Role of MRI in Detection of Recurrent Ovarian Cancer: Comparison with Integrated PET/CT

Abstract

Despite performing latest technology in the diagnosis and treatment of ovarian cancer, today it still remains the leadingt cause of death and the fifth most common cancer death in women. The main reason of the low rates of 5 years survival is the recurrence of disease. For this reason imaging modalities has been focused on early detection of the recurrence. Despite adequate treatment and complete response, recurrence is major problem for patients with ovarian cancer. It has been estimated that 60% of patients diagnosed in an advanced stage will develop abdominal relapse mainly owing to metastasis hidden in the peritoneum and to retroperitoneal metastasis .The commonest sites of relapse were with a pelvic mass (48%), peritoneal disease(45%), large or small bowel serosal disease (45%) and nodal disease (33%), most commonly in the paraaortic region. Unusual sites of recurrence included cerebral, liver, pleura, muscle, splenic and biliary deposits. In the pelvis, MRI has been shown to have a 91–93% overall accuracy for differentiating benign from malignant adnexal tumors . The role of MRI in staging ovarian cancer remains a problem-solving modality MRI had good accuracy for diagnosing pelvic and abdominal cancer spread in patients with ovarian cancer, showing 71–87% sensitivity and 44–87% specificity for peritoneal dissemination, and 64% sensitivity and 75% specificity for pelvic and para-aortic LN metastasis. MRI is recommended in patients with contraindications to CT, e.g., to use of contrast agents, in pregnant patients and complementary to inconclusive CT findings.