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Whole-body diffusion-weighted magnetic resonance imaging in the staging of oncological patients: comparison with positron emission tomography computed tomography (PET-CT) in a pilot study

Risonanza magnetica con diffusione total-body nella stadiazione di pazienti oncologici. Confronto con TAC-PET in uno studio pilota

La radiologia medica volume 114, pages 1–17 (2009)Cite this article

Abstract

Purpose

The aim of this pilot study was to compare positron emission tomography computed tomography (PET-CT) and whole-body DWIBS in staging oncological patients to determine the staging accuracy of whole-body DWIBS.

Materials and methods

We initiated a prospective, blinded investigation on 29 patients affected by oncological diseases (n=14) or lymphoma (n=15), who underwent fluorodeoxyglucose (FDG)-based PET-CT and whole-body DWIBS for restaging purposes. Magnetic resonance (MR) imaging was conducted with a multistack (n=4) DWIBS pulse sequence. Images were read independently by two experienced radiologists and one nuclear physician. Statistical analysis assessed interobserver agreement and diagnostic accuracy.

Results

Whole-body DWIBS had a room occupation time of 20 min. Mean postprocessing time was 15 min (range 10–17 min). Mean reading time was 20 min for reader 1 (range 15–25 min) and 18 min for reader 2 (range 13–22 min). Interobserver agreement was almost perfect (=0.93). Reader 1 had a sensitivity of 89.07%, a specificity of 98.5%, and an accuracy of 97.65%, with a positive predictive value (PPV) of 85.48% and a negative predictive value (NPV) of 98.91%. Reader 2 had a sensitivity of 87.39%, a specificity of 98.39% and a diagnostic accuracy of 97.8%, with a PPV of 88.13% and a NPV of 98.75%.

Conclusions

The whole-body DWIBS protocol provided a fast whole-body examination with high specificity and NPV. One major bias of the study was the inclusion of patients with diffuse disease and advanced disease stage and the heterogeneity of the neoplastic diseases included.

Riassunto

Obiettivo

Lo scopo dello studio è il confronto tra la risonanza magnetica con difflusione total-body (WBDWIBS) e la TAC-PET nella stadiazione dei pazienti oncologici al fine di valutarne l’accuratezza diagnostica.

Materiali e metodi

Abbiamo avviato uno studio prospettico, in cieco, su 29 pazienti oncologici (15 con linfoma e 14 con altre neoplasie), che si sono sottoposte nel loro normale percorso diagnostico a TAC-PET con fluro-desossi-glucosio (FDG) e anche ad un’indagine con WB-DWIBS, per restaging di malattia. L’esame RM è stato condotto con una sequenza DWIBS acquisita in multipli pacchetti (4). Le immagini sono state lette indipendentemente da due radiologi esperti e un medico nucleare non consapevoli del quadro clinico dei pazienti. Sono stati calcolati la concordanza inter-osservatore e l’accuratezza diagnostica.

Risultati

Il protocollo WB-DWIBS ha occupato la macchina per un totale di 20 minuti. Il tempo medio di post-elaborazione è stato di 15 minuti (10–17). Il tempo di lettura medio è stato di 20 minuti per il lettore 1 (15–25) e 18 minuti per il lettore 2 (13–22). L’agreement tra i due radiologi è risultata quasi perfetta (κ=0,93). Rispettivamente i due radiologi hanno avuto una sensibilità del 89,07% e 87,39%, specificità del 98,5% e del 98,39%, accuratezza diagnostica del 97,65% e 97,8% per i due lettori, PPV del 85,48% e 88,13% e NPV 98,91 e 98,75%.

Conclusioni

Il protocollo WB-DWIBS è risultato un esame total-body veloce, con elevata specificità e NPV. Un difetto dello studio è sicuramente l’arruolamento di pazienti con lesioni multiple disseminate, l’eterogeneità della casistica.

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Affiliations

  1. SCDU Radiologia, Università del Piemonte Orientale “A. Avogadro”, C.so Mazzini 18, 28100, Novara, Italy

    A. Stecco, G. Romano, D. Volpe, A. Saponaro, S. Costantino & A. Carriero

  2. SCDU Oncologia, Università del Piemonte Orientale “A. Avogadro”, C.so Mazzini 18, 28100, Novara, Italy

    M. Negru & O. Alabiso

  3. SCDU Medicina Nucleare, ASO Maggiore della Carità, Università del Piemonte Orientale “A. Avogadro”, C.so Mazzini 18, 28100, Novara, Italy

    G. Sacchetti & E. Inglese

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  1. A. Stecco
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  2. G. Romano
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  3. M. Negru
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  4. D. Volpe
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  5. A. Saponaro
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  6. S. Costantino
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  7. G. Sacchetti
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  8. E. Inglese
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  9. O. Alabiso
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  10. A. Carriero
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Correspondence to A. Stecco.

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Stecco, A., Romano, G., Negru, M. et al. Whole-body diffusion-weighted magnetic resonance imaging in the staging of oncological patients: comparison with positron emission tomography computed tomography (PET-CT) in a pilot study. Radiol med 114, 1–17 (2009). https://doi.org/10.1007/s11547-008-0348-4

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  • DOI: https://doi.org/10.1007/s11547-008-0348-4

Keywords

  • Diffusion weighted imaging
  • Whole-body
  • PET-CT

Parole chiave

  • Diffusion weighted imaging
  • Whole body
  • TC-PET