MRI Versus CT in Planning Primary Debulking Surgery for Epithelial Ovarian Cancer

To assess the performance of whole-abdomen diffusion-weighted imaging (DWI) combined with conventional MRI compared with CT in preoperative planning of the primary debulking surgery (PDS) in epithelial ovarian cancer (EOC) patients.

Fifty-seven patients with EOC who underwent preoperative whole-abdomen MRI and CT were recruited for this study. During a multidisciplinary treatment (MDT) discussion, anatomical sites were allocated to specialized surgeons and the surgical plan, including assistant and backup surgeons, was finalized. According to the surgical records and pathological diagnoses, the χ 2 test was used to compare the consistency rates of CT and MRI for planning PDS. Diagnostic efficiencies of MRI and CT for planning PDS were compared using a 2-tailed McNemar test.

For the hepatobiliary sites, MRI demonstrated significantly higher sensitivity (0.947 vs. 0.632, P =0.022), specificity (0.842 vs. 0.684, P =0.039), and accuracy (0.912 vs. 0.649, P =0.041) than CT. For gastrointestinal sites, MRI showed a significantly higher sensitivity (0.750 vs. 0.450, P =0.021), specificity (0.941 vs. 0.882, P =0.031), and accuracy (0.807 vs. 0.579, P =0.027) than CT. No significant differences in sensitivity (0.769 vs. 0.385, P =0.289), specificity (0.909 vs. 0.909, P =0.453), or accuracy (0.877 vs. 0.789, P =0.227) were found between MRI and CT for the urological sites. In addition, MRI demonstrated a significantly higher consistency rate with the surgical plans and records (0.667 vs. 0.281, P <0.001) than CT.

MRI offers superior diagnostic efficiency over CT for evaluating sites relevant to hepatobiliary and gastrointestinal surgeons, enhancing the accuracy of surgical planning and potentially becoming the preferred imaging modality for preoperative PDS planning.