Whole-body diffusion-weighted magnetic resonance imaging in the diagnosis of recurrent ovarian cancer: a clinical feasibility study

Abstract

WB-DWI/MRI allowed better detection of ovarian cancer recurrence and better prediction of complete resection than CT. Advances in knowledge: WB-DWI/MRI could assist in optimizing treatment planning for recurrent ovarian cancer, particularly by improving patient selection for salvage surgery, thus giving eligible patients the highest chance on prolonged survival and refraining patients who would not benefit from extensive surgery reducing related morbidity and mortality.

ESMO–ESGO consensus conference recommendations on ovarian cancer: pathology and molecular biology, early and advanced stages, borderline tumours and recurrent disease

“…Further to clinical examination and checking for symptoms, CA-125 is the simplest tool to trigger imaging and is a better approach than regular routine imaging for diagnosis of recurrent ovarian cancer [244,251]. Radiographic imaging, such as ultrasound, chest-abdomen-pelvis CT, whole-body MRI or PET-CT, should only be carried out if clinically indicated, based on symptoms, clinical examination or a rising CA-125 level [252][253][254][255]. Mucinous and clear cell ovarian cancers could represent a potential source of PET-negative findings [256].…”

Positive DESKTOP and Tian Scores Systems Are Adequate to Predict Optimal (R0) Secondary Debulking Surgery in Ovarian Cancer, But a Negative Score Does Not Preclude Secondary Surgery

“…Moreover, WB-DWI MRI correctly predicted complete resection in 94% of the patients eligible for SDS compared with 49% for CT (P G 0.001). 23 Our results indicate that other selection tools than the DESKTOP or Tian score should be considered when selecting patients for SDS, such as detailed WB-DWI MRI. …”

“…Whole-body DWI MRI showed greater accuracy in the characterization of primary tumors and peritoneal staging in patients with suspected ovarian cancer compared with CT or fluorodeoxyglucose PET/CT, and then CT in the recurrent setting. 22,23 A recent study 31,32 showed the superiority of WB-DWI MRI compared with CT as preoperative assessment of patients suspected of having ovarian cancer. 33 In this study, 151 females clinically suspected of having ovarian cancer underwent WB-DWI MRI in addition to contrast-enhanced CT. Whole-body DWI MRI showed a significantly higher accuracy than CT (93% vs 82%, P = 0.001) in predicting malignancy.…”

“…In that respect, we believe that other selection tools should be evaluated using detailed information on the site and extent of the disease as used at primary diagnosis. 22,23 …”

Current Possibilities of Magnetic – Resonance Imaging in Detection of Ovarian Cancer

“…Оценивая возможности ДВ МРТ в диагностике рецидива РЯ, отметим, что, например, в исследовании K. L. Michielsen et al была проведена оценка клинической целесообраз-ности применения ДВИ в диагностике и прогнозировании результатов резекции опухоли у больных с подозрением на рецидив РЯ [60]. Была обследована 51 пациентка с по-дозрением на рецидив опухоли, которым выполнялась ДВ МРТ в дополнение к КТ с контрастным усилением.…”