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Updated: Mar 23, 2026
Quantitation of Intra-peritoneal Ovarian Cancer Metastasis
Published on: July 18, 2016
Diffusion-Weighted Imaging of Small Peritoneal Implants in "Potentially" Early-Stage Ovarian Cancer
Laretta Grabowska-Derlatka1, Pawel Derlatka2, Wojciech Szeszkowski1
12nd Department of Clinical Radiology, Medical University of Warsaw, Banacha 1a Street, 02-097 Warsaw, Poland.
Introduction:
MRI is established modality for the diagnosis of ovarian malignancies. Advances in MRI technology, including DW imaging, could lead to the further increase in the sensitivity of MRI for the detection of peritoneal metastases. The aim of this study was to assess the accuracy of DW imaging for detection of peritoneal metastatic disease in patients suspected of having potentially early ovarian cancer and secondly to evaluate ADC values of peritoneal implants.
Materials And Methods:
The prospective study group consisted of 26 women with sonographic or/and CT diagnosis of suspected ovarian tumor. Based on the results of the above imaging, in none of them was extraovarian spread of disease or ascites recognized. All patients underwent MRI with DW imaging.
Results:
Overall, 18 extraovarian peritoneal lesions were found on DW images in 10 from 26 examined patients. All implants had diameter ≤10 mm. The presence of all lesions diagnosed by MRI was confirmed intraoperatively. Histopathologic findings in 17 proofs confirmed ovarian cancer. PPV was 94%. On all DW images (with b values of 0, 50, 100, 150, 200, 400, 800, and 1200 s/mm(2)) the mean signal intensities of peritoneal lesions were significantly higher than the mean signal intensities of normal adjacent tissue (p = 0.000001).
Insights
Diffusion-weighted imaging (DWI) MRI enhances the detection of small peritoneal metastases in early ovarian cancer. This advanced MRI technique accurately identifies metastatic lesions, improving diagnostic sensitivity for peritoneal spread.
Area of Science:
- Radiology
- Oncology
- Medical Imaging
Background:
- Magnetic Resonance Imaging (MRI) is a standard diagnostic tool for ovarian cancer.
- Diffusion-weighted imaging (DWI) may improve MRI's sensitivity for detecting peritoneal metastases.
- Early detection of peritoneal spread is crucial for ovarian cancer management.
Purpose of the Study:
- To evaluate the accuracy of DWI MRI in detecting peritoneal metastatic disease in patients with suspected early ovarian cancer.
- To assess the apparent diffusion coefficient (ADC) values of peritoneal implants.
- To determine the utility of DWI in identifying small peritoneal lesions not recognized by conventional imaging.
Main Methods:
- Prospective study of 26 women with suspected ovarian tumors.
- All patients underwent MRI with DWI, including various b values (0-1200 s/mm²).
- Conventional imaging (sonography/CT) did not reveal extraovarian spread or ascites prior to MRI.
Main Results:
- DWI MRI identified 18 extraovarian peritoneal lesions in 10 patients, all ≤10 mm in diameter.
- All detected lesions were confirmed intraoperatively, with 17 proving to be ovarian cancer.
- Mean signal intensity of peritoneal lesions on DWI was significantly higher than adjacent normal tissue (p = 0.000001).
- Positive Predictive Value (PPV) for lesion detection was 94%.
Conclusions:
- DWI MRI is a highly accurate technique for detecting small peritoneal metastases in early ovarian cancer.
- DWI MRI significantly improves the detection of peritoneal spread compared to conventional imaging.
- ADC values and signal intensity changes on DWI can aid in identifying peritoneal implants.
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