Lindgren, AuniAuniLindgrenAnttila, MaaritMaaritAnttilaRautiainen, SuviSuviRautiainenArponen, OtsoOtsoArponenKivelä, AnnukkaAnnukkaKiveläMäkinen, PetriPetriMäkinenHärmä, Kirsi HanneleKirsi HanneleHärmäHämäläinen, KirsiKirsiHämäläinenKosma, Veli-MattiVeli-MattiKosmaYlä-Herttuala, SeppoSeppoYlä-HerttualaVanninen, RitvaRitvaVanninenSallinen, HannaHannaSallinen2024-10-252024-10-252017-09https://boris-portal.unibe.ch/handle/20.500.12422/162315OBJECTIVES We aimed to investigate whether apparent diffusion coefficients (ADCs) measured by 3.0T diffusion-weighted magnetic resonance imaging (DWI) associate with histological aggressiveness of ovarian cancer (OC) or predict the clinical outcome. This prospective study enrolled 40 patients with primary OC, treated 2011-2014. METHODS DWI was performed prior to surgery. Two observers used whole lesion single plane region of interest (WLsp-ROI) and five small ROIs (S-ROI) to analyze ADCs. Samples from tumours and metastases were collected during surgery. Immunohistochemistry and quantitative reverse transcription polymerase chain reaction (qRT-PCR) were used to measure the expression of vascular endothelial growth factor (VEGF) and its receptors. RESULTS The interobserver reliability of ADC measurements was excellent for primary tumours ICC 0.912 (WLsp-ROI). Low ADCs significantly associated with poorly differentiated OC (WLsp-ROI P = 0.035). In primary tumours, lower ADCs significantly associated with high Ki-67 (P = 0.001) and low VEGF (P = 0.001) expression. In metastases, lower ADCs (WLsp-ROI) significantly correlated with low VEGF receptors mRNA levels. ADCs had predictive value; 3-year overall survival was poorer in patients with lower ADCs (WLsp-ROI P = 0.023, S-ROI P = 0.038). CONCLUSION Reduced ADCs are associated with histological severity and worse outcome in OC. ADCs measured with WLsp-ROI may serve as a prognostic biomarker of OC. KEY POINTS • Reduced ADCs correlate with prognostic markers: poor differentiation and high Ki-67 expression • ADCs also significantly correlated with VEGF protein expression in primary tumours • Lower ADC values are associated with poorer survival in ovarian cancer • Whole lesion single plane-ROI ADCs may be used as a prognostic biomarker in OC.enCell proliferation Diffusion magnetic resonance imaging Neoplasm metastasis Neovascularization pathologic Ovarian neoplasms600 - Technology::610 - Medicine & healtharticle10.7892/boris.1169942828993810.1007/s00330-017-4786-z