . . . . 155 Ingrid Millet, H. Perrochia, E. Pages-Bouic, F. Curros- Doyon, G. Rathat, and P. Taourel Part IV Borderline and Malignant Tumor Borderline Tumor (Serous/Mucinous/Endometrioid) (Clinical Setting and US). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 179 Caterina Exacoustos Computed Tomographic and Magnetic Resonance Imaging of Borderline and Serous Tumors. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 201 Eito Kozawa Malignant Ovarian Tumors (Serous/Mucinous/Endometrioid/ Clear Cell Carcinoma): Clinical Setting and Ultrasound Appearance. . . . . . . . . . . 229 Juan Luis Alcázar and Jesús Utrilla-Layna CT and MR Imaging of Ovarian Adenocarcinoma (Serous/Mucinous/Endometrioid) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 243 Marc Bazot, Isabelle Thomassin-Naggara, and Emile Daraï Rare Malignant Tumor (Clear Cell Adenocarcinoma, Transitional Cell Carcinoma, Malignant Brenner Tumor) (Clinical Setting and US) . . . . . . . . . 263 Testa Antonia Carla, Ludovisi Manuela, De Blasis Ilaria, Giansiracusa Carmelo, and Mascilini Floriana Rare Ovarian Tumors: Computed Tomography and Magnetic Resonance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 269 Takashi Koyama, Takashi Ikeuchi, and Kaori Togashi Sex Cord-Stromal Tumors: Clinical Setting and Ultrasound Findings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 279 Caroline Van Holsbeke and Dirk Timmerman Malignant Sex Cord-Stromal Tumor: Computed Tomography and Magnetic Resonance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 297 Takashi Koyama Malignant Germ Cell: Stromal Tumors (Clinical Setting and US). . . . . . . . . . . . . . 301 Dorella Franchi, Ailyn Vidal Urbinati, and Vanna Zanagnolo CT and MR Imaging of Malignant Germinal and Stromal Ovarian Tumours. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 319 Corinne Balleyguier, Wassef Khaled, Sandra Canale, Laura Ciolovan, Elise Zareski, Pierre Duvillard, Laurence Brugières, and Philippe Morice Metastatic Ovarian Tumors (Clinical Setting and US). . . . . . . . . . . . . . . . . . . . . . . . 335 Daniela Fischerova Metastatic Tumours of the Ovaries: Computed Tomography and Magnetic Resonance. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 365 Stavroula Kyriazi, Jennifer C. Wakefi eld, and Nandita M. deSouza Contents vii Part V New Prospectives Three-Dimensional Ultrasound in Adnexal Masses . . . . . . . . . . . . . . . . . . . . . . . . . . 387 Juan Luis Alcázar, Begoña Olartecoechea, and María Aubá Ovarian Tumor Characterization Using 3D Ultrasound . . . . . . . . . . . . . . . . . . . . . . 399 U. Rajendra Acharya, M. Muthu Rama Krishnan, Luca Saba, Filippo Molinari, Stefano Guerriero, and Jasjit S. Suri Ovarian Tumor Characterization and Classifi cation Using Ultrasound: A New Online Paradigm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 413 U. Rajendra Acharya, Luca Saba, Filippo Molinari, Stefano Guerriero, and Jasjit S. Suri Evolutionary Algorithm-Based Classifi er Parameter Tuning for Automatic Ovarian Cancer Tissue Characterization and Classifi cation . . . . . . . . . 425 U. Rajendra Acharya, Muthu Rama Krishnan Mookiah, S. Vinitha Sree, Ratna Yanti, Roshan Martis, Luca Saba, Filippo Molinari, Stefano Guerriero, and Jasjit S. Suri FDG-PET/CT Imaging of Ovarian Cancer. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 441 Lin Ho Contrast-Enhanced Transvaginal Sonography of Ovarian Masses: Potential Role in Early Diagnosis of Ovarian Cancer . . . . . . . . . . . . . . . . . . . . . . . . 465 Arthur C. Fleischer, Andre Lyshchik, and David A. Fishman Molecular Imaging of Ovarian Carcinoma. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 479 Lucia M.A. Crane, Rick G. Pleijhuis, Marleen van Oosten, and Gooitzen M. van Dam Author Index. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 497 Subject Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 527 Part I General Concepts Epidemiology of Epithelial Ovarian Carcinoma Anna Maria Paoletti , Bruno Piras , Monica Pilloni , Maria Francesca Marotto , Marisa Orrù , Valentina Corda , and Gian Benedetto Melis Abstract Epithelial ovarian cancer is the fi fth to sixth most common cancer in women, causing more annual deaths than any other gynecological malignancies in women worldwide. In the majority of cases, a good prognosis cannot be made at the diagnosis because clinical pre- sentation of the disease occurs at an advanced stage. In the United States, approximately one-half of ovarian cancer- affl icted women die of this disease. S everal environmental factors can interfere on the risk of ovarian cancer, and the differ- ent interferences of some risk factors on the histologic type of tumor lead to hypothesize a different mechanism of carcinogenesis. In this view, the epithelial ovarian cancer seems to recognize a proper oncogenetic mech- anism in which genetic factors, reproductive factors, and some lifestyle factors play an important role. Keywords Epidemiology • Epithelial ovarian cancer • Oncogenetic mechanism • Prevalence • Incidence Introduction E pithelial ovarian cancer is the fi fth to sixth most common cancer in women, causing more annual deaths than any other A. M. Paoletti (*) gynecological malignancies in women worldwide [1 ] . In the Clinica Ginecologica Ostetrica e di Fisiopatologia della majority of cases, a good prognosis cannot be made at the Riproduzione Umana, Dipartimento di Scienze Chirurgiche , diagnosis because clinical presentation of the disease occurs Università degli Studi di Cagliari, Azienda Ospedaliero Universitaria di Cagliari , at an advanced stage [2 ] . In the United States, approximately Cagliari , Italy one-half of ovarian cancer-affl icted women die of this dis- Dipartimento Chirurgico Materno Infantile e di Scienze ease [3 ] . One group of tumors is represented by endometri- delle Immagini, Sezione di Clinica Ginecologica oid, mucinous, and low-grade serous carcinomas. They are Ostetrica e di Fisiopatologia della Riproduzione Umana , discovered in the substance of the ovary, and likely they pro- Università di Cagliari , Via Ospedale 54 , ceed in a gradual fashion from benign to malignant. In the I-09124 , Cagliari , Italy e-mail: [email protected] second group, there are the serous carcinomas that appear on the ovarian surface with the involvement of fallopian tubes, B. Piras • M. Pilloni • M. F. Marotto • M. Orrù V. Corda • G. B. Melis mesentery, and omentum. This latter group are the most Clinica Ginecologica Ostetrica e di Fisiopatologia della lethal form of epithelial ovarian cancer [4 , 5 ]. Riproduzione Umana, Dipartimento di Scienze Chirurgiche , In the absence of current screening methods of the dis- Università degli Studi di Cagliari, ease, the evaluation of risk factors seems to play a key role to Azienda Ospedaliero Universitaria di Cagliari , Cagliari , Italy do an adequate prevention. L. Saba et al. (eds.), Ovarian Neoplasm Imaging, 3 DOI 10.1007/978-1-4614-8633-6_1, © Springer Science+Business Media New York 2013

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​Diagnostic and pre-operative imaging has become increasingly adopted throughout the field of gynecology. In particular accurate preoperative analysis of ovarian pathology can improve the selection of the correct therapeutical approach, to reduce the length of operations, maximize surgical techniq
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