Role of New Functional MRI Techniques in the Diagnosis, Staging, and Followup of Gynecological Cancer: Comparison with PET-CT

Figure 2

Peritoneal dissemination from recurrent ovarian serous adenocarcinoma in a 45-year-old woman. Image illustrates the diagnostic accuracy of different techniques. First row (a1) PET, (a2) CT, and (a3) DWI. Tumor deposit along the fissure of the hepatoduodenal ligament (arrows). PET and CT show only one lesion, being difficult to differentiate between a hepatic deposit and peritoneal implant. At DWI, two adjacent millimetric lesions are depicted, suggesting peritoneal implants. Second row (b1) PET, (b2) CT, and (b3) DWI. Implant in splenic helium, clearly visible in PET, but hardly visible at CT. However, DWI cannot detect the lesion because of the physiological hyperintensity of spleen. Third row (c1) PET, (c2) CT and (c3) DWI. A small implant in right paracolic gutter, measuring as small as 3 mm. DWI clearly demonstrates peritoneal disseminated implants as markedly hyperintense foci.