High-grade serous ovarian cancer: Associations between BRCA mutation status, CT imaging phenotypes, and clinical outcomes Journal Article


Authors: Nougaret, S.; Lakhman, Y.; Gönen, M.; Goldman, D. A.; Miccò, M.; D'Anastasi, M.; Johnson, S. A.; Juluru, K.; Arnold, A. G.; Sosa, R. E.; Soslow, R. A.; Vargas, H. A.; Hricak, H.; Kauff, N. D.; Sala, E.
Article Title: High-grade serous ovarian cancer: Associations between BRCA mutation status, CT imaging phenotypes, and clinical outcomes
Abstract: Purpose: To investigate the associations between BRCA mutation status and computed tomography (CT) phenotypes of high-grade serous ovarian cancer (HGSOC) and to evaluate CT indicators of cytoreductive outcome and survival in patients with BRCA-mutant HGSOC and those with BRCA wild-type HGSOC. Materials and Methods: This HIPAA-compliant, institutional review board-approved retrospective study included 108 patients (33 with BRCA mutant and 75 with BRCA wild-type HGSOC) who underwent CT before primary debulking. Two radiologists independently reviewed the CT findings for various qualitative CT features. Associations between CT features, BRCA mutation status, cytoreductive outcome, and progression-free survival (PFS) were evaluated by using logistic regression and Cox proportional hazards regression, respectively. Results: Peritoneal disease (PD) pattern, presence of PD in gastrohepatic ligament, mesenteric involvement, and supradiaphragmatic lymphadenopathy at CT were associated with BRCA mutation status (multiple regression: P < .001 for each CT feature). While clinical and CT features were not associated with cytoreductive outcome for patients with BRCA-mutant HGSOC, presence of PD in lesser sac (odds ratio [OR] = 2.40) and left upper quadrant (OR = 1.19), mesenteric involvement (OR = 7.10), and lymphadenopathy in supradiaphragmatic (OR = 2.83) and suprarenal para-aortic (OR = 4.79) regions were associated with higher odds of incomplete cytoreduction in BRCA wild-type HGSOC (multiple regression: P < .001 each CT feature). Mesenteric involvement at CT was associated with significantly shorter PFS for both patients with BRCA-mutant HGSOC (multiple regression: hazard ratio [HR] = 26.7 P < .001) and those with BRCA wild-type HGSOC (univariate analysis: reader 1, HR = 2.42, P < .001; reader 2, HR = 2.61; P < .001). Conclusion: Qualitative CT features differed between patients with BRCA-mutant HGSOC and patients with BRCA wild-type HGSOC. CT indicators of cytoreductive outcome varied according to BRCA mutation status. Mesenteric involvement at CT was an indicator of significantly shorter PFS for both patients with BRCA-mutant HGSOC and those with BRCA wild-type HGSOC. © RSNA, 2017.
Keywords: adult; cancer survival; controlled study; aged; aged, 80 and over; disease-free survival; middle aged; cancer surgery; retrospective studies; gene mutation; major clinical study; genetics; mutation; clinical feature; mortality; disease free survival; outcome assessment; paraaortic lymph node; cytoreductive surgery; ovarian neoplasms; phenotype; progression free survival; computer assisted tomography; ovary cancer; genetic association; tomography, x-ray computed; diagnostic imaging; retrospective study; wild type; oncogene; tumor suppressor gene; genes, brca1; genes, brca2; lymph node; lymphadenopathy; qualitative analysis; peritoneal disease; ligament; mesentery lymph node; very elderly; humans; human; female; priority journal; article; x-ray computed tomography; high grade serous ovarian cancer; supradiaphragmatic lymph node
Journal Title: Radiology
Volume: 285
Issue: 2
ISSN: 0033-8419
Publisher: Radiological Society of North America, Inc.  
Date Published: 2017-11-01
Start Page: 472
End Page: 481
Language: English
DOI: 10.1148/radiol.2017161697
PUBMED: 28628421
PROVIDER: scopus
PMCID: PMC5673044
DOI/URL:
Notes: Article -- Export Date: 4 December 2017 -- Source: Scopus
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MSK Authors
  1. Yuliya Lakhman
    32 Lakhman
  2. Evis Sala
    94 Sala
  3. Noah Kauff
    122 Kauff
  4. Mithat Gonen
    701 Gonen
  5. Robert Soslow
    641 Soslow
  6. Hedvig Hricak
    330 Hricak
  7. Debra Alyssa Goldman
    92 Goldman
  8. Angela Arnold
    24 Arnold
  9. Maura Micco
    10 Micco
  10. Ramon Elias Sosa
    16 Sosa
  11. Krishna   Juluru
    11 Juluru