Comparison of the MRI and Integrated PET/CT Findings in the Preoperative Detection of Peritoneal Carcinomatosis Arising from Primary Ovarian Cancer

Abstract

Purpose: To compare the diagnostic performance of MRI and integrated PET/CT for the preoperative detection of peritoneal carcinomatosis arising from primary ovarian cancer. Materials and Methods: Twenty-three patients with suspected ovarian tumors underwent a contrast-enhanced 1.5 Tesla MRI and a 18F-fluorodeoxyglucose (FDG) PET/CT prior to surgery. The peritoneal cavity was subdivided into six specific sites for a lesion-based analysis. The imaging findings were compared statistically with the histopathological findings using McNemar’s test with Bonferroni’s adjustment and generalized estimation equations. Results: The histopathological results of all 23 patients were confirmed for primary malignant epithelial ovarian cancer. Of the 23 patients, 19 had a total of 83 sites with peritoneal seedings throughout the abdomen and pelvis. The comparison of the patient-based sensitivity, specificity and accuracy of the use of MRI versus PET/CT for the detection of peritoneal carcinomatosis were 95% versus 84% (p > 0.05; N.S.), 50% versus 50% (p > 0.05; N.S.), and 87% versus 78% (p > 0.05; N.S.), respectively. Moreover, the comparison of the lesion-based sensitivity, specificity and accuracy of MRI versus integrated PET/CT were 86% and 75% (p = 0.004), 76% and 84% (p > 0.05; N.S.), and 82% and 78% (p > 0.05; N.S.), respectively. Conclusion: We found that MRI was more sensitive than integrated PET/CT for the detection of preoperative peritoneal carcinomatosis arising from primary ovarian cancer.