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Background <p>Prediction of surgical and survival outcomes following neoadjuvant chemotherapy (NACT) in ovarian cancer remains challenging. This study evaluated whole-body diffusion-weighted magnetic resonance imaging (WB-DWI/MRI) after NACT for predicting complete resection at interval debulking surgery (IDS), progression-free survival, and overall survival.</p> Methods <p>In this prospective, single-centre study, 105 patients with non-primary resectable ovarian cancer underwent WB-DWI/MRI following NACT. The performance of WB-DWI/MRI in predicting complete resection and survival was assessed. Prediction of complete resection was compared with computed tomography (CT) when available.</p> Results <p>Seventy-four (70%) patients achieved complete resection. WB-DWI/MRI-predicted complete resection with 97.3% sensitivity, 83.9% specificity and 93.3% accuracy. MRI-based complete resection prediction, complete resection at IDS, and serum CA-125 significantly affected progression-free survival&#xa0;(MRI: Hazard Ratio [HR] = 5.43, IDS: HR = 4.19, CA-125: HR = 1.68; <i>p</i> &lt; 0.01) with the first two parameters also significantly affecting overall survival (MRI: HR = 4.24, IDS: HR = 2.87; <i>p</i> &lt; 0.01). Multivariate analysis confirmed MRI-based complete resection prediction and serum CA-125 as significant for progression-free (<i>p</i> &lt; 0.001 and <i>p</i> = 0.04) and MRI-based prediction significant for overall survival (<i>p</i> &lt; 0.001). In a 69-patient subanalysis, WB-DWI/MRI-predicted complete resection was significantly better than CT (91.3% vs. 72.5% accuracy, <i>p</i> &lt; 0.001).</p> Conclusion <p>WB-DWI/MRI after NACT is accurate for predicting surgical and survival outcomes in patients with non-primary resectable ovarian cancer.</p>

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Value of whole-body diffusion-weighted MRI for the prediction of surgical and clinical outcome after neoadjuvant chemotherapy in advanced ovarian cancer

  • 期刊论文

  • 发表日期：

    2026年4月4日

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  • Vincent Vandecaveye,
  • Raphaëla C. Dresen,
  • Thaïs Baert,
  • Valérie Broeckhoven,
  • Els Van Nieuwenhuysen,
  • Toon Van Gorp,
  • Frederik. De Keyzer,
  • Ignace Vergote

摘要

Background

Prediction of surgical and survival outcomes following neoadjuvant chemotherapy (NACT) in ovarian cancer remains challenging. This study evaluated whole-body diffusion-weighted magnetic resonance imaging (WB-DWI/MRI) after NACT for predicting complete resection at interval debulking surgery (IDS), progression-free survival, and overall survival.

Methods

In this prospective, single-centre study, 105 patients with non-primary resectable ovarian cancer underwent WB-DWI/MRI following NACT. The performance of WB-DWI/MRI in predicting complete resection and survival was assessed. Prediction of complete resection was compared with computed tomography (CT) when available.

Results

Seventy-four (70%) patients achieved complete resection. WB-DWI/MRI-predicted complete resection with 97.3% sensitivity, 83.9% specificity and 93.3% accuracy. MRI-based complete resection prediction, complete resection at IDS, and serum CA-125 significantly affected progression-free survival (MRI: Hazard Ratio [HR] = 5.43, IDS: HR = 4.19, CA-125: HR = 1.68; p < 0.01) with the first two parameters also significantly affecting overall survival (MRI: HR = 4.24, IDS: HR = 2.87; p < 0.01). Multivariate analysis confirmed MRI-based complete resection prediction and serum CA-125 as significant for progression-free (p < 0.001 and p = 0.04) and MRI-based prediction significant for overall survival (p < 0.001). In a 69-patient subanalysis, WB-DWI/MRI-predicted complete resection was significantly better than CT (91.3% vs. 72.5% accuracy, p < 0.001).

Conclusion

WB-DWI/MRI after NACT is accurate for predicting surgical and survival outcomes in patients with non-primary resectable ovarian cancer.