A study looking at diffusion weighted MRI scans to check if treatment is working for ovarian cancer (DISCOVAR)

The team found that the results of the DW-MRI scans were reliable and informative. The scans could find very small, early changes that happen when treatment is working. This study was looking at people with advanced ovarian cancer.

About this study
This study included women whose cancer had spread elsewhere in the body. This is advanced cancer. There were 2 groups (cohorts) in this study:

• 47 people were studied before any treatment for their cancer. They went on to have chemotherapy followed by surgery. This group was called cohort 1.
• 78 people with cancer that had come back after treatment were also studied. They went on to have more chemotherapy. This group was called cohort 2. 

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In cohort 1 everyone had: 

• 2 MRI scans before starting chemotherapy
• another MRI before surgery

The 2 scans before treatment were to make sure that it was possible to repeat the scan and get the same results. 

In cohort 2 everyone had an MRI:

• before starting chemotherapy
• after 1 cycle of chemotherapy
• after 3 cycles of chemotherapy 

The team used a particular measurement from the DW-MRI scan to assess if treatment was working. 

Results
The team ran the study at a number of different hospitals. To begin with they made sure that it was possible to get the same results across the different sites. They checked this carefully and found that it was possible.

Then they checked if the DW-MRI scans could show that treatment was working. First, they looked to see whose treatment was working in the usual way. They did this by:

• checking the results of the CA125 blood tests
• measuring the size of the cancer on the routine MRI scan

They compared these results with the DW-MRI scans results. 

Cohort 1 
After 3 or 4 cycles of chemotherapy they checked if treatment was working. 

They found it was in:

• 33 out of 35 people based on monitoring their CA 125 blood test
• 31 out of 36 people based on the routine MRI scan 

Cohort 2 
After 3 or 4 cycles of chemotherapy they checked if treatment was working.

They found it was in:

• 47 out of 65 people when monitored using the CA 125 blood test
• 44 out of 66 people based on the routine MRI scan

DW-MRI scans
The team looked at the results of the DW-MRI scans after 3 or 4 cycles of treatment. They compared the study scan to:

• the baseline study scan done before treatment started
• the routine MRI scan and CA 125 blood test results

In people whose treatment was working the increase in the measurement on DW-MRI scan was bigger. It was much bigger than in people whose treatment was not working. 

The team also looked at the scans after 1 cycle of treatment in people having treatment for cancer that had come back. This was cohort 2. They wanted to see if it was possible to predict whose cancer might start to grow again. 

They found that a few people had early increases in the DW-MRI measurement. The team say that these people had a longer period of time before the cancer started to grow again.

Conclusion
The team concluded that it was possible to use a DW-MRI scan to see if treatment was working in people with ovarian cancer that had spread. They found that the measurements from the DW-MRI scans were reliable and could find early changes that show the treatment is working. 

The team say they need to do more research in a larger trial for ovarian cancer. This is to confirm the usefulness of the measurement they used from the DW-MRI scan in ovarian cancer.  

Measurements from DW-MRI were useful to check how treatment worked in larger trials in breast cancer. 

Where this information comes from    
We have based this summary on information from the research team. The information they sent us has been reviewed by independent specialists (peer reviewed ) and published in a medical journal. The figures we quote above were provided by the trial team who did the research. We have not analysed the data ourselves.