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Do DWI and quantitative DCE perfusion MR have a prognostic value in high-grade serous ovarian cancer?

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Abstract

Purpose

To evaluate whether perfusion and diffusion parameters from staging MR in ovarian cancer (OC) patients may predict the presence of residual tumor at surgery and the progression-free survival (PFS) in 12 months.

Materials and methods

Patients who are from a single institution, candidate for OC to cytoreductive surgery and undergoing MR for staging purposes were included in this study. Inclusion criteria were: preoperative MR including diffusion-weighted imaging (DWI) and perfusion dynamic contrast-enhanced (DCE) sequence; cytoreductive surgery performed within a month from MR; and minimum follow-up of 12 months. Patients’ characteristics including the presence of residual tumor at surgery (R0 or R1) and relapse within 12 months from surgery were recorded. DWI parameters included apparent diffusion coefficient (ADC) of the largest ovarian mass (O-ADC) and normalized ovarian ADC as a ratio between ovarian ADC and muscle ADC (M-ADC). DCE quantitative parameters included were descriptors of tumor vascular properties such as forward and backward transfer constants, plasma volume and volume of extracellular space. Statistical analysis was performed, and p values < 0.05 were considered significant.

Results

Forty-nine patients were included. M-ADC showed a slightly significant association with the presence of residual tumor at surgery. None of the other functional parameters showed either difference between R0 and R1 patients or association with PFS in the first 12 months.

Conclusions

This preliminary study demonstrated a slightly significant association between normalized ovarian ADC and the presence of residual tumor at surgery. The other perfusion and diffusion parameters were not significant for the endpoints of this study.

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Acknowledgements

We hereby thank Dr. Antonello Vidiri for sharing his knowledge about the use of the software tool for quantitative DCE analysis. We also thank Lorenzo Viarengo and Carmelo Parisi, GE employees, for their kind assistance during the study.

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Authors and Affiliations

  1. Postgraduate School of Radiodiagnostics, Università degli Studi di Milano, Via Festa del Perdono 7, 20122, Milan, Italy

    Francesca De Piano & Dulia Maresca

  2. Department of Radiology, ASLVC, Corso Mario Abbiate 21, 13100, Vercelli, Italy

    Valentina Buscarino

  3. Division of Epidemiology and Biostatistics, IEO European Institute of Oncology IRCCS, Milan, Italy

    Patrick Maisonneuve

  4. Department of Gynecology, IEO European Institute of Oncology IRCCS, Via Ripamonti 435, 20141, Milan, Italy

    Giovanni Aletti

  5. Department of Oncology and Hemato-Oncology, Università degli Studi di Milano, Milan, Italy

    Giovanni Aletti & Massimo Bellomi

  6. Department of Radiotherapy, IEO European Institute of Oncology IRCCS, Via Ripamonti 435, 20141, Milan, Italy

    Roberta Lazzari & Andrea Vavassori

  7. Department of Radiology, IEO European Institute of Oncology IRCCS, Via Ripamonti 435, 20141, Milan, Italy

    Massimo Bellomi & Stefania Rizzo

  8. Clinica di Radiologia EOC- Istituto Imaging della Svizzera Italiana, Via Tesserete 47, 6900, Lugano, Switzerland

    Stefania Rizzo

Authors
  1. Francesca De Piano
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  2. Valentina Buscarino
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  4. Patrick Maisonneuve
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  9. Stefania Rizzo
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Corresponding author

Correspondence to Stefania Rizzo.

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The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional research committee (IEO-CCM Ethical Committee; R 466/16-IEO482) and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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De Piano, F., Buscarino, V., Maresca, D. et al. Do DWI and quantitative DCE perfusion MR have a prognostic value in high-grade serous ovarian cancer?. Radiol med 124, 1315–1323 (2019). https://doi.org/10.1007/s11547-019-01075-z

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  • DOI: https://doi.org/10.1007/s11547-019-01075-z

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