Volume 14 Supplement 1
Whole-body diffusion-weighted MRI versus CT for detection, restaging and operability assessment of recurrent ovarian carcinoma
© Michielsen et al; licensee BioMed Central Ltd. 2014
Published: 9 October 2014
To evaluate whole body diffusion-weighted MR imaging (WB-DWI MRI) for detection, staging and operability assessment in recurrent ovarian cancer compared with CT.
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.
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.
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.
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.