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01-04-2014 | Urogenital

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

Authors: Katrijn Michielsen, Ignace Vergote, Katya Op de beeck, Frederic Amant, Karin Leunen, Philippe Moerman, Christophe Deroose, Geert Souverijns, Steven Dymarkowski, Frederik De Keyzer, Vincent Vandecaveye

Published in: European Radiology | Issue 4/2014

Abstract

Objectives

To evaluate whole-body MRI with diffusion-weighted sequence (WB-DWI/MRI) for staging and assessing operability compared with CT and FDG-PET/CT in patients with suspected ovarian cancer.

Methods

Thirty-two patients underwent 3-T WB-DWI/MRI, ¹⁸ F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) and CT before diagnostic open laparoscopy (DOL). Imaging findings for tumour characterisation, peritoneal and retroperitoneal staging were correlated with histopathology after DOL and/or open surgery. For distant metastases, FDG-PET/CT or image-guided biopsies were the reference standards. For tumour characterisation and peritoneal staging, WB-DWI/MRI was compared with CT and FDG-PET/CT. Interobserver agreement for WB-DWI/MRI was determined.

Results

WB-DWI/MRI showed 94 % accuracy for primary tumour characterisation compared with 88 % for CT and 94 % for FDG-PET/CT. WB-DWI/MRI showed higher accuracy of 91 % for peritoneal staging compared with CT (75 %) and FDG-PET/CT (71 %). WB-DWI/MRI and FDG-PET/CT showed higher accuracy of 87 % for detecting retroperitoneal lymphadenopathies compared with CT (71 %). WB-DWI/MRI showed excellent correlation with FDG-PET/CT (κ = 1.00) for detecting distant metastases compared with CT (κ = 0.34). Interobserver agreement was moderate to almost perfect (κ = 0.58–0.91).

Conclusions

WB-DWI/MRI shows high accuracy for characterising primary tumours, peritoneal and distant staging compared with CT and FDG-PET/CT and may be valuable for assessing operability in ovarian cancer patients.

Key Points

• Whole-body MRI with diffusion weighting (WB-DWI/MRI) helps to assess the operability of suspected ovarian cancer.

• Interobserver agreement is good for primary tumour characterisation, peritoneal and distant staging.

• WB-DWI/MRI improves mesenteric/serosal metastatic spread assessment compared with CT and FDG-PET/CT.

• Retroperitoneal/cervical-thoracic nodal staging using qualitative DWI criteria was reasonably accurate.

• WB-DWI/MRI and FDG-PET/CT showed the highest diagnostic impact for detecting thoracic metastases.

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Title: 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
Authors: Katrijn Michielsen
Ignace Vergote
Katya Op de beeck
Frederic Amant
Karin Leunen
Philippe Moerman
Christophe Deroose
Geert Souverijns
Steven Dymarkowski
Frederik De Keyzer
Vincent Vandecaveye
Publication date: 01-04-2014
Publisher: Springer Berlin Heidelberg
Published in: European Radiology / Issue 4/2014
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-013-3083-8

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

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

Abstract

Objectives

Methods

Results

Conclusions

Key Points

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

Key Points

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