A Novel Predictive Tool for Discriminating Endometriosis Associated Ovarian Cancer from Ovarian Endometrioma: The R2 Predictive Index
Open accessAbstract
Background: Magnetic resonance (MR) relaxometry provides a noninvasive tool to discriminate between ovarian endometrioma (OE) and endometriosis-associated ovarian cancer (EAOC), with a sensitivity and specificity of 86% and 94%, respectively. MRI models that can measure R2 values are limited, and the R2 values differ between MRI models. This study aims to extract the factors contributing to the R2 value, and to make a formula for estimating the R2 values, and to assess whether the R2 predictive index calculated by the formula could discriminate EAOC from OE. Methods: This retrospective study was conducted at our institution from November 2012 to February 2019. A total of 247 patients were included in this study. Patients with benign ovarian tumors mainly received laparoscopic surgery, and the patients suspected of having malignant tumors underwent laparotomy. Information from a chart review of the patients’ medical records was collected. Results: In the investigative cohort, among potential factors correlated with the R2 value, multiple regression analyses revealed that tumor diameter and CEA could predict the R2 value. In the validation cohort, multivariate analysis confirmed that age, CRP, and the R2 predictive index were the independent factors. Conclusions: The R2 predictive index is useful and valuable to the detection of the malignant transformation of endometrioma.
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Atypical endometriosis is the precursor of endometrioid ovarian cancer and clear cell cancer in 15-32% of cases.
“In particular, atypical endometriosis was found as the precursor of endometrioid ovarian cancer and clear cell cancer in 15–32% of the cases [20,21,22].”
From Malignancy in Abdominal Wall Endometriosis: Is There a Way to Avoid It? A Systematic Review (2024) · cites this paper as [20]
The Simple Summary calls ovarian endometrioma a precancerous condition for endometriosis-associated ovarian cancer, and the Case Report describes endometrioid carcinoma within an endometrioma. Neither passage identifies atypical endometriosis as the precursor or gives the claimed 15–32% figure; searches for those terms found no supporting passage. (LLM, conf=0.76)
Experimental — accuracy not yet measuredOvarian and/or pelvic endometriosis is associated with approximately 42% of endometrioid ovarian cancer.
“Ovarian and/or pelvic endometriosis is associated with approximately 42% of endometrioid ovarian cancer [18,19,20,21].”
From Malignancy in Abdominal Wall Endometriosis: Is There a Way to Avoid It? A Systematic Review (2024) · cites this paper as [20]
The Introduction links endometriosis in the pelvic peritoneum or ovaries to subsequent endometriosis-associated ovarian cancer, and the Case Report describes endometrioid carcinoma within an endometrioma. Neither passage establishes that approximately 42% of endometrioid ovarian cancers are associated with ovarian or pelvic endometriosis; a search for “42%” found no such estimate. (LLM, conf=0.85)
Experimental — accuracy not yet measuredKawahara et al. (2021) published a formula that estimates R2 values by incorporating CEA and tumor diameters as independent predictive factors for discriminating endometriosis ovarian cancer from ovarian endometrioma.
“Kawahara et al. (2021) published a formula that estimates R2 values by incorporating CEA and tumor diameters as independent predictive factors for discriminating endometriosis ovarian cancer, from ovarian endometrioma [20,51].”
From Malignancy in Abdominal Wall Endometriosis: Is There a Way to Avoid It? A Systematic Review (2024) · cites this paper as [20]
To distinguish benign ovarian endometrioma from ovarian cancer, MRI relaxometry could be a non-invasive preoperative tool (sensitivity 86%, specificity 94%).
“To distinguish benign ovarian endometrioma from ovarian cancer, MRI relaxometry could be a non-invasive preoperative tool (sensitivity 86%, specificity 94%) [20].”
From Malignancy in Abdominal Wall Endometriosis: Is There a Way to Avoid It? A Systematic Review (2024) · cites this paper as [20]
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References 40 · Cited by 18
- Authors
- Kawahara, N., Miyake, R., Yamanaka, S., & Kobayashi, H.
- Affiliations
- Nara Medical University (JP)
- Corresponding author
- Kawahara, Naoki
- Venue
- Cancers
- Publisher
- MDPI AG
- Published
- 2021-07-29
- Volume
- 13
- Issue
- 15
- Pages
- 3829
- ISSN
- 2072-6694 (ISSN-L)
- PMC
- PMC8345171
- OpenAlex
- W3186328319
- Cited by
- 18
- References
- 40
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 8 · 2023: 3 · 2022: 4
- FWCI
- 3.24
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Cancers (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Japan Society for the Promotion of Science (19K09809, 20K09604, 21K16819)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
- Health Sciences › Medicine › Reproductive Medicine › Ovarian cancer diagnosis and treatment
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › MRI in cancer diagnosis
- Keywords
- endometriosis-associated ovarian cancer, endometrioma, R2* relaxometry, MRI relaxometry, tumor diameter, carcinoembryonic antigen, C-reactive protein, differential diagnosis
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