Value of 3T diffusion weighted MRI in comparison with CECT in detection of ovarian cancer and ovarian cancer recurrence

Authors

  • Härmä Kirsi Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Switzerland
  • Sipola Petri J Departments of Clinical Radiology, Kuopio University Hospital, Kuopio, Finland
  • Vainio Pauli Departments of Clinical Radiology, Kuopio University Hospital, Kuopio, Finland
  • Pelkonen Outi Departments of Clinical Radiology, Kuopio University Hospital, Kuopio, Finland
  • Rautiainen Suvi Departments of Clinical Radiology, Kuopio University Hospital, Kuopio, Finland
  • Anttila Maarit Departments of Gynaecology, Kuopio University Hospital, Kuopio, Finland
  • Ritva L Vanninen Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland

Abstract

Purpose: To investigate the value of 3T diffusion weighted magnetic resonance imaging (DW-MRI)
compared to contrast enhanced computed tomography (CECT), in the preoperative staging of patients
with suspected ovarian cancer (OC) or with suspected recurrence of ovarian cancer (ROC).
Materials and methods: Thirty-two women (mean age 65 ± 14) with suspected (n = 23) or recurrent
(n = 9) ovarian cancer were included prospectively in a single center study. CECT and abdominal 3T
DW-MRI were performed. Both methods were used to independently score the presence of 1) ovarian
tumor, 2) peritoneal or omental carcinomatosis, 3) pathological lymph nodes (LN), along with 4) liver
parenchymal, 5) liver capsular, 6) diaphragmatic, and 7) extra-abdominal metastases. Findings were
scored as: 0=benign, 1=suspicious for malignancy, or 2=definitely malignant. In addition, the lowest
ADC values were measured in existing primary tumors. The extent of disease burden and correlation to
histopathological findings were analyzed.
Results: The mean disease score was higher in DW-MRI than in CT (4.9 ± 2.6 vs. 3.5 ± 2.2, P < 0.001).
Compared to CT, DW-MRI depicted more LN (P = 0.001) and diaphragmatic (P = 0.024) lesions. The
lowest ADC values were significantly lower in malignant tumors (n = 18) than in benign tumors (n = 5)
(0.640 x10-3mm2/s ± 159 vs. 0.992 x10-3mm2/s ± 218, P = 0.002).
Conclusion: The results of our prospective single center study show incremental value of abdominal
3T DW-MRI in comparison with CECT, especially in detecting diaphragmatic and peritoneal ovarian
cancer metastases, excluding lymph nodal metastases and in differentiating malignant adnexal tumors
from benign.

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Published

2021-05-05

Issue

Vol. 1 No. 2

Section

Articles