Volume 15 Supplement 1

Proceedings of the International Cancer Imaging Society (ICIS) 15th Annual Teaching Course

Open Access

Tumour characterisation, staging and operability assessment in ovarian carcinoma: whole body diffusion-weighted MRI versus CT

  • K Michielsen1Email author,
  • I Vergote2,
  • R Vanslembrouck1,
  • E Mussen1,
  • F Amant2,
  • K Leunen2,
  • P Moerman3,
  • S Fieuws4,
  • F De Keyzer1,
  • G Souverijns5,
  • S Dymarkowski1 and
  • V Vandecaveye1
Cancer Imaging201515(Suppl 1):P40

https://doi.org/10.1186/1470-7330-15-S1-P40

Published: 2 October 2015

Aim

To prospectively evaluate whole body diffusion-weighted MRI (WB-DWI/MRI) for tumour characterisation, staging and prediction of complete (R0)-resection compared with computed tomography (CT) in patients with suspected ovarian carcinoma.

Methods

One-hundred-sixty-six patients suspected for ovarian carcinoma underwent 3T WB-DWI/MRI using 2 b-values (b=0-1000 s/mm2), T2-weighted and contrast-enhanced T1-weighted sequences in addition to contrast-enhanced CT. WB-DWI/MRI and CT were independently and blindly evaluated and correlated with pathological findings at surgery as reference standard. Superiority was assessed using two-tailed McNemar tests for following parameters: characterisation of the malignant nature and primary origin of the ovarian mass, assessment of disease extent according to FIGO stage and prediction of R0-resection according to predefined operability criteria. Inter observer agreement for WB-DWI/MRI and CT was determined using Cohen’s kappa statistics.

Results

For characterisation of malignancy, WB-DWI/MRI showed significantly higher accuracy compared with CT (93 versus 82%, p=0.001). WB-DWI/MRI correctly depicted a non-ovarian malignant mass in 24/32 (75%) of cases compared to only 6/32 (19%) for CT (p<0.001). WB-DWI/MRI assigned more ovarian carcinoma patients to the correct FIGO stage (71/94, 76%) compared with CT (39/94, 41%). For prediction of R0-resection, WB-DWI/MRI showed significantly higher sensitivity (95 versus 80%), specificity (92 versus 74%) and accuracy (94 versus 77%) compared with CT (p=0.039, p=0.012 and p<0.001, respectively). Interobserver agreement was moderate to almost perfect (κ=0.53-1.00) for WB-DWI/MRI and slight to moderate (κ=0.04-0.52) for CT.

Conclusion

WB-DWI/MRI is superior to CT for lesion characterisation, staging and operability assessment of ovarian cancer justifying its development for pre-operative assessment of ovarian cancer patients.

Authors’ Affiliations

(1)
Department of Radiology, Leuven Cancer Institute, University Hospitals Leuven
(2)
Department of Obstetrics and Gynaecology, Division of Gynaecologic Oncology, Leuven Cancer Institute, University Hospitals Leuven
(3)
Department of Pathology, Leuven Cancer Institute, University Hospitals Leuven
(4)
Department of Public Health and Primary Care, Leuven Cancer Institute, University Hospitals Leuven
(5)
Department of Radiology, Jessa Hospitals

Copyright

© Michielsen et al. 2015

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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