Volume 14 Supplement 1

Proceedings of the International Cancer Imaging Society (ICIS) 14th Annual Teaching Course

Open Access

Whole-body diffusion-weighted MRI versus CT for detection, restaging and operability assessment of recurrent ovarian carcinoma

  • K Michielsen1Email author,
  • I Vergote2,
  • K Op de beeck1,
  • F Amant2,
  • K Leunen2,
  • S Dymarkowski1,
  • P Moerman3,
  • F De Keyzer1 and
  • V Vandecaveye1
Cancer Imaging201414(Suppl 1):S7

https://doi.org/10.1186/1470-7330-14-S1-S7

Published: 9 October 2014

Aim

To evaluate whole body diffusion-weighted MR imaging (WB-DWI MRI) for detection, staging and operability assessment in recurrent ovarian cancer compared with CT.

Methods

Fifty-one women suspected for recurrent ovarian cancer underwent 3-Tesla WB-DWI/MRI using 2 b-values (b=0-1000 s/mm²), T2- and contrast T1-weighted sequences in addition to CT. WB-DWI/MRI and CT were compared for per-patient detection of recurrence, per-site detection of disease extent including peritoneal, serosal, retroperitoneal, periportal and distant metastases and for detecting disease extent according to institutional operability criteria. Imaging findings were correlated with surgical/pathological findings or imaging follow-up for at least 6 months.

Results

According to the reference standard, recurrence was confirmed in 48/51 patients. WB-DWI MRI showed 94% accuracy for detecting recurrence, versus 78% for CT. Per-site analysis showed significantly higher sensitivity of WB-DWI MRI over CT for assessing disease extent of the peritoneum, small bowel and colon mesentery and serosa (p<0.000001, p<0.000001 and p=0.00002, respectively), retroperitoneal suprarenal lymphadenopathies and periportal lesions (both p=0.031). Following institutional operability criteria, WB-DWI/MRI showed better sensitivity for detection of disease extent compromising operability; mesenteric root infiltration (p=0.008), carcinomatosis of small bowel (p=0.002) and colon (p=0.016), high volumetric peritoneal disease load (p=0.004) and irresectable distant metastases (p=0.016). WB-DWI MRI correctly predicted complete cytoreduction in 93% patients undergoing cytoreductive surgery versus 40% for CT.

Conclusion

WB-DWI MRI showed higher accuracy compared with CT for recurrence detection while improving the sensitivity for staging and operability assessment of disease extent. WB-DWI MRI may be most valuable to select patients for surgical resection.

Authors’ Affiliations

(1)
Department of Radiology, Leuven Cancer Institute, University Hospitals Leuven
(2)
Department of Obstetrics and Gynaecology, Leuven Cancer Institute, University Hospitals Leuven
(3)
Department of Pathology, Leuven Cancer Institute, University Hospitals Leuven

Copyright

© Michielsen et al; licensee BioMed Central Ltd. 2014

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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