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Detection of peritoneal dissemination in gynecological malignancy: evaluation by diffusion-weighted MR imaging
Shinya Fujii1, Eiji Matsusue, Yoshiko Kanasaki
1Division of Radiology, Department of Pathophysiological and Therapeutic Science, Faculty of Medicine, Tottori University, 36-1, Nishi-cho, Tottori, Yonago, 683-8504, Japan. sfujii@grape.med.tottori-u.ac.jp
Abstract:
The aim of this study is to evaluate the usefulness of diffusion-weighted (DW) magnetic resonance (MR) imaging in detecting peritoneal dissemination in cases of gynecological malignancy. We retrospectively analyzed MR images obtained from 26 consecutive patients with gynecological malignancy. Peritoneal dissemination was histologically diagnosed in 15 of the 26 patients after surgery. We obtained DW images and half-Fourier single-shot turbo-spin-echo images in the abdomen and pelvis, and then generated fusion images. Coronal maximum-intensity-projection images were reconstructed from the axial source images. Reader interpretations were compared with the laparotomy findings in the surgical records. Receiver-operating characteristic (ROC) curves were used to represent the presence of peritoneal dissemination. In addition, the sensitivity and specificity were calculated. DW imaging depicted the tumors in 14 of 15 patients with peritoneal dissemination as abnormal signal intensity. ROC analysis yielded Az values of 0.974 and 0.932 for the two reviewers. The mean sensitivity and specificity were 90 and 95.5%. DW imaging plays an important role in the diagnosis and therapeutic management of patients with gynecological malignancy.
Insights
Diffusion-weighted magnetic resonance (MR) imaging effectively detects peritoneal dissemination in gynecological cancers. This advanced imaging technique aids in diagnosis and treatment planning for patients with these malignancies.
Area of Science:
- Radiology
- Oncology
- Gynecology
Background:
- Peritoneal dissemination is a significant factor in gynecological malignancy progression.
- Accurate detection of peritoneal spread is crucial for effective treatment planning.
- Conventional imaging modalities may have limitations in visualizing subtle peritoneal disease.
Purpose of the Study:
- To assess the diagnostic utility of diffusion-weighted (DW) magnetic resonance (MR) imaging for detecting peritoneal dissemination in gynecological malignancies.
- To compare the performance of DW MR imaging with histological findings.
Main Methods:
- Retrospective analysis of MR images from 26 patients with gynecological malignancy.
- Acquisition of DW images and half-Fourier single-shot turbo-spin-echo images in the abdomen and pelvis.
- Generation of fusion images and coronal maximum-intensity-projection reconstructions.
- Comparison of imaging findings with postsurgical histological diagnoses and laparotomy records.
- Use of Receiver-Operating Characteristic (ROC) curves to evaluate diagnostic performance.
Main Results:
- DW imaging identified peritoneal dissemination in 14 out of 15 histologically confirmed cases.
- Mean sensitivity and specificity for detecting peritoneal dissemination were 90% and 95.5%, respectively.
- ROC analysis demonstrated high diagnostic accuracy with Az values of 0.974 and 0.932 for the two reviewers.
Conclusions:
- Diffusion-weighted MR imaging is a valuable tool for diagnosing peritoneal dissemination in gynecological malignancies.
- DW imaging can significantly aid in the management and therapeutic strategies for patients with these cancers.
