MRI with diffusion-weighted imaging to predict feasibility of complete cytoreduction with the peritoneal cancer index (PCI) in advanced stage ovarian cancer patients

被引:46
作者
Engbersen, M. P. [1 ,4 ]
van' t Sant, I [1 ]
Lok, C. [2 ]
Lambregts, D. M. J. [1 ]
Sonke, G. S. [3 ]
Beets-Tan, R. G. H. [1 ,4 ]
van Driel, W. J. [2 ]
Lahaye, M. J. [1 ]
机构
[1] Netherlands Canc Inst, Dept Radiol, POB 900203, NL-1006 BE Amsterdam, Netherlands
[2] Netherlands Canc Inst, Dept Gynecol, Ctr Gynecol Oncol Amsterdam, POB 900203, NL-1006 BE Amsterdam, Netherlands
[3] Netherlands Canc Inst, Dept Med Oncol, POB 900203, NL-1006 BE Amsterdam, Netherlands
[4] Maastricht Univ, Med Ctr, GROW Sch Oncol & Dev Biol, Maastricht, Netherlands
关键词
Cytoreductive surgery; Diffusion-weighted MRI; Advanced-stage ovarian cancer; Peritoneal carcinomatosis; HYPERTHERMIC INTRAPERITONEAL CHEMOTHERAPY; COMPUTED-TOMOGRAPHY; SURGERY; SURVIVAL; CT; LAPAROSCOPY; METASTASIS;
D O I
10.1016/j.ejrad.2019.03.007
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
Objectives: To determine the diagnostic performance of MRI with diffusion-weighted imaging (DW-MRI) in assessing the peritoneal tumor load and predicting whether a complete cytoreduction can be achieved in patients with epithelial ovarian cancer (EOC). Methods: For this observational prospective study, 25 patients with epithelial ovarian cancer scheduled for cytoreductive surgery were included. Patients underwent a 3 T DW-MRI scan prior to surgery. The MR protocol consisted of a T1 and T2 weighted, a contrast-enhanced T1 weighted, and a diffusion-weighted (b0, b1000) sequence. The Peritoneal Cancer Index (PCI) was determined on DW-MR images (MRI-PCI) by two readers, independently, and was compared to the PCI determined during surgery (S-PCI). The inter-observer agreement between the two radiologists was evaluated. In addition, receiver operating characteristics curves were calculated for predicting complete cytoreduction with the S-PCI and MRI-PCI. Results: Staging with DW-MRI showed a correlation to surgical staging with an intraclass correlation coefficient (ICC) 0.86 and 0.85 for reader 1 and 2, respectively. Inter-observer agreement was excellent with an ICC of 0.90 (95% CI: 0.64-0.96). The MRI-PCI scores of reader 1 (AUC = 0.96), reader 2 (AUC = 0.98), and the S-PCI (AUC = 0.92) showed similar predictive values for complete cytoreduction. Conclusion: DW-MRI is accurate in predicting the S-PCI and can be helpful to predict whether a complete resection in ovarian cancer patients is feasible.
引用
收藏
页码:146 / 151
页数:6
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