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A modified diffusion-weighted magnetic resonance imaging-based model from the radiologist's perspective: improved

Jing Lu1, Qinhao Guo2, Ya Zhang3

  • 1Department of Radiology, Fudan University Shanghai Cancer Center, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.

American Journal of Obstetrics and Gynecology
|March 3, 2024
PubMed
Summary

A new modified diffusion-weighted MRI model accurately predicts surgical resectability in advanced high-grade serous ovarian cancer, improving upon the Memorial Sloan Kettering Cancer Center model. Patients with scores of 0-6 are candidates for primary debulking surgery.

Keywords:
MSKCC modeldiffusion-weighted imagingmagnetic resonance imagingmorphological characteristicsovarian cancerprimary debulking surgerytranscriptomics

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Area of Science:

  • Oncology
  • Radiology
  • Medical Imaging

Background:

  • Complete resection of visible lesions in primary debulking surgery (PDS) is crucial for favorable prognosis in advanced high-grade serous ovarian cancer (HGSOC).
  • Accurate preoperative assessment of resectability is essential for optimizing patient management and surgical planning.

Purpose of the Study:

  • To evaluate a modified diffusion-weighted magnetic resonance imaging (DW-MRI) model for predicting resectability in advanced HGSOC.
  • The modified model integrates the Memorial Sloan Kettering Cancer Center (MSKCC) criteria with additional DW-MRI features and lesion growth patterns.

Main Methods:

  • 184 advanced HGSOC patients underwent preoperative DW-MRI.
  • Radiologists independently assessed resectability using the MSKCC and modified DW-MRI models.
  • Tumor morphology (mass-like vs. infiltrative) and transcriptomic data were analyzed.

Main Results:

  • Both MSKCC and modified DW-MRI models showed excellent intra- and interobserver agreement.
  • The modified DW-MRI model demonstrated improved predictive performance (AUC 0.867 study cohort, 0.806 internal, 0.913 external validation).
  • Complete debulking rates decreased with increasing scores in the modified model, with 0-6 indicating eligibility for PDS.

Conclusions:

  • The modified DW-MRI model offers enhanced accuracy for preoperative resectability prediction in advanced HGSOC compared to the MSKCC model.
  • This improved prediction facilitates better patient selection for primary debulking surgery.