| Title: |
Prediction of Resectability of Peritoneal Disease in Ovarian Cancer Patients Using the Peritoneal Cancer Index (PCI) and Fagotti Score on MRI |
| Authors: |
Marianna Konidari; Sofia Gourtsoyianni; Nikolaos Thomakos; Georgia Lymperopoulou; Chara Tzavara; Vasilios Pergialiotis; Alexandros Rodolakis; Lia Angela Moulopoulos; Charis Bourgioti |
| Source: |
Cancers ; Volume 18 ; Issue 1 ; Pages: 165 |
| Publisher Information: |
Multidisciplinary Digital Publishing Institute |
| Publication Year: |
2026 |
| Collection: |
MDPI Open Access Publishing |
| Subject Terms: |
ovarian cancer; MRI; peritoneal carcinomatosis; cytoreduction; Peritoneal Cancer Index; Fagotti score; Diffusion-Weighted Imaging |
| Description: |
Background/Objectives: Cytoreduction status is a critical prognostic factor in ovarian cancer, yet preoperative selection of patients suitable for primary debulking surgery and accurate prediction of surgical outcome remain challenging. This study aimed to evaluate the prognostic ability of MRI-based Fagotti score and Peritoneal Cancer Index (PCI) for predicting resectability of peritoneal disease in ovarian cancer patients. Methods: This was a prospective single-center observational study. Patients with suspected primary ovarian cancer who underwent preoperative MRI of the abdomen and pelvis with a dedicated protocol were considered. MRI-based Fagotti score and PCI were determined by two readers independently, using a combination of T2W, Diffusion-Weighted Imaging (DWI), and contrast-enhanced T1W sequences. In cases of discordance, a third radiologist reviewed the scans and consensus was reached. ROC analysis and logistic regression were used to evaluate prognostic performance. The reference standard to predict resectability was optimal cytoreduction defined as residual disease ≤1 cm. Results: Forty-six women with epithelial ovarian cancer (mean age 56.3 ± 2.6 years) who underwent preoperative MRI, followed by laparoscopy and/or laparotomy, were included in the study. Both MRI-based Fagotti score and PCI showed high predictive value for predicting resectability (AUC 0.92 and 0.94, respectively). Optimal cut-offs were ≤6 for Fagotti score and ≤20 for PCI. Patients with scores below these thresholds had >60-fold (Fagotti) and >100-fold (PCI) increased odds for successful primary cytoreduction (p < 0.001). Conclusions: MRI-based Fagotti score and PCI may serve as powerful noninvasive predictors of surgical outcome in ovarian cancer. MRI may reliably guide treatment decisions, reducing unnecessary laparotomies and optimizing patient selection. |
| Document Type: |
text |
| File Description: |
application/pdf |
| Language: |
English |
| Relation: |
Methods and Technologies Development; https://dx.doi.org/10.3390/cancers18010165 |
| DOI: |
10.3390/cancers18010165 |
| Availability: |
https://doi.org/10.3390/cancers18010165 |
| Rights: |
https://creativecommons.org/licenses/by/4.0/ |
| Accession Number: |
edsbas.FFBBDD95 |
| Database: |
BASE |