Prognostic Value of Preoperative Dynamic Contrast-Enhanced Magnetic Resonance Imaging in Epithelial Ovarian Cancer

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2019Author(s)
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10.1016/j.ejrad.2019.03.023Metadata
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Lindgren, Auni. Anttila, Maarit. Arponen, Otso. Rautiainen, Suvi. Könönen, Mervi. Vanninen, Ritva. Sallinen, Hanna. (2019). Prognostic Value of Preoperative Dynamic Contrast-Enhanced Magnetic Resonance Imaging in Epithelial Ovarian Cancer. European journal of radiology, 115, 66-73. 10.1016/j.ejrad.2019.03.023.Rights
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Abstract
Objectives
To investigate whether semi-quantitative and pharmacokinetic perfusion dynamic contrast-enhanced (DCE) parameters are associated with traditional prognostic factors and can predict clinical outcome in ovarian cancer (OC).
Methods
This prospective study, approved by local ethical committee, enrolled 38 patients with primary OC, 2011–2014. After preoperative DCE-MRI (3.0 T), two observers measured perfusion (Ktrans, Kep, Ve, Vp) and semi-quantitative parameters (area under the curve, peak, time-to-peak) by drawing regions of interest (ROIs) covering the large solid lesion (L-ROI) and the most enhancing small area (S-ROI) (NordicICE platform). Kruskal–Wallis was used to analyze associations between MRI parameters and classified prognostic factors.
Results
Mean Ktrans values were higher in high-grade serous OC than in other types (L-ROI, P = 0.041; S-ROI, P = 0.018), and lower mean Ktrans values predicted residual tumor (L-ROI P = 0.030; S-ROI, P = 0.012). Higher minimum Vp values were associated with higher International Federation of Gynecology and Obstetrics (FIGO) stage (S-ROI, P = 0.023).Shorter recurrence-free survival was predicted by higher Ve (minimum L-ROI, P = 0.035; maximum S-ROI, P = 0.046), Vp (maximum S-ROI, P = 0.033), and lower time-to-peak (maximum S-ROI, P = 0.047) in Kaplan–Meier analysis. Multiparametric MRI variables combining DCE and diffusion weighted data were also predictive for survival.
Conclusion
DCE-MRI parameters may represent imaging biomarkers for predicting tumor aggressiveness and prognosis in OC. Higher Ktrans levels were associated with better results in cytoreductive surgery but with earlier recurrence.
Subjects
ovarian cancer magnetic resonance imaging dynamic contrast-enhanced imaging biomarkers prognosisLink to the original item
http://dx.doi.org/10.1016/j.ejrad.2019.03.023Publisher
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