title: Whole-body diffusion-weighted magnetic resonance imaging in the diagnosis of recurrent ovarian cancer: a clinical feasibility study.
abstract: OBJECTIVE
  To assess the clinical feasibility of whole-body diffusion-weighted MRI (WB-DWI/MRI) for diagnosis and prediction of complete tumour resection in patients with suspected recurrent ovarian cancer.
  
  
  METHODS
  51 females clinically suspected for ovarian cancer recurrence underwent 3-T WB-DWI/MRI in addition to contrast-enhanced CT. WB-DWI/MRI was assessed for detection of tumour recurrence, prediction of tumour extent and complete resection compared with CT. Tumour presence was confirmed by pathology obtained by surgery or biopsy, or by imaging follow-up.
  
  
  RESULTS
  WB-DWI/MRI showed 94% accuracy for detecting ovarian cancer recurrence, compared with 78% for CT (p = 0.008). WB-DWI/MRI showed better sensitivity [% (95% confidence interval)] than CT for detecting involvement of surgically critical tumour sites including mesenteric root infiltration [92 (62-100) vs 31 (10-61)], small bowel [93 (64-100) vs 21 (6-51)], colon carcinomatosis [91 (57-100) vs 27 (7-61)] and unresectable distant metastases [90 (54-99) vs 20 (4-56)]. WB-DWI/MRI correctly predicted complete resection in 33 of 35 (94%) patients eligible for salvage surgery compared with 17 of 35 (49%) for CT (p < 0.001).
  
  
  CONCLUSIONS
  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.
authors: 1 Department of Imaging and Pathology, University Hospitals Leuven, Leuven, Belgium.
authors: Katrijn L M
authors: KL
authors: Michielsen
authors: 2 Department of Obstetrics and Gynaecology, Leuven Cancer Institute, University Hospitals Leuven, Leuven, Belgium.
authors: Ignace
authors: I
authors: Vergote
authors: 1 Department of Imaging and Pathology, University Hospitals Leuven, Leuven, Belgium.
authors: Raphaëla
authors: R
authors: Dresen
authors: 1 Department of Imaging and Pathology, University Hospitals Leuven, Leuven, Belgium.
authors: Katya
authors: K
authors: Op de Beeck
authors: 1 Department of Imaging and Pathology, University Hospitals Leuven, Leuven, Belgium.
authors: Ragna
authors: R
authors: Vanslembrouck
authors: 2 Department of Obstetrics and Gynaecology, Leuven Cancer Institute, University Hospitals Leuven, Leuven, Belgium.|3 Belgium and Center Gynaecological Oncology Amsterdam (CGOA), Antoni van Leeuwenhoek, Amsterdam, Netherlands.
authors: Frédéric
authors: F
authors: Amant
authors: 2 Department of Obstetrics and Gynaecology, Leuven Cancer Institute, University Hospitals Leuven, Leuven, Belgium.
authors: Karin
authors: K
authors: Leunen
authors: 1 Department of Imaging and Pathology, University Hospitals Leuven, Leuven, Belgium.
authors: Philippe
authors: P
authors: Moerman
authors: 4 Department of Public Health and Primary Care, University Hospitals Leuven, Leuven, Belgium.
authors: Steffen
authors: S
authors: Fieuws
authors: 1 Department of Imaging and Pathology, University Hospitals Leuven, Leuven, Belgium.
authors: Frederik
authors: F
authors: De Keyzer
authors: 1 Department of Imaging and Pathology, University Hospitals Leuven, Leuven, Belgium.
authors: Vincent
authors: V
authors: Vandecaveye
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D003287:Contrast Media; D038524:Diffusion Magnetic Resonance Imaging; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007483:Iothalamic Acid / Q000031:analogs & derivatives; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D010051:Ovarian Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D014283:Triiodobenzoic Acids; D051598:Whole Body Imaging
chemical_list: D003287:Contrast Media; D014283:Triiodobenzoic Acids; D007483:Iothalamic Acid; C002587:ioxitalamic acid; C044834:iodixanol