Diffusion-weighted MRI and PET/CT reproducibility in epithelial ovarian cancers during neoadjuvant chemotherapy - 23/09/21
, Lisa Gauquelin d, Stéphanie Nougaret e, Marine Chicart f, Marina Pulido d, Anne Floquet g, Frédéric Guyon h, Sabrina Croce i, Michèle Kind a, Anne-Laure Cazeau f
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Highlights |
• | Visual assessment of MRI and 18F-Fluorodeoxyglucose positron emission tomography/computed tomography shows high inter- and intra-observer agreements on baseline examinations. |
• | SUV-max, SUL-peak, SUV-mean at baseline and their changes show at least good reproducibility. |
• | The measurement used and the evaluation time significantly influence the reproducibility. |
Abstract |
Purpose |
To investigate the reproducibility of diffusion-weighted (DW) MRI and 18F-Fluorodeoxyglucose (18F-FDG)-Positron emission tomography/CT (PET/CT) in monitoring response to neoadjuvant chemotherapy in epithelial ovarian cancer.
Materials and methods |
Ten women (median age, 67 years; range: 41.8–77.3 years) with stage IIIC-IV epithelial ovarian cancers were included in this prospective trial (NCT02792959) between 2014 and 2016. All underwent initial laparoscopic staging, four cycles of carboplatine-paclitaxel-based chemotherapy and interval debulking surgery. PET/CT and DW-MRI were performed at baseline (C0), after one cycle (C1) and before surgery (C4). Two nuclear physicians and two radiologists assessed five anatomic sites for the presence of ≥1 lesion. Target lesions in each site were defined and their apparent diffusion coefficient (ADC), maximal standardized uptake value (SUV-max), SUV-mean, SUL-peak, metabolic tumor volume (MTV) and total lesion glycolysis (TLG) were monitored (i.e., 10 patients ×5 sites ×3 time-points). Their relative early and late changes were calculated. Intra/inter-observer reproducibilities of qualitative and quantitative analysis were estimated with Kappa and intra-class correlation coefficients (ICCs).
Results |
For both modalities, inter- and intra-observer agreement percentages were excellent for initial staging but declined later for DW-MRI, leading to lower Kappa values for inter- and intra-observer variability (0.949 and 1 at C0, vs. 0.633 and 0.643 at C4, respectively) while Kappa values remained>0.8 for PET/CT. Inter- and intra-observer ICCs were>0.75 for SUV-max, SUL-peak, SUV-mean and their change regardless the time-point. ADC showed lower ICCs (range: 0.013–0.811). ANOVA found significant influences of the evaluation time, the measurement used (ADC, SUV-max, SUV-mean, SUV-max, SUL-peak, MTV or TLG) and their interaction on ICC values (P=0.0023, P<0.0001 and P =0.0028, respectively).
Conclusion |
While both modalities demonstrated high reproducibility at baseline, only SUV-max, SUL-peak, SUV-mean and their changes maintained high reproducibility during chemotherapy.
Le texte complet de cet article est disponible en PDF.Keywords : Carcinoma, Ovarian epithelial, Diffusion-weighted magnetic resonance imaging, Positron-emission tomography/Computed tomography, Reproducibility of results, Biomarkers, Tumors
Abbreviations : 18F-FDG, ADC, ANOVA, C0, C1, C4, CE, CI, dC0C1, dC0C4, DWI, ICC, LOA, MTV, PCI, PET/CT, ROI, SD, SUL-peak, SUV-max, SUV-mean, TLG
Plan
Vol 102 - N° 10
P. 629-639 - octobre 2021 Retour au numéro
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