OBJECTIVE: To assess the clinical feasibility of whole-body diffusion-weighted MRI (WB-DWI/MRI) for diagnosis and prediction of complete tumour resection in patients with suspected recurrent ovarian cancer. METHODS: 51 females clinically suspected for ovarian cancer recurrence underwent 3-T WB-DWI/MRI in addition to contrast-enhanced CT. WB-DWI/MRI was assessed for detection of tumour recurrence, prediction of tumour extent and complete resection compared with CT. Tumour presence was confirmed by pathology obtained by surgery or biopsy, or by imaging follow-up. RESULTS: WB-DWI/MRI showed 94% accuracy for detecting ovarian cancer recurrence, compared with 78% for CT (p = 0.008). WB-DWI/MRI showed better sensitivity [% (95% confidence interval)] than CT for detecting involvement of surgically critical tumour sites including mesenteric root infiltration [92 (62-100) vs 31 (10-61)], small bowel [93 (64-100) vs 21 (6-51)], colon carcinomatosis [91 (57-100) vs 27 (7-61)] and unresectable distant metastases [90 (54-99) vs 20 (4-56)]. WB-DWI/MRI correctly predicted complete resection in 33 of 35 (94%) patients eligible for salvage surgery compared with 17 of 35 (49%) for CT (p < 0.001). CONCLUSION: WB-DWI/MRI allowed better detection of ovarian cancer recurrence and better prediction of complete resection than CT. Advances in knowledge: WB-DWI/MRI could assist in optimizing treatment planning for recurrent ovarian cancer, particularly by improving patient selection for salvage surgery, thus giving eligible patients the highest chance on prolonged survival and refraining patients who would not benefit from extensive surgery reducing related morbidity and mortality.
OBJECTIVE: To assess the clinical feasibility of whole-body diffusion-weighted MRI (WB-DWI/MRI) for diagnosis and prediction of complete tumour resection in patients with suspected recurrent ovarian cancer. METHODS: 51 females clinically suspected for ovarian cancer recurrence underwent 3-T WB-DWI/MRI in addition to contrast-enhanced CT. WB-DWI/MRI was assessed for detection of tumour recurrence, prediction of tumour extent and complete resection compared with CT. Tumour presence was confirmed by pathology obtained by surgery or biopsy, or by imaging follow-up. RESULTS:WB-DWI/MRI showed 94% accuracy for detecting ovarian cancer recurrence, compared with 78% for CT (p = 0.008). WB-DWI/MRI showed better sensitivity [% (95% confidence interval)] than CT for detecting involvement of surgically critical tumour sites including mesenteric root infiltration [92 (62-100) vs 31 (10-61)], small bowel [93 (64-100) vs 21 (6-51)], colon carcinomatosis [91 (57-100) vs 27 (7-61)] and unresectable distant metastases [90 (54-99) vs 20 (4-56)]. WB-DWI/MRI correctly predicted complete resection in 33 of 35 (94%) patients eligible for salvage surgery compared with 17 of 35 (49%) for CT (p < 0.001). CONCLUSION:WB-DWI/MRI allowed better detection of ovarian cancer recurrence and better prediction of complete resection than CT. Advances in knowledge: WB-DWI/MRI could assist in optimizing treatment planning for recurrent ovarian cancer, particularly by improving patient selection for salvage surgery, thus giving eligible patients the highest chance on prolonged survival and refraining patients who would not benefit from extensive surgery reducing related morbidity and mortality.
Authors: Rafli van de Laar; Leon F A G Massuger; Toon Van Gorp; Joanna IntHout; Petra L M Zusterzeel; Roy F P M Kruitwagen Journal: Gynecol Oncol Date: 2015-02-10 Impact factor: 5.482
Authors: Isabelle Thomassin-Naggara; Irwin Toussaint; Nicolas Perrot; Roman Rouzier; Charles A Cuenod; Marc Bazot; Emile Daraï Journal: Radiology Date: 2010-12-30 Impact factor: 11.105
Authors: R van de Laar; J IntHout; T Van Gorp; S Verdonschot; A M van Altena; C G Gerestein; L F A G Massuger; P L M Zusterzeel; R F P M Kruitwagen Journal: Br J Cancer Date: 2013-11-19 Impact factor: 7.640