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• Clinical Articles •
Study on the application value of DWI combined with conventional MRI in making surgical plan of PDS for advanced ovarian cancer
YANG Qingling  REN Jing  HAN Ye  WANG Yang  XIAO Zunjian  GUO Yan  SHEN Fan 

Cite this article as: YANG Q L, REN J, HAN Y, et al. Study on the application value of DWI combined with conventional MRI in making surgical plan of PDS for advanced ovarian cancer[J]. Chin J Magn Reson Imaging, 2023, 14(7): 73-77, 92. DOI:10.12015/issn.1674-8034.2023.07.013.


[Abstract] Objective To investigate the clinical application value of diffusion weighted imaging (DWI) combined with conventional MRI in making surgical plan of primary debulking surgery (PDS) in patients with advanced ovarian cancer.Materials and Methods The imaging data of 57 patients with advanced ovarian cancer confirmed by pathology in our hospital from November 2018 to June 2022 were retrospectively analyzed. All patients underwent abdominal conventional MRI, DWI and enhanced computed tomography (CT), and then PDS surgery was performed. According to the FAGOTTI laparoscopic score and peritoneal cancer index (PCI) and combined with multiple disciplinary team discussion in our hospital, the anatomical areas to be observed in the imaging data of this study were determined. The presence of metastasis in each area was recorded and need for the assistance of corresponding departments was determined. Using intraoperative records and pathology as the gold standard, the diagnostic efficacy of DWI combined with conventional MRI and enhanced CT was compared. χ2 test was used to compare the statistical differences between the two groups, and to compare the formulation value of the two methods of imaging examinations in the PDS surgery plan for advanced ovarian cancer. Kappa analysis evaluated the consistency of two radiologists in determining clinical assistance departments.Results In this group of 57 patients, the cases with different surgical plans were recorded as follows: 9 cases of gynecologic surgery alone, 7 cases required the assistance of hepatobiliary surgery department, 5 cases required the assistance of digestive surgery department, 23 cases required the assistance of both liver and gallbladder surgery and digestive surgery department, 5 cases required the assistance of both digestion and urology surgery department, 1 case required the assistance with hepatobiliary surgery and urology department, liver and gallbladder surgery, digestive surgery and urology common assist with surgery in 7 cases. The coincidence of preoperative DWI combined with MRI (38/57) was significantly higher than that of enhanced CT (16/57) (P＜0.001). Intraoperative records showed that 40, 38 and 13 cases needed assistance from digestive surgery, hepatobiliary surgery and urology surgery, respectively. Preoperative DWI combined with MRI plain scan confirmed that 30, 36 and 10 cases needed assistance from above departments, with accuracy of 80.70%, 91.23% and 87.72%, respectively. Preoperative enhanced CT showed 18, 24 and 5 cases from above departments, with the accuracy of 57.89%, 64.91% and 78.95%, respectively. The accuracy of DWI combined with conventional MRI was higher than that of contrast-enhanced CT (χ2=4.762, P=0.027; χ2=4.050, P=0.041) in patients requiring digestive surgery and hepatobiliary surgery. The consistency range of clinical assistance departments determined by two radiologists under different imaging methods was 0.437-0.843, both of which were above medium.Conclusions Compared with enhanced CT, DWI combined with conventional MRI has higher accuracy and better clinical significance in making surgical plan of PDS for advanced ovarian cancer.
[Keywords] ovarian cancer；primary debulking surgery；magnetic resonance imaging；computed tomography

YANG Qingling   REN Jing*   HAN Ye   WANG Yang   XIAO Zunjian   GUO Yan   SHEN Fan  

Department of Radiology, Xijing Hospital, Air Force Medical University, Xi'an 710032, China

Corresponding author: Ren J, E-mail: jrenmm@126.com

Conflicts of interest   None.

ACKNOWLEDGMENTS Natural Science Basic Research Program of Shaanxi Province (No. 2021JZ-25); Science and Technology Innovation Team of Shaanxi Province (No. 2021TD-39).
Received  2023-02-13
Accepted  2023-06-28
DOI: 10.12015/issn.1674-8034.2023.07.013
Cite this article as: YANG Q L, REN J, HAN Y, et al. Study on the application value of DWI combined with conventional MRI in making surgical plan of PDS for advanced ovarian cancer[J]. Chin J Magn Reson Imaging, 2023, 14(7): 73-77, 92. DOI:10.12015/issn.1674-8034.2023.07.013.

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