Introduction/Background There is no consensus on the gold standard method for the preoperative evaluation of peritoneal carcinomatosis from ovarian cancer.This systematic review aims to determine the usefulness of whole-body MRI in the preoperative assessment of ovarian cancer based on the available evidence.

Methodology A systematic review of the literature was performed in PubMed, Web of Science and Scopus. Inclusion criteria were prospective or retrospective studies in English or Spanish comparing whole-body MRI findings grouped into zones according to the peritoneal carcinomatosis index (PCI) with operative findings at laparotomy and/or histology. Sensitivity and specificity for the detection of peritoneal disease by whole-body MRI, as well as post-test probabilities and ROC curve in each zone were calculated. A QUADAS-2 was performed for quality-of-evidence analysis and risk of bias. Heterogeneity was calculated through Cochran’s Q and I2.

Results A total of 104 articles were found. Afte the inclusion and exclusion criteria were applied, 5 articles were included, with 275 women with suspected ovarian cancer being assessed through whole-body MRI. Specificity was greater than 75% in all anatomical areas and sensitivity less than 75% in all areas, except in areas PCI 0 86% (95% CI, 76–92%), PCI 1 75% (95% CI, 68–81%), PCI 4 80% (95% CI, 54–93%), PCI 6 86% (95% CI, 63–95%). PCI areas 5 and 7 were not evaluated because there were insufficient data in the articles reviewed.

Conclusion Whole body MRI has a high specificity to exclude the presence of peritoneal carcinomatosis in all areas of the PCI while the sensitivity varies depending on the area, being high in the center of the abdomen (PCI 0), right hypochondrium (PCI 1), left flank (PCI 4) and pelvis (PCI 6).