Katrijn Michielsen PhD, Presenter: Nothing to Disclose

Ignace Vergote MD, PhD, Abstract Co-Author: Nothing to Disclose

Katya Op de beeck MD, Abstract Co-Author: Nothing to Disclose

Frederic Amant MD, PhD, Abstract Co-Author: Nothing to Disclose

Karin Leunen MD, Abstract Co-Author: Nothing to Disclose

Steven Dymarkowski MD, Abstract Co-Author: Nothing to Disclose

Philippe Moerman MD, PhD, Abstract Co-Author: Nothing to Disclose

Frederik De Keyzer, Abstract Co-Author: Nothing to Disclose

Vincent Ronny Andre Vandecaveye MD, Abstract Co-Author: Nothing to Disclose

To evaluate whole body diffusion-weighted imaging (WB-DWI/MRI) for detection, staging and operability assessment in recurrent ovarian cancer compared with computed tomography (CT).

Fifty-one women suspected for recurrent ovarian cancer underwent 3 Tesla WB-DWI/MRI using 2 b-values (b=0-1000 s/mm²), T2- and contrast T1-weighted sequences in addition to CT. WB-DWI/MRI and CT were compared for detection of tumor recurrence on a per-patient basis, detection of disease extent on a per-site basis including peritoneal, serosal, retroperitoneal, periportal and distant metastases and for detection of disease extent according to reported institutional operability criteria (Vergote et al, Gynaecol Oncol 2013). Imaging findings were correlated with surgical/pathological findings or imaging follow-up for at least 6 months.

According to the reference standard, recurrence was confirmed in 48/51 patients. WB-DWI/MRI showed 94% accuracy for detecting recurrence, compared with 78% for CT. Per-site analysis showed significantly higher sensitivity of WB-DWI/MRI over CT for assessing disease extent of the peritoneum, small bowel and colon mesentery and serosa (91 versus 46%, p<0.000001; 96 versus 56%, p<0.000001 and 88 versus 38%, p=0.00002), retroperitoneal suprarenal lymphadenopathies (100 versus 14%, p=0.031) and periportal lesions (73 versus 18%, p=0.031). Following institutional operability criteria, WB-DWI/MRI showed better sensitivity for detection of disease extent compromising operability; mesenteric root infiltration (92 versus 31%, p=0.008), carcinomatosis of small bowel (93 versus 21%, p=0.002) and colon (91 versus 27%, p=0.016), high volumetric peritoneal disease load (100 versus 50%, p=0.004) and irresectable distant metastases (90 versus 20%, p=0.016). WB-DWI/MRI correctly predicted complete cytoreduction in 93% patients undergoing cytoreductive surgery compared with 40% for CT.

WB-DWI/MRI showed higher accuracy compared with CT for recurrence detection while improving the sensitivity for staging and operability assessment of disease extent. WB-DWI/MRI may be most valuable to select patients for surgical resection.

WB-DWI/MRI may be of added value to CT for selecting women with recurrent ovarian cancer for complete cytoreductive surgery.

Michielsen, K, Vergote, I, Op de beeck, K, Amant, F, Leunen, K, Dymarkowski, S, Moerman, P, De Keyzer, F, Vandecaveye, V, The Value of Whole Body Diffusion-weighted MRI for Detection, Restaging and Evaluation of Operability in Recurrent Ovarian Carcinoma as Compared with CT.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14007038.html