Diffusion-weighted magnetic resonance imaging in peritoneal carcinomatosis from suspected ovarian cancer: Diagnostic performance in correlation with surgical findings

Abstract

INTRODUCTION: Ovarian Cancer (OC) is the first death cause by gynaecological cancer in developed countries and the third cause of gynaecological cancer in the world. Detecting irresectable disease is crucial to select surgical candidates and Peritoneal Carcinomatosis (PC) depiction helps to get a complete debulking without residual disease >1cm, the best prognostic predictor in advanced OC. CT is the elective technique for abdominal imaging, although its accuracy for PC in OC and cytoreduction success prediction ability is limited. PET/CT is considered for systemic evaluation in OC however, it is not a reference standard for PC. PC presents as high signal foci in DWI, with higher contrast than conventional MRI. Whole Body DWI with Background Suppression MRI (WB-DWIBS/MRI) combines conventional anatomic with Diffusion Weighted Imaging (DWI). This study aims to assess the diagnostic performance and tumour burden correlation of WB-DWIBS/MRI in ovarian PC using PCI, referred to cytoreduction surgery as standard reference. MATERIAL AND METHODS: Our local ethical board approved this prospective study and all participants signed written informed consent. 50 out of 217 consecutive patients with disseminated primary or recurrent OC were eligible for cytoreduction and WB-DWIBS/MRI. Peritoneal Cancer Index (PCI) scores (0-3) tumour burden in 13 anatomical regions, hence global ranging 0-39. Two radiologists (R1 and R2) preoperatively assessed PCI and the gynaecologic-oncologist team after. Diagnostic performance was calculated for each of the PCI regions and globally. We evaluated interobserver agreement using Cohen´s Kappa, statistic differences with the *Manuscript containing Abstract, Sections and References (Without corresponding author details) Click here to view linked References

Clinical Utility of Preoperative Assessment in Ovarian Cancer Cytoreduction

“…This study found that MRI was useful in determining the PCI and that it may have a role in predicting successful cytoreduction, but this study was limited with only 25 participants [76]. A second study had similar findings in a slightly larger sample of 50 patients, but further research is needed prior to expanding the role of MRI in the diagnosis and management of ovarian cancer [77].…”

Fuzzy C-Means Clustering Algorithm-Based Magnetic Resonance Imaging Image Segmentation for Analyzing the Effect of Edaravone on the Vascular Endothelial Function in Patients with Acute Cerebral Infarction

“…MCR [ 10 ] and objective evaluation index KI [ 11 ] are adopted to analyze the accuracy of algorithm segmentation. Among them, the calculation method of MCR is MCR=( M / T ), where M represents the number of misclassified pixels, and N represents the total number of pixels in the image.…”

Imaging of Gastric Carcinomatosis

“…Both MRI and PET/CT have been shown to be useful in the preoperative staging of peritoneal metastases. In particular, diffusion MRI has been shown to provide better diagnostic performance than CT or PET/CT, with good correlation with surgical PCI [56,57]. However, both imaging modalities have limitations.…”