Mayumi Takeuchi MD, PhD, Presenter: Nothing to Disclose

Kenji Matsuzaki MD, PhD, Abstract Co-Author: Nothing to Disclose

Masafumi Harada MD, PhD, Abstract Co-Author: Nothing to Disclose

1. Conventional MRI may occasionally fail to diagnose highly malignant tumors with necrosis due to the reduction of viable tumor cells. The presence of necrosis revealed by MR necrosis imaging using a multi-sequence imaging approach combining DWI, high resolution (HR) CE images and MR spectroscopy (MRS) may be the clue to the diagnosis. 2. Small unenhanced areas on HR CE images and DW-low /high ADC areas may reflect small macroscopic necrosis in malignant tumors and lymph node metastasis. 3. Lipid peak on MRS reflects mobile lipid droplets resulting from cellular death due to rapid cellular turnover, and be sensitive for microscopic necrosis in malignant tumors, or necrotic materials in abscess. 4. Combination of macroscopic and microscopic MR necrosis imaging may reveal necrotic tendency of malignant tumors and useful for the diagnosis, and may be applied to assessment of therapeutic response of gynecologic malignancies.

Imaging techniques of MR necrosis imaging: - Macroscopic necrosis detection on HR CE images and DWI with ADC map - Microscopic necrosis detection by MRS: mobile lipid droplets accumulation Diagnostic impacts in clinical cases: - Uterine cancers and sarcomas - Ovarian tumors - Lymph node metastasis - Abscess Assessment of therapeutic response of gynecologic malignancies

http://abstract.rsna.org/uploads/2014/14013893/14013893_mo7t.pdf

Takeuchi, M, Matsuzaki, K, Harada, M, MR Necrosis Imaging of the Female Pelvis: Diagnostic Impact for High Grade Malignant Tumors.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14013893.html