Feasibility study on QSM and R2* mapping for quantitative evaluation of iron deposition and ovarian function assessment in endometriotic ovarian cysts.

OBJECTIVES

To evaluate the feasibility of quantitative susceptibility mapping (QSM) and R2* mapping in assessing iron deposition in endometriotic ovarian cysts (EMO) and their potential implications for ovarian reserve.

MATERIALS AND

METHODS

This prospective study included 28 patients (33 lesions) with histopathologically confirmed EMO who underwent preoperative MRI examinations, including R2* mapping and QSM. Cyst fluid iron concentration ([Fe]) was measured via inductively coupled plasma optical emission spectrometry. Serum anti-Müllerian hormone (AMH) levels were quantified as a marker of ovarian reserve. Pearson correlation and regression analyses were performed to assess associations among AMH, [Fe], R2*, and QSM values.

RESULTS

In Group All Ages, AMH was negatively correlated with age (r = -0.74, p < 0.001) and [Fe] (r = -0.35, p = 0.048), while [Fe] showed moderate positive correlations with R2* (r = 0.55, p < 0.001) and QSM (r = 0.56, p < 0.001). In Group < 40 years, AMH exhibited moderate negative correlations with [Fe] (r = -0.45, p = 0.031), R2* (r = -0.48, p = 0.019), QSM (r = -0.49, p = 0.018). Multiple regression analyses confirmed that [Fe], R2*, QSM were significant predictors of AMH levels (p < 0.05). R2* and QSM were highly correlated (r = 0.72, p < 0.001), validating their consistency in assessing iron content.

CONCLUSION

R2* mapping and QSM reliably quantify iron deposition in EMO, with in vitro validation supporting their accuracy. Moreover, the potential link between iron deposition and ovarian reserve highlights the preliminary value of these methods in assessing ovarian function.