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BMC Cancer
Published in: BMC Cancer 1/2023

Open Access 01-12-2023 | Ovarian Cancer | Research

Neoadjuvant chemotherapy induces an elevation of tumour apparent diffusion coefficient values in patients with ovarian cancer

Authors: Milja Reijonen, Erikka Holopainen, Otso Arponen, Mervi Könönen, Ritva Vanninen, Maarit Anttila, Hanna Sallinen, Irina Rinta-Kiikka, Auni Lindgren

Published in: BMC Cancer | Issue 1/2023

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Abstract

Objectives

Multiparametric magnetic resonance imaging (mMRI) is the modality of choice in the imaging of ovarian cancer (OC). We aimed to investigate the feasibility of different types of regions of interest (ROIs) in the measurement of apparent diffusion coefficient (ADC) values of diffusion-weighted imaging in OC patients treated with neoadjuvant chemotherapy (NACT).

Methods

We retrospectively enrolled 23 consecutive patients with advanced OC who had undergone NACT and mMRI. Seventeen of them had been imaged before and after NACT. Two observers independently measured the ADC values in both ovaries and in the metastatic mass by drawing on a single slice of (1) freehand large ROIs (L-ROIs) covering the solid parts of the whole tumour and (2) three small round ROIs (S-ROIs). The side of the primary ovarian tumour was defined. We evaluated the interobserver reproducibility and statistical significance of the change in tumoural pre- and post-NACT ADC values. Each patient’s disease was defined as platinum-sensitive, semi-sensitive, or resistant. The patients were deemed either responders or non-responders.

Results

The interobserver reproducibility of the L-ROI and S-ROI measurements ranged from good to excellent (ICC range: 0.71–0.99). The mean ADC values were significantly higher after NACT in the primary tumour (L-ROI p  < 0.001, S-ROIs p < 0.01), and the increase after NACT was associated with sensitivity to platinum-based chemotherapy. The changes in the ADC values of the omental mass were associated with a response to NACT.

Conclusion

The mean ADC values of the primary tumour increased significantly after NACT in the OC patients, and the amount of increase in omental mass was associated with the response to platinum-based NACT. Our study indicates that quantitative analysis of ADC values with a single slice and a whole tumour ROI placement is a reproducible method that has a potential role in the evaluation of NACT response in patients with OC.

Trial registration

Retrospectively registered (institutional permission code: 5302501; date of the permission: 31.7.2020).
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Metadata
Title
Neoadjuvant chemotherapy induces an elevation of tumour apparent diffusion coefficient values in patients with ovarian cancer
Authors
Milja Reijonen
Erikka Holopainen
Otso Arponen
Mervi Könönen
Ritva Vanninen
Maarit Anttila
Hanna Sallinen
Irina Rinta-Kiikka
Auni Lindgren
Publication date
01-12-2023
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2023
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/s12885-023-10760-2

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