Whole-body MRI with diffusion-weighted sequence for staging of patients with suspected ovarian cancer: a clinical feasibility study in comparison to CT and FDG-PET/CT

Michielsen, Koen; Vergote, Ignace; Beeck, Ken Op de; Amant, Frédéric; Leunen, Karin; Moerman, Philippe; Deroose, Christophe M.; Souverijns, Geert; Dymarkowski, Steven; Keyzer, Frederik De; Vandecaveye, Vincent

doi:10.1007/s00330-013-3083-8

Cited by 197 publications

(169 citation statements)

References 46 publications

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“…With simultaneous PET/MR imaging being a novel technique, few studies have investigated it. Comparing the diagnostic accuracy of whole-body DWI and MR imaging with that of PET/CT for tumor staging, Michielsen et al reported an equivalent diagnostic accuracy for characterization of primary ovarian cancers and detection of lymph nodes and distant metastases yet also revealed the superiority of DWI and MR imaging for detecting and characterizing peritoneal lesions (9). Similar results were shown by Soussan et al, who found that DWI and MR imaging are superior to PET/CT for detecting peritoneal implants in the right supramesocolic area (7).…”

Section: Discussionmentioning

confidence: 99%

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Diagnostic Value of Diffusion-Weighted Imaging in Simultaneous ¹⁸F-FDG PET/MR Imaging for Whole-Body Staging of Women with Pelvic Malignancies

et al. 2014

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The aim of this study was to assess the diagnostic benefit of diffusion-weighted imaging (DWI) in an 18 F-FDG PET/MR imaging protocol for whole-body staging of women with primary or recurrent malignancies of the pelvis. Methods: Forty-eight patients with a primary pelvic malignancy or suspected recurrence of a pelvic malignancy were included in our study. All patients underwent a whole-body 18 F-FDG PET/MR imaging examination that included DWI. Two radiologists separately evaluated the PET/MR imaging datasets without DWI followed by a second interpretation with DWI. First, both readers identified all primary tumors, as well as lymph node and distant metastases. In a second session, PET and DWI data were assessed qualitatively. Image interpretation comprised lesion conspicuity defined as visual lesion-to-background contrast (4-point ordinal scale) and diagnostic confidence (3-point ordinal scale) for all tumors. The results from histopathologic examination and cross-sectional imaging follow-up ($6 mo) were used as the reference standard. Statistical analysis was performed to assess the significance of differences between obtained values. Results: Among the 122 suspected lesions seen, 98 (80.3%) were considered malignant. PET/MR imaging without DWI had a sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of 92.9%, 87.5%, 96.8%, 75.0%, and 91.8%, respectively, for the detection of malignant lesions. PET/MR imaging with DWI had slightly higher values (94.9%, 83.3%, 95.9%, 80.0%, and 92.6%, respectively), but the difference was not significant (P . 0.05). In the qualitative assessment of lesion-to-background contrast, PET had significantly (P , 0.05) higher values (3.79 ± 0.58) than DWI (3.63 ± 0.77). Furthermore, significantly (P , 0.05) higher scores were found for diagnostic confidence using PET (2.68 ± 0.64) for the determination of malignant lesions, when compared with DWI (2.53 ± 0.69). Conclusion: DWI in PET/MR imaging has no diagnostic benefit for whole-body staging of women with pelvic malignancies. The omission of DWI for staging or restaging gynecologic cancer may significantly reduce examination times, thus increasing patient comfort without a relevant decrease in diagnostic competence.

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Section: Discussionmentioning

confidence: 99%

“…The use of integrated PET/CT has become well established within the last decade for whole-body staging in oncologic patients (6). Various studies investigating the diagnostic capacity of DWI or MR imaging and of PET/CT have reported comparable results for detection and characterization of tumors, including gynecologic malignancies (7)(8)(9).…”

mentioning

confidence: 99%

Diagnostic Value of Diffusion-Weighted Imaging in Simultaneous ¹⁸F-FDG PET/MR Imaging for Whole-Body Staging of Women with Pelvic Malignancies

et al. 2014

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“…Diagnostic imaging is used to determine the suitability of the patient for surgery by assessing the primary tumor or by describing the disease volume and extent (7,8). DWI, as a functional MRI technique, provides non-invasive and high-resolution information on tissue characteristics based on molecular water diffusion properties, and the imaging output is useful to determine tissue microstructure, density, microcirculation and cellular organization (9,11,33). Several studies describe a close association between cell density and ADC values (16,(33)(34)(35).…”

