title: Prospective evaluation of contrast-enhanced MRI in the depiction of peritoneal spread in primary or recurrent ovarian cancer.
abstract: The purpose of this study was to assess the accuracy of MRI in the staging of intra-abdominal tumor seeding of ovarian carcinoma. Fifty-seven patients with suspected primary or recurrent ovarian carcinoma were included in this study. All patients received laparotomy within 8 weeks after MRI. The MRI protocol included fat-saturated T1-weighted spin-echo (SE) sequences pre- and post i.v. application of gadopentetate dimeglumine. The criteria for tumor manifestation was contrast enhancement of intra-abdominal soft tissue lesions or peritoneum. The image review was performed by a blinded radiologist, a specialist in gynecological and abdominal MR imaging. Results were compared with findings during laparotomy. Sensitivity, specificity, positive and negative predictive values, and corresponding 95% confidence intervals were calculated for single intra-abdominal locations and for groups of locations defined according to surgical strategies for intra-abdominal cytoreduction. Laparotomy and histopathology confirmed 251 abdominal tumor locations. Sensitivity was high in lower pelvis locations (73-83%) except for ureter or bladder infiltration (40%). Bowel or mesentery locations displayed sensitivity values from 73 to 77%. Sensitivity was very low for pelvic lymph nodes (28%), greater omentum (38%), and lesser sac (43%). Magnetic resonance imaging based on contrast-enhanced fat-saturated T1 SE sequences improves planning of cytoreduction preceding chemotherapy in advanced primary or relapsed ovarian carcinoma.
authors.affiliation: Department of Radiology, Charité Virchow-Klinikum, Medical Faculty, Humboldt University, Augustenburgerplatz 1, 13353 Berlin, Germany. jens@charite.de
authors.forename: Jens
authors.initials: J
authors.lastname: Ricke
authors.forename: Jalid
authors.initials: J
authors.lastname: Sehouli
authors.forename: Constanze
authors.initials: C
authors.lastname: Hach
authors.forename: Enrique Lopez
authors.initials: EL
authors.lastname: Hänninen
authors.forename: Werner
authors.initials: W
authors.lastname: Lichtenegger
authors.forename: Roland
authors.initials: R
authors.lastname: Felix
mesh_terms: D000008:Abdominal Neoplasms / Q000175:diagnosis / Q000556:secondary; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D005189:False Positive Reactions; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000175:diagnosis / Q000556:secondary; D005833:Genital Neoplasms, Female / Q000175:diagnosis / Q000556:secondary; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis / Q000556:secondary; D008207:Lymphatic Metastasis; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D016609:Neoplasms, Second Primary; D010051:Ovarian Neoplasms / Q000175:diagnosis / Q000473:pathology*; D010386:Pelvic Neoplasms / Q000175:diagnosis / Q000556:secondary; D010534:Peritoneal Neoplasms / Q000175:diagnosis / Q000556:secondary*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011856:Radiographic Image Enhancement; D012680:Sensitivity and Specificity; D016037:Single-Blind Method; D016387:Women's Health
chemical_list: D003287:Contrast Media