Julia Fehniger1, Stephen Thomas2, Ernst Lengyel1, Chuanhong Liao3, Meaghan Tenney1, Aytekin Oto2, S Diane Yamada4. 1. The University of Chicago Medicine, Section of Gynecologic Oncology, Department of Obstetrics and Gynecology, 5841 S. Maryland Avenue, MC 2050, Chicago, IL 60637, United States. 2. The University of Chicago Medicine, Department of Radiology, 5841 S. Maryland Avenue, MC 2026, Chicago, IL 60637, United States. 3. The University of Chicago, Department of Public Health Sciences, 5841 S. Maryland Avenue, MC 2000, Chicago, IL 60637, United States. 4. The University of Chicago Medicine, Section of Gynecologic Oncology, Department of Obstetrics and Gynecology, 5841 S. Maryland Avenue, MC 2050, Chicago, IL 60637, United States. Electronic address: sdyamada@uchicago.edu.
Abstract
OBJECTIVES: To evaluate and compare the ability of DW-MRI and CT to detect sites of peritoneal dissemination in gynecologic malignancies. The reproducibility of DW-MRI and CT interpretation between radiologists was also assessed. METHODS: Single institution prospective cohort study of women with suspected advanced gynecologic cancer who underwent surgical staging from 2010 to 2013. Participants underwent both DW-MRI and contrast-enhanced CT prior to surgery. Radiologists and surgeons were blinded, respectively, to surgical and DW-MRI results. The area under the receiver operator characteristic curve (AUC) was calculated for each disease site for CT and DW-MRI and compared to surgical findings. Kappa statistics quantified interobserver agreement between both radiologists. RESULTS: Twenty seven patients were enrolled. Mean age at surgery was 59years. Ninety percent of participants had stage IIIC/IV disease. For right diaphragm disease, the AUC for DW-MRI was 0.95 compared to 0.81 for CT. For left diaphragm disease, the AUC was 0.89 for DW-MRI compared to 0.74 for CT. The AUC was similar for DW-MRI and CT for omental disease (0.79 versus 0.64); the liver surface (0.61 versus 0.67); bowel mesentery (0.73 versus 0.64); and cul de sac (0.75 versus 0.64). Interobserver agreement for DW-MRI was greater than CT for omental, Morrison's pouch, liver surface, and right diaphragm disease. CONCLUSIONS: DW-MRI detects right diaphragmatic disease found at surgery with greater accuracy than CT. For other disease sites key to surgical planning, DW-MRI is equivalent to CT. Interobserver agreement was superior for a majority of disease sites evaluated by DW-MRI compared to CT.
OBJECTIVES: To evaluate and compare the ability of DW-MRI and CT to detect sites of peritoneal dissemination in gynecologic malignancies. The reproducibility of DW-MRI and CT interpretation between radiologists was also assessed. METHODS: Single institution prospective cohort study of women with suspected advanced gynecologic cancer who underwent surgical staging from 2010 to 2013. Participants underwent both DW-MRI and contrast-enhanced CT prior to surgery. Radiologists and surgeons were blinded, respectively, to surgical and DW-MRI results. The area under the receiver operator characteristic curve (AUC) was calculated for each disease site for CT and DW-MRI and compared to surgical findings. Kappa statistics quantified interobserver agreement between both radiologists. RESULTS: Twenty seven patients were enrolled. Mean age at surgery was 59years. Ninety percent of participants had stage IIIC/IV disease. For right diaphragm disease, the AUC for DW-MRI was 0.95 compared to 0.81 for CT. For left diaphragm disease, the AUC was 0.89 for DW-MRI compared to 0.74 for CT. The AUC was similar for DW-MRI and CT for omental disease (0.79 versus 0.64); the liver surface (0.61 versus 0.67); bowel mesentery (0.73 versus 0.64); and cul de sac (0.75 versus 0.64). Interobserver agreement for DW-MRI was greater than CT for omental, Morrison's pouch, liver surface, and right diaphragm disease. CONCLUSIONS: DW-MRI detects right diaphragmatic disease found at surgery with greater accuracy than CT. For other disease sites key to surgical planning, DW-MRI is equivalent to CT. Interobserver agreement was superior for a majority of disease sites evaluated by DW-MRI compared to CT.
Authors: Jack W Power; Philip J Dempsey; Andrew Yates; Helen Fenlon; Jurgen Mulsow; Conor Shields; Carmel G Cronin Journal: Br J Radiol Date: 2021-12-08 Impact factor: 3.629
Authors: Jan Bednarsch; Zoltan Czigany; Daniel Heise; Henning Zimmermann; Joerg Boecker; Tom Florian Ulmer; Ulf Peter Neumann; Christian Klink Journal: World J Surg Oncol Date: 2020-01-31 Impact factor: 2.754