Comparison of the MRI and Integrated PET/CT Findings in the Preoperative Detection of Peritoneal Carcinomatosis Arising from Primary Ovarian Cancer

Abstract

Purpose:To compare the diagnostic performance of MRI and integrated PET/CT for the preoperative detection of peritoneal carcinomatosis arising from primary ovarian cancer. Materials and Methods: Twenty-three patients with suspected ovarian tumors underwent a contrast-enhanced 1.5 Tesla MRI and a 18F-fluorodeoxyglucose (FDG) PET/CT prior to surgery. The peritoneal cavity was subdivided into six specific sites for a lesion-based analysis. The imaging findings were compared statistically with the histopathological findings using McNemar's test with Bonferroni's adjustment and generalized estimation equations. Results:The histopathological results of all 23 patients were confirmed for primary malignant epithelial ovarian cancer. Of the 23 patients, 19 had a total of 83 sites with peritoneal seedings throughout the abdomen and pelvis. The comparison of the patient-based sensitivity, specificity and accuracy of the use of MRI versus PET/CT for the detection of peritoneal carcinomatosis were 95% versus 84% (p > 0.05; N.S.), 50% versus 50% (p > 0.05; N.S.), and 87% versus 78% (p > 0.05; N.S.), respectively. Moreover, the comparison of the lesion-based sensitivity, specificity and accuracy of MRI versus integrated PET/CT were 86% and 75% (p = 0.004), 76% and 84% (p > 0.05; N.S.), and 82% and 78% (p > 0.05; N.S.), respectively. Conclusion: We found that MRI was more sensitive than integrated PET/CT for the detection of preoperative peritoneal carcinomatosis arising from primary ovarian cancer.

Optimizing of preoperative computed tomography for diagnosis in patients with peritoneal carcinomatosis

“…MRI and spiral CT show similar accuracy in the detection of PC and PC size, spread and localization compared to CT. In a study by Kim et al it is showed that MRI achieves a sensitivity of 95% [ 30 ]. The mandatory long hold of breath proves to be difficult for many patients with tumors due to their generally weak condition.…”

“…The mandatory long hold of breath proves to be difficult for many patients with tumors due to their generally weak condition. This could lead to evaluation artifacts and diminish the quality of MRI depiction [ 30 ]. Another disadvantage is the existence of ascites which could also lead to artifacts using MRI and could often be the reason for high wrong positive-rates [ 30 ].…”

Extraovarian primary peritoneal carcinoma: staging with 18F-FDG PET/CT

“…18 F-FDG uptake in EOPPC was described initially in two small studies, however the pattern of FDG uptake was not described, and no distinction was made in the imaging characteristics between EOPPC and EOC patients [3,4]. Subsequent larger studies examining the role of 18 F-FDG PET or PET/CT in the evaluation of peritoneal carcinomatosis did not include any EOPPC patients [2,[25][26][27][28][29][30]. To date, the 18 F-FDG PET/CT imaging characteristics of EOPPC have never been described and the possibility of differentiating EOPPC from EOC based on patterns of 18 F-FDG distribution has not been investigated.…”

Imaging in ovarian Cancer

“…18 Kim CK et al (2009) have done a comparative study of MRI and integrated PET/CT for the preoperative detection of peritoneal carcinomatosis arising from primary ovarian cancer in 253 patients and has concluded that patient-based sensitivity, specificity and accuracy of the use of MRI versus PET/CT for the detection of peritoneal carcinomatosis were 95% versus 84%, 50% versus 50% and 87% versus 78% respectively. 19 Moreover, the comparison of the lesion-based sensitivity, specificity and accuracy of MRI versus integrated PET/CT were 86% and 75% , 76% and 84% , and 82% and 78% , respectively concluding that MRI was more sensitive that PET/CT for detection of peritoneal carcinomatosis.…”