HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Low, R. N. Articles by Goldfarb, P. M. Search for Related Content PubMed PubMed Citation Articles by Low, R. N. Articles by Goldfarb, P. M.

Treated Ovarian Cancer: Comparison of MR Imaging with Serum CA-125 Level and Physical Examination-A Longitudinal Study¹

¹ From the Departments of Diagnostic Radiology, Oncology, and Surgical and Gynecologic Oncology, Sharp and Children's MRI Center, Sharp Memorial Hospital, 7901 Frost St, San Diego, CA 92123. From the 1997 RSNA scientific assembly. Received March 30, 1998; revision requested June 25; revision received August 7; accepted November 6. Address reprint requests to R.N.L.

PURPOSE: To evaluate whether gadolinium-enhanced magnetic resonance (MR) imaging can demonstrate clinically occult tumors in women with treated ovarian cancer and to compare the diagnostic accuracy of MR imaging, serum CA-125 (ovarian cancer antigen) level, and physical examination.

MATERIALS AND METHODS: From 1992 to 1997, a longitudinal study comparing MR imaging findings, CA-125 values, and physical examination results with eventual clinical outcome in 69 women with treated ovarian cancer was performed. Tumor presence was determined with surgery, by an elevated CA-125 value, or with follow-up of patients longitudinally to assess for tumor recurrence. Absence of tumor was accepted with a disease-free interval of at least 2 years.

RESULTS: Twenty-three of 39 patients in clinical remission with a normal CA-125 level and physical examination result had subclinical tumor proved at laparotomy or clinical follow-up. Gadolinium-enhanced MR imaging correctly demonstrated residual tumor in 20 of 23 patients. In all 69 patients, MR images had a 91% sensitivity, 87% specificity, 90% accuracy, and 72% negative predictive value and were superior to serum CA-125 level (53%, 94%, 63%, and 38%, respectively) (P < .001) and physical examination (26%, 94%, 43%, and 29%, respectively) (P < .001) in the depiction of residual tumor.

CONCLUSION: Gadolinium-enhanced MR imaging is a valuable clinical tool in patients with ovarian cancer. An abnormal MR examination with a normal CA-125 value is a strong indication of residual or recurrent tumor.

Index terms: Abdomen, MR, 791.121411, 791.121412, 791.121415, 791.12143 • Magnetic resonance (MR), contrast agents, 791.12143 • Ovary, neoplasms, 852.32 • Pelvis, MR, 44.121411, 44.121412, 44.121415, 44.12143 • Peritoneum, neoplasms, 791.33

This article has been cited by other articles:

				R. N. Low, R. M. Barone, J. M. Gurney, and W. D. Muller Mucinous Appendiceal Neoplasms: Preoperative MR Staging and Classification Compared with Surgical and Histopathologic Findings Am. J. Roentgenol., March 1, 2008; 190(3): 656 - 665. [Abstract] [Full Text] [PDF]

				T. D. Yan, J. Sim, and D. L. Morris Selection of Patients with Colorectal Peritoneal Carcinomatosis for Cytoreductive Surgery and Perioperative Intraperitoneal Chemotherapy Ann. Surg. Oncol., June 1, 2007; 14(6): 1807 - 1817. [Abstract] [Full Text] [PDF]

				J A Spencer A multidisciplinary approach to ovarian cancer at diagnosis Br. J. Radiol., October 1, 2005; 78(Special_Issue_2): S94 - S102. [Full Text] [PDF]

				R. N. Low, B. Duggan, R. M. Barone, F. Saleh, and S. Y. T. Song Treated Ovarian Cancer: MR Imaging, Laparotomy Reassessment, and Serum CA-125 Values Compared with Clinical Outcome at 1 Year Radiology, June 1, 2005; 235(3): 918 - 926. [Abstract] [Full Text] [PDF]

				H. K. Pannu, R. E. Bristow, C. Cohade, E. K. Fishman, and R. L. Wahl PET-CT in Recurrent Ovarian Cancer: Initial Observations RadioGraphics, January 1, 2004; 24(1): 209 - 223. [Abstract] [Full Text] [PDF]

				H. Kattlove and R. J. Winn Ongoing Care of Patients After Primary Treatment for Their Cancer CA Cancer J Clin, May 1, 2003; 53(3): 172 - 196. [Abstract] [Full Text] [PDF]

				H. K. Pannu, R. E. Bristow, F. J. Montz, and E. K. Fishman Multidetector CT of Peritoneal Carcinomatosis from Ovarian Cancer RadioGraphics, May 1, 2003; 23(3): 687 - 701. [Abstract] [Full Text] [PDF]

				F. V. Coakley, P. H. Choi, C. A. Gougoutas, B. Pothuri, E. Venkatraman, D. Chi, A. Bergman, and H. Hricak Peritoneal Metastases: Detection with Spiral CT in Patients with Ovarian Cancer Radiology, May 1, 2002; 223(2): 495 - 499. [Abstract] [Full Text] [PDF]