Objective:
Our aim was to determine the sensitivity and comparison of abdominal MRI, diffusion weighted MRI (DWI), PET-CT in detecting peritoneal implants in patients with gynecologic neoplasms.
Material and Methods:
Twenty-one patients with gynecological malignant tumors were enrolled in this retrospective study. Twenty-one oncology patients underwent abdominal and pelvic MRI, diffusion weighted MRI with a b value of 0-500-1000 s/mm² and whole body PET-CT for follow-up. All MRI images were evaluated by a radiologists and PET-CT images were reviewed by a nuclear medicine physician. The results were compared with surgery or laparotomy exploratis, follow-up MRI or CT at a varying time between 2 and 12 months from the initial MRI, and moreover they were also evaluated with laboratory values and clinical outcomes at the 12 to 36th month from the initial MRI.
Results:
Forty lesions were identified with PET-CT, forty-nine lesions with MRI and 65 lesions with MRI+DWI. In 8 patients there were no implants with all imaging modalities. Although PET-CT and MRI were negative for two patients, MRI+DWI was positive for them. And also PET-CT was negative for one patient whereas MRI and MRI+DWI was positive. On a lesion-based analysis, overall lesion numbers for PET-CT and MRI+DWI were significantly different (p<0,05).
Conclusion:
In our study we found with MRI and MRI+DWI more implants than PET-CT. DWI which may be an alternative to PET-CT with conventional MRI can improve the sensitivity in depicting peritoneal implants.
Keywords: Diffusion weighted MRI, malignancies, gynecologic neoplasms