Diffusion-weighted magnetic resonance imaging in peritoneal carcinomatosis from suspected ovarian cancer: Diagnostic performance in correlation with surgical findings

Highlights: • Ovarian cancer disseminates by the peritoneum with high mortality associated. • Cytoreduction surgery with residual tumour • Peritoneal Cancer Index (PCI) provides information about peritoneal tumour burden. • Diffusion MRI provides better diagnostic performance than reported for CT or PET/CT. • Diffusion MR PCI correlates with surgical PCI and with residual tumour after cytoreduction. - Abstract: PurposeOvarian cancer (OC) is the commonest cause of death by gynaecological cancer in developed countries. Peritoneal carcinomatosis (PC) complete debulking without residual disease of >1 cm is the best prognostic predictor in advanced OC. PC is assessed with Computed tomography (CT). CT accuracy and cytoreduction success predictive ability are limited. PET/CT is not an imaging standard for PC. PC shows high signal foci in Diffusion-weighted magnetic resonance imaging (DWI MRI). We assessed the diagnostic performance (DP) and tumour burden correlation of Whole body DWI with background suppression MRI (WB-DWIBS/MRI) in PC of suspected OC using the Peritoneal Cancer Index (PCI), referring to cytoreduction surgery as the standard reference.