Assessment of peritoneal metastases with DW-MRI,CT, and FDG PET/CT before cytoreductive surgery for advanced stage epithelial ovarian cancer |
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| Affiliation: | 1. Department of Gynecology and Obstetrics, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark;2. Open Patient Explorative Data Network, Department of Clinical Research, University of Southern Denmark, J.B. Winsløws Vej 9 a, 3. Etage, 5000, Odense C, Denmark;3. Department of Clinical Research, University of Southern Denmark, J.B. Winsløvs Vej 15, 5000, Odense C, Denmark;4. Department of Gynecology and Obstetrics, Odense University Hospital, J. B. Winsløws Vej 4, 5000, Odense, Denmark;5. Department of Radiology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark;6. Department of Nuclear Medicine & PET Center, Aarhus University Hospital, Palle Juul-Jensens Boulevard 165, 8200, Aarhus N, Denmark;7. Department of Surgery, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark;8. Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard 82, 8200, Aarhus N, Denmark;1. Department of Visceral, Vascular and Endocrine Surgery, Martin-Luther-University Halle-Wittenberg, University Medical Center Halle, Halle, Germany;2. Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany;3. Department of General, Visceral, Endocrine and Transplantation Surgery, Kantonsspital St. Gallen, St. Gallen, Switzerland;4. Institute of Medical Biometry and Informatics, University of Heidelberg, Heidelberg, Germany;5. Institute for Pathology, Industriestr. 11c, 67063, Ludwigshafen, Germany;1. Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden;2. Division of Surgery, Danderyd Hospital, Stockholm, Sweden;3. Department of Diagnostic Radiology, Karolinska University Hospital, Stockholm, Sweden;4. Department of Pelvic Cancer, GI Oncology and Colorectal Surgery Unit, Karolinska University Hospital, Stockholm, Sweden;1. Breast Unit, Cancer Center, IRCCS Clinical Institute Humanitas, Rozzano (MI), Italy;2. Anatomia Patologica Ospedaliera, IRCCS Ospedale Policlinico San Martino, Genova, Italy;3. Epidemiologia Clinica, IRCCS Ospedale Policlinico San Martino, Genova, Italy;4. Breast Unit, Ospedale Villa Scassi, Genova, Italy |
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| Abstract: | BackgroundPreoperative assessment of peritoneal metastases is an important factor for treatment planning and selection of candidates for cytoreductive surgery (CRS) in primary advanced stage (FIGO stages III–IV) epithelial ovarian cancer (EOC). The primary aim was to evaluate the efficacy of DW-MRI, CT, and FDG PET/CT used for preoperative assessment of peritoneal cancer index (PCI).Material and methodsIn this prospective observational cohort study, 50 advanced stage EOC patients were examined with DW-MRI and FDG PET/CT with contrast enhanced CT as part of the diagnostic program. All patients were deemed amenable for upfront CRS. Imaging PCI was determined for DW-MRI, CT, and FDG PET/CT by separate readers blinded to the surgical findings. The primary outcome was agreement between the imaging PCI and PCI determined at surgical exploration (the reference standard) evaluated with Bland-Altman statistics.ResultsThe median surgical PCI was 18 (range: 3–32). For all three imaging modalities, the imaging PCI most often underestimated the surgical PCI. The mean differences between the surgical PCI and the imaging PCI were 4.2 (95% CI: 2.6–5.8) for CT, 4.4 (95% CI: 2.9–5.8) for DW-MRI, and 5.3 (95% CI: 3.6–7.0) for FDG PET/CT, and no overall statistically significant differences were found between the imaging modalities (DW-MRI – CT, p = 0.83; DW-MRI – FDG PET/CT, p = 0.24; CT – FDG PET/CT, p = 0.06).ConclusionNeither DW-MRI nor CT nor FDG PET/CT was superior in preoperative assessment of the surgical PCI in patients scheduled for upfront CRS for advanced stage EOC. |
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| Keywords: | Epithelial ovarian cancer DW-MRI CT FDG PET/CT Peritoneal cancer index Cytoreductive surgery EOC" },{" #name" :" keyword" ," $" :{" id" :" kwrd0045" }," $$" :[{" #name" :" text" ," _" :" epithelial ovarian cancer CRS" },{" #name" :" keyword" ," $" :{" id" :" kwrd0055" }," $$" :[{" #name" :" text" ," _" :" cytoreductive surgery PCI" },{" #name" :" keyword" ," $" :{" id" :" kwrd0065" }," $$" :[{" #name" :" text" ," _" :" peritoneal cancer index DW-MRI" },{" #name" :" keyword" ," $" :{" id" :" kwrd0075" }," $$" :[{" #name" :" text" ," _" :" diffusion-weighted magnetic resonance imaging CT" },{" #name" :" keyword" ," $" :{" id" :" kwrd0085" }," $$" :[{" #name" :" text" ," _" :" computed tomography FDG PET/CT" },{" #name" :" keyword" ," $" :{" id" :" kwrd0095" }," $$" :[{" #name" :" text" ," _" :" fluorodeoxyglucose positron emission tomography/computed tomography |
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