Comparison of the diagnostic performance of MRI and MSCT in preoperative diagnosis of advanced ovarian cancer
- Authors: Syrkashev E.M.1, Solopova A.E.1
-
Affiliations:
- V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia
- Issue: No 12 (2020)
- Pages: 137-142
- Section: Articles
- URL: https://journals.eco-vector.com/0300-9092/article/view/249086
- DOI: https://doi.org/10.18565/aig.2020.12.137-142
- ID: 249086
Cite item
Open Access
Access granted
Abstract
Relevance. Ovarian cancer ranks ninth as the most common malignancy among women in the Russian Federation. Patients with ovarian cancer have a 5-year survival rate of 92% for a localized and 29% for advanced disease. Aim. To compare the diagnostic performance of multislice spiral computed tomography (MSCT) and magnetic resonance imaging (MRI) in the detection of secondary changes in advanced ovarian carcinoma (III-IV). Materials and methods. The study included 38 women with advanced ovarian carcinoma (AOC). Before the operation, they underwent MRI (20) and MSCT (20). The local spread and secondary changes in the abdominal cavity were analyzed. For each diagnostic modality, the diagnostic performance characteristics and odds ratios for any residual tumor tissue were calculated. Results Stage IIIa/b, IIIc, andIVovarian cancer (FIGO) were diagnosed in 18.4% (7), 47.4% (18), and 34.2% (13) of cases, respectively. High and low-grade serous carcinomas were detected in 94.7% (36) and 5.3% (2) of patients. MSCT had sensitivity, specificity, and accuracy of 0.67, 0.94, and 0.83 for detecting secondary changes, while MRI showed sensitivity, specificity, and accuracy of 0.84, 0.89, and 0.87. Complete, optimal and incomplete cytoreduction was achieved in 26 (68.4%), 7 (18.4%), and 5 (13.2%) cases, respectively. Two patients underwent life-saving surgery, which corresponds to the incidence of suboptimal cytoreduction (7.8%). The odds ratio for incomplete cytoreduction (any residual tumor tissue) with diffuse small intestine lesions (miliary dissemination) and its mesentery were 5.13 (95%CI 1.19; 22.10) and 5.92 (95%CI 1.09; 31.94), respectively. MRI had sensitivity, specificity, and accuracy of 0.73, 0.91, and 0.85 for detecting these secondary changes; corresponding characteristics for MSCT were 0.41, 1.0, and 0.77. Conclusion. Diagnostic accuracy of MRI is superior to MSCT in detecting metastatic dissemination of ovarian cancer, thus allowing accurate staging of the disease and detecting secondary changes at most significant abdominal locations, which has implications for cytoreductive treatment.
Full Text
About the authors
Egor M. Syrkashev
V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia
Email: e_syrkashev@oparina4.ru
MD, Researcher at the Department of Diagnostic Imaging
Alina E. Solopova
V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia
Email: a_solopova@oparina4.ru
Dr.Med.Sci., Associate Professor, Leading Researcher at the Department of Diagnostic Imaging
References
- American Cancer Society. Cancer Facts & Figures 2018. Atlanta: American Cancer Society; 2018. BMJ. 2018; 309(6970): 1689.
- Mikula-Pietrasik J., Uruski P., Tykarski A., Ksiqzek K. The peritoneal ‘soil’ for a cancerous ‘seed’: a comprehensive review of the pathogenesis of intraperitoneal cancer metastases. Cell. Mol. Life Sci. 2018; 75(3): 509-25.
- Manning-Geist B.L., Hicks-Courant K., Gockley A.A., Clark R.M., Del Carmen M.G, Growdon W.B. et al. A novel classification of residual disease after interval debulking surgery for advanced-stage ovarian cancer to better distinguish oncologic outcome. Am. J. Obstet. Gynecol. 2019; 221(4): 326. e1-326. e7. https://dx.doi.org/10.1016/j.ajog.2019.05.006.
- Нечушкина В.М., Хохлова С.В. Практические рекомендации по лекарственному лечению рака яичников, первичного рака брюшины и рака маточных труб. Злокачественные опухоли. 2019; 9(9): 164-76. [Nechushkina V.M., Khokhlova S.V. Practical recommendations for drug treatment of ovarian cancer, primary peritoneal cancer and fallopian tube cancer. Malignant tumor. 2019; 9(9): 164-76. (in Russian)].
- Sisovska I., Minaf L., Felsinger M., Anton M., Brednafikova M., Hausnerova J. et al. Current FIGO staging classification for cancer of ovary, fallopian tube and peritoneum. Ceska Gynekol. 2017; 82(3): 230-6.
- Javadi S., Ganeshan D.M., Qayyum A., Iyer R.B., Bhosale P. Ovarian cancer, the revised FIGO staging system, and the role of imaging. AJR Am. J. Roentgenol. 2016; 206(6): 1351-60. https://dx.doi.ois/10.2214/AJR.15.15199.
- Colombo N., Sessa C., du Bois A., Ledermann J., McCluggage W.G., McNeish I. et al. ESMO-ESGO consensus conference recommendations on ovarian cancer: Pathology and molecular biology, early and advanced stages, borderline tumours and recurrent disease. Ann. Oncol. 2019; 30(5): 672-705. https://dx.doi. org/10.1093/annonc/mdz062.
- Gadelhak B., Tawfik A.M., Saleh G.A., Batouty N.M., Sobh D.M., Hamdy O., Refky B. Extended abdominopelvic MRI versus CT at the time of adnexal mass characterization for assessing radiologic peritoneal cancer index (PCI) prior to cytoreductive surgery. Abdom. Radiol. (NY). 2019; 44(6): 2254-61. https:// dx.doi.org/10.1007/s00261-019-01939-y.
- Low R.N., Barone R.M., Lucero J. Comparison of MRI and CT for predicting the peritoneal cancer index (PCI) preoperatively in patients being considered for cytoreductive surgical procedures. Ann. Surg. Oncol. 2015; 22(5): 1708-15. https://dx.doi.org/10.1245/s10434-014-4041-7.
- Coakley F.V., Choi P.H., Gougoutas C.A., Pothuri B., Venkatraman E., Chi D. et al. Peritoneal metastases: detection with spiral CT in patie. Radiology. 2002; 223(2): 495-9. https://dx.doi.org/10.1148/radiol.2232011081.
- Low R.N., Barone R.M., Lacey C., Sigeti J.S., Alzate G.D., Sebrechts C.P. Peritoneal tumor: MR imaging with dilute oral barium and intravenous gadolinium-containing contrast agents compared with unenhanced MR imaging and CT. Radiology. 1997; 204(2): 513-20.
- Koh J.-L., Yan T.D., Glenn D., Morris D.L. Evaluation of preoperative computed tomography in estimating peritoneal cancer index in colorectal peritoneal carcinomatosis. Ann. Surg. Oncol. 2009;16(2):327-33. https://dx.doi. org/10.1245/s10434-008-0234-2.
- Nakayama K., Nakayama N., Katagiri H., Miyazaki K. Mechanisms of ovarian cancer metastasis: biochemical pathways. Int. J. Mol. Sci. 2012; 13(9): 11705-17. https://dx.doi.org/10.3390/ijms130911705.
- van Baal J.O.A.M., van Noorden C.J.F., Nieuwland R., Van de Vijver K.K., Sturk A. et al. Development of peritoneal carcinomatosis in epithelial ovarian cancer: a review. J. Histochem. Cytochem. 2018; 66(2): 67-83. https://dx.doi. org/10.1369/0022155417742897.
Supplementary files