Section: Discussionmentioning

confidence: 99%

“…Diffusion weighted imaging (DWI) is a non-invasive technique based on molecular water diffusion properties, and may be used to characterize tissue architecture based on microstructure, cellular density, microcirculation and cell organization (9)(10)(11). DWI has been demonstrated to be more accurate compared with computed tomography (CT) for characterizing the sites of implants of ovarian cancers, including metastases to the liver, lungs, kidneys, uterus and pancreas (12,13).…”

Section: Introductionmentioning

confidence: 99%

Diffusion weighted imaging for the differential diagnosis of benign vs. malignant ovarian neoplasms

et al. 2016

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Abstract. In order to assess the diagnostic accuracy of diffusion weighted imaging (DWI) in differentiating between benign and malignant ovarian neoplasms, a systemic meta-analysis was conducted. Relevant studies were retrieved from scientific literature databases, including the PubMed, Wiley, EBSCO, Ovid, Web of Science, Wanfang, China National Knowledge Infrastructure and VIP databases. Following a multi-step screening and study selection process, the relevant data was extracted for use in the present study. Statistical analyses were performed using Meta-disc software version 1.4 and STATA statistical software version 12.0. A total of 285 articles were retrieved from the database searches. Following a careful screening process, 10 case-control studies were selected for the present meta-analysis. The 10 studies investigated the efficacy of DWI in diagnosing ovarian neoplasms, and included a combined total of 1,159 subjects, of which 559 patients had malignant lesions and 600 had benign lesions. The results showed that the pooled sensitivity, pooled specificity, pooled positive likelihood ratio, pooled negative likelihood ratio, pooled diagnostic odds ratio (DOR) and area under the curve of the summary receiver operating characteristics curve of DWI for differentiating between benign and malignant ovarian neoplasms were 0. 93, 0.89, 7.58, 0.10, 85.33 and 0.95, respectively

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“…Thus, any other extra-abdominal localization as well as abdominal intraparenchymal and retroperitoneal metastases cannot be assessed. The value of this approach consists in the fact that a) most AEOC cases have trans-celomatic diffusion, which is the key point for surgical debulking and finally prognosis, b) standard imaging techniques have a high false negative rate in term of intraperitoneal staging [4].…”

Section: First Perspectivementioning

confidence: 99%

The role of laparoscopy in evaluating cytoreduction in advanced ovarian cancer

Fagotti

Scambia

Pignata

et al. 2017

CBN

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Whole-body MRI with diffusion-weighted sequence for staging of patients with suspected ovarian cancer: a clinical feasibility study in comparison to CT and FDG-PET/CT

Cited by 197 publications

References 46 publications

Diagnostic Value of Diffusion-Weighted Imaging in Simultaneous ¹⁸F-FDG PET/MR Imaging for Whole-Body Staging of Women with Pelvic Malignancies

Diagnostic Value of Diffusion-Weighted Imaging in Simultaneous ¹⁸F-FDG PET/MR Imaging for Whole-Body Staging of Women with Pelvic Malignancies

Diffusion weighted imaging for the differential diagnosis of benign vs. malignant ovarian neoplasms

The role of laparoscopy in evaluating cytoreduction in advanced ovarian cancer

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Whole-body MRI with diffusion-weighted sequence for staging of patients with suspected ovarian cancer: a clinical feasibility study in comparison to CT and FDG-PET/CT

Cited by 197 publications

References 46 publications

Diagnostic Value of Diffusion-Weighted Imaging in Simultaneous 18F-FDG PET/MR Imaging for Whole-Body Staging of Women with Pelvic Malignancies

Diagnostic Value of Diffusion-Weighted Imaging in Simultaneous 18F-FDG PET/MR Imaging for Whole-Body Staging of Women with Pelvic Malignancies

Diffusion weighted imaging for the differential diagnosis of benign vs. malignant ovarian neoplasms

The role of laparoscopy in evaluating cytoreduction in advanced ovarian cancer

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Product

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Diagnostic Value of Diffusion-Weighted Imaging in Simultaneous ¹⁸F-FDG PET/MR Imaging for Whole-Body Staging of Women with Pelvic Malignancies

Diagnostic Value of Diffusion-Weighted Imaging in Simultaneous ¹⁸F-FDG PET/MR Imaging for Whole-Body Staging of Women with Pelvic Malignancies