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Ovarian cancer recurrence: value of MR imaging
R Forstner1, H Hricak, C B Powell
1Department of Radiology, University of California School of Medicine, San Francisco 94143, USA.
Purpose:
To assess magnetic resonance (MR) imaging in depiction of ovarian tumor recurrence and for identification of patients who may not benefit from surgical reexploration.
Materials And Methods:
In a prospective study, 34 patients (mean age, 57.07 years) with surgically staged ovarian cancer underwent MR imaging before reexploration. Findings at MR imaging and surgery were correlated. MR imaging tumor depiction was correlated with tumor size, presence of ascites, and CA-125 levels.
Results:
Tumor recurrence was identified in 29 patients at surgery. MR imaging depicted tumor in 20 patients. Accuracy for lesions smaller than 2 cm was 35% and increased to 82% for lesions larger than 2 cm (P < .01). MR imaging had low sensitivity for depiction of implants in the peritoneum and mesentery. Ascites improved depiction of smaller lesions (< 2 cm). MR imaging in combination with CA-125 levels improved detection of recurrent disease (CA-125 measurement alone 53% vs CA-125 measurement and MR imaging 75%, P = .048).
Conclusion:
MR imaging is a useful adjunct to the clinical examination to identify patients with recurrent disease and those in whom reexploration may not be beneficial.