Diagnostic value of whole-body MRI with diffusion-weighted sequence for detection of peritoneal metastases in colorectal malignancy

作者：Zhang, Huan; Dai, Weixing; Fu, Caixia; Yan, Xu; Stemmer, Alto; Tong, Tong^*; Cai, Guoxiang^*

来源：Cancer Biology & Medicine, 2018, 15(2): 165-170.

DOI：10.20892/j.issn.2095-3941.2017.0162

• MRI
• diffusion weighted imaging
• peritoneal cancer index
• peritoneal metastases
• colorectal malignancy

Objective: To assess the diagnostic accuracy of whole body MRI using diffusion weighted sequence (WB-DWI) to determine the peritoneal cancer index (PCI) in correlation with surgical and histopathological findings. @@@ Methods: Twenty seven patients underwent preoperative WB MRI, followed by cytoreductive surgery for primary tumors of the appendix (n = 15), colorectum (n = 12), and associated peritoneal disease. A total of 351 regions were retrospectively reviewed. The sensitivity, specificity, and accuracy were calculated at 13 anatomical sites. The WB-DWI PCI and PCI type were compared with surgical and histopathological findings. @@@ Results: No statistical difference was found between the WB-DWI PCI and surgical PCI (P = 0.574). WB-DWI correctly predicted the PCI type in 24 of 27 patients with high accuracy (88.9%), including 10 of 10 patients with small volume tumor, 12 of 14 with moderate volume tumor, and 2 of 3 with large volume tumor. WB-DWI correctly depicted tumors in 163 of 203 regions, with 40 false negative and 23 false positive regions. The overall sensitivity, specificity, and accuracy of WB-DWI for the detection of peritoneal tumors were 80.3%, 84.5%, and 82.1%, respectively. For lesions < 0.5 cm in diameter, WB DWI demonstrated good sensitivity (69.4%). @@@ Conclusions: WB-DWI accurately predicted PCI before surgery in patients undergoing evaluation for cytoreductive surgery.

• 出版日期2018-5
• 单位复旦大学