Whole-Body MRI with an Ultrahigh b-Value of 2000 s/mm2 Improves the Specificity of Diffusion-Weighted Imaging in Patients with Plasma Cell Dyscrasias
In: Academic Radiology, Jg. 29 (2022), S. e1- (8S.)
Online
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Zugriff:
RATIONALE AND OBJECTIVES Our study compared sensitivity, specificity, and accuracy of whole-body diffusion-weighted imaging (WB-DWI) using a b-value of 2000 s/mm2 with that of the commonly used b-value of 800 s/mm2 for depiction of active tumor sites in patients with plasma cell diseases. We introduced an ultrahigh b-value to reduce interfering signals from benign and post-therapeutic inactive lesions by suppressing T2-shine-through effects. MATERIALS AND METHODS The prospective single-center study included patients when they went through a whole-body MRI (WB-MRI) staging or response evaluation procedure. The apparent diffusion coefficient (ADC) and morphologic appearance served as reference for classifying focal lesions on WB-DWI as vital or post-therapeutic. Additionally, we compared our classification with patients' serological markers of disease activity. RESULTS One hundred participants (65 ± 10 years, 58 men) underwent WB-DWI between June and October 2019. The detection rate of vital focal lesions was similar for both b-values with a sensitivity of 0.99 using b = 800 s/mm2 and 0.98 using b = 2000 s/mm2. By contrast, specificity and accuracy were 0.09 and 0.71 when using a b-value of 800 s/mm2, and 0.96 and 0.98 when using a b-value of 2000 s/mm2, respectively. The difference in specificity and accuracy was statistically significant (p < 0.001). CONCLUSION Using a b-value of 2000 s/mm2 significantly improved the specificity of lesion detection with WB-DWI as compared to the commonly used b-value of 800 s/mm2. The high b-value significantly reduced signal intensities of post-therapeutic or benign lesions and provided a significantly more accurate representation of active tumor load.
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Whole-Body MRI with an Ultrahigh b-Value of 2000 s/mm2 Improves the Specificity of Diffusion-Weighted Imaging in Patients with Plasma Cell Dyscrasias
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Autor/in / Beteiligte Person: | K. Martin Kortüm ; Heidemeier, Anke ; Bley, Thorsten A. ; Thurner, Annette ; Heidemeier, Heike ; Pabst, Thomas ; Einsele, Hermann ; Rasche, Leo ; Grimm, Robert ; Metz, Corona ; Weiland, Elisabeth |
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Zeitschrift: | Academic Radiology, Jg. 29 (2022), S. e1- (8S.) |
Veröffentlichung: | Elsevier BV, 2022 |
Medientyp: | unknown |
ISSN: | 1076-6332 (print) |
DOI: | 10.1016/j.acra.2020.09.016 |
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