MRI assessment of ovarian masses and correlating with CA-125

Background:The combined use of appropriate imaging modalities and serum biomarkers like serum Carcinoembryonic Antigen-125 (CA-125) helps plan treatment strategies and reduce overall mortality. Aims and Objectives:To assess ovarian masses on Magnetic Resonance Imaging (MRI) and correlate them with serum CA-125 values. To derive a new serum CA-125 cut-off value for differentiating benign from malignant ovarian masses. Materials and Methods:This cross-sectional study was conducted from August 2020 to January 2021 on patients with suspected pelvic masses referred to the department of radio-diagnosis and meeting inclusion and exclusion criteria. Serum CA-125 values and imaging features on MRI were recorded. Results:A total of 37 ovarian masses were included in the study, of which 14 were malignant and 23 were benign. The mean CA-125 values among benign [35.95 25.42 (mean +/- SD) IU/ml] and malignant ovarian masses [444.82 +/- 232.9 (mean +/- SD) IU/ml] were statistically significant (<0.001). Using the reference serum CA-125 value of 35 IU/ml, specificity and accuracy were 61% and 75.68%. A cut-off value of 80.5 IU/ml recorded specificity and accuracy of 95.7% and 94.59%, respectively, with a sensitivity of 92.86% in differentiating benign from malignant ovarian masses. Conclusion:The serum CA-125 cut-off value of 80.5 IU/ml is a sensitive and specific serum biomarker for ovarian malignancies. A combined approach of MR imaging and serum CA-125 correlation can be used in characterizing ovarian malignancies in routine clinical practice.