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DIFFUSION WEIGHTED MAGNETIC RESONANCE IMAGING IN OVARIAN CANCER NEOADJUVANT CHEMOTHERAPY RESPONSE EVALUATION

Solopova A.E.1, Ternovoy S.K.1,2, Makatsaria A.D.1, Gurov S.N.3

1 - I.M. Sechenov First Moscow State Medical University.

2 - A.L. Myasnikov Russian cardiology Research Center.

3 - Oncology clinical health center №1. Moscow, Russia.

Purpose. To evaluate the capability of the integrated MRI with diffusion sequences in the assessment of neoadjuvant chemotherapy treatment response of ovarian cancer

Materials and methods. From 2015 to 2016 23 patients with disseminated stages of ovarian cancer underwent pelvic and abdominal MRI to clarify the tumor spread, the issue of neoadjuvant chemotherapy (NHT) and again after 1 and 3 courses in the evaluation of its effectiveness. MR-study was performed on a superconductive 1.5 T MRI, using protocol: T2- , stir, T1-, Dynamic 3D FS, DWI with b-factors 0, 1000 m/mm2, with an estimate value of the apparent diffusion coefficient (ADC). The evaluation of differences in size of the entities was performed in accordance with RECIST 1.1 criteria, parameters measured: ADC, reproducibility of the technique.

Results. The average values of the measured diffusion coefficient in the primary tumor before treatment was significantly higher than in the omental and peritoneal implants (p=0,018 and p=0,021, respectively). A comparative assessment of ADC before and after treatment revealed significant increase after 3 courses of chemotherapy (p=0,008), improvement after 1 course in the primary tumor and differences in the ADC before and after treatment in the omental and the peritoneal implants are less pronounced and insignificant (R=0,89; 0,758; 0,695 respectively). Informativity in evaluation of residual tumor and the degree of therapeutic MRI pathomorphosis were: sensitivity – 93,3%, specificity – 84,6%, and accuracy – 91,3%.

Conclusions. According to the results of the study MRI DWI shows high informativity and reproducibility in determination of response to neoadjuvant chemotherapy in advanced ovarian cancer. A significant difference in the mean ADC values was obtained for the solid component of the primary tumors, indicating their greater sensitivity to neoadjuvant chemotherapeutic treatment.

Keywords: ovarian cancer, MRI, diffusion sequences, neoadjuvant chemotherapy, optimal debulking surgery.


 

Corresponding author:  Solopova A.E. Этот e-mail адрес защищен от спам-ботов, для его просмотра у Вас должен быть включен Javascript

 

For citation: Solopova A.E., Ternovoy S.K., Makatsaria A.D., Gurov S.N. Diffusion weighted magnetic resonance imaging in ovarian cancer neoadjuvant chemotherapy response evaluation. REJR. 2016; 6 (4):68-80. DOI:10.21569/2222-7415-2016-6-4-68-80.

Received: 30.10.2016 Accepted: 14.11.2016