Whole-body MRI in oncology: can a single anatomic T2 Dixon sequence replace the combination of T1 and STIR sequences to detect skeletal metastasis and myeloma?
Cancer
Magnetic resonance imaging
Metastasis
Multiple myeloma
Whole-body imaging
Journal
European radiology
ISSN: 1432-1084
Titre abrégé: Eur Radiol
Pays: Germany
ID NLM: 9114774
Informations de publication
Date de publication:
Jan 2023
Jan 2023
Historique:
received:
09
02
2022
accepted:
30
06
2022
revised:
21
06
2022
pubmed:
5
8
2022
medline:
20
12
2022
entrez:
4
8
2022
Statut:
ppublish
Résumé
To compare the diagnostic accuracy of a single T2 Dixon sequence to the combination T1+STIR as anatomical sequences used for detecting tumoral bone marrow lesions in whole-body MRI (WB-MRI) examinations. Between January 2019 and January 2020, seventy-two consecutive patients (55 men, 17 women, median age = 66 years) with solid (prostate, breast, neuroendocrine) cancers at high risk of metastasis or proven multiple myeloma (MM) prospectively underwent a WB-MRI examination including coronal T1, STIR, T2 Dixon and axial diffusion-weighted imaging sequences. Two radiologists independently assessed the combination of T1+STIR sequences and the fat+water reconstructions from the T2 Dixon sequence. The reference standard was established by consensus reading of WB-MRI and concurrent imaging available at baseline and at 6 months. Repeatability and reproducibility of MRI scores (presence and semi-quantitative count of lesions), image quality (SNR: signal-to-noise, CNR: contrast-to-noise, CRR: contrast-to-reference ratios), and diagnostic characteristics (Se: sensitivity, Sp: specificity, Acc: accuracy) were assessed per-skeletal region and per-patient. Repeatability and reproducibility were at least good regardless of the score, region, and protocol (0.67 ≤ AC1 ≤ 0.98). CRR was higher on T2 Dixon fat compared to T1 (p < 0.0001) and on T2 Dixon water compared to STIR (p = 0.0128). In the per-patient analysis, Acc of the T2 Dixon fat+water was higher than that of T1+STIR for the senior reader (Acc = +0.027 [+0.025; +0.029], p < 0.0001) and lower for the junior reader (Acc = -0.029 [-0.031; -0.027], p < 0.0001). A single T2 Dixon sequence with fat+water reconstructions offers similar reproducibility and diagnostic accuracy as the recommended combination of T1+STIR sequences and can be used for skeletal screening in oncology, allowing significant time-saving. • Replacement of the standard anatomic T1 + STIR WB-MRI protocol by a single T2 Dixon sequence drastically shortens the examination time without loss of diagnostic accuracy. • A protocol based on fat + water reconstructions from a single T2 Dixon sequence offers similar inter-reader agreement and a higher contrast-to-reference ratio for detecting lesions compared to the standard T1 + STIR protocol. • Differences in the accuracy between the two protocols are marginal (+ 3% in favor of the T2 Dixon with the senior reader; -3% against the T2 Dixon with the junior reader).
Identifiants
pubmed: 35925384
doi: 10.1007/s00330-022-09007-8
pii: 10.1007/s00330-022-09007-8
pmc: PMC9755082
doi:
Substances chimiques
Water
059QF0KO0R
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
244-257Informations de copyright
© 2022. The Author(s).
Références
Radiology. 2011 Dec;261(3):700-18
pubmed: 22095994
J Natl Compr Canc Netw. 2014 May;12(5):686-718
pubmed: 24812137
Diagn Interv Imaging. 2019 Sep;100(9):513-519
pubmed: 31130374
Eur Radiol. 2020 Jun;30(6):3083-3093
pubmed: 32065282
J Clin Oncol. 1994 Jul;12(7):1415-21
pubmed: 8021732
Cancer Med. 2018 Jun;7(6):2699-2709
pubmed: 29733523
J Magn Reson Imaging. 2008 Sep;28(3):543-58
pubmed: 18777528
Eur Radiol. 2006 May;16(5):1005-14
pubmed: 16463030
J Magn Reson Imaging. 2000 Apr;11(4):343-50
pubmed: 10767062
J Clin Oncol. 2007 Aug 1;25(22):3281-7
pubmed: 17664475
Radiol Artif Intell. 2021 Jul 14;3(5):e200279
pubmed: 34617028
Magn Reson Med. 2018 Oct;80(4):1402-1415
pubmed: 29446127
Radiology. 2017 Apr;283(1):168-177
pubmed: 27875103
Eur Radiol. 2021 Dec;31(12):9418-9427
pubmed: 34041569
Radiology. 1992 Dec;185(3):833-40
pubmed: 1438772
Semin Musculoskelet Radiol. 2015 Sep;19(4):335-47
pubmed: 26583362
Eur Radiol. 2000;10(2):224-9
pubmed: 10663751
Br J Radiol. 2012 Aug;85(1016):1102-6
pubmed: 22457319
Eur Urol. 2017 Jan;71(1):81-92
pubmed: 27317091
Radiology. 2014 Jun;271(3):785-94
pubmed: 24475858
Br J Radiol. 2018 May;91(1085):20170782
pubmed: 29393668
Eur Radiol. 2019 Aug;29(8):4503-4513
pubmed: 30413957
Radiology. 2018 Mar;286(3):948-959
pubmed: 29095674
Br J Math Stat Psychol. 2008 May;61(Pt 1):29-48
pubmed: 18482474
Eur Radiol. 2020 May;30(5):2583-2593
pubmed: 32020402
Radiat Med. 2004 Jul-Aug;22(4):275-82
pubmed: 15468951
AJR Am J Roentgenol. 1994 Jan;162(1):215-21
pubmed: 8273669
Eur Radiol. 2016 Apr;26(4):932-40
pubmed: 26162578
AJR Am J Roentgenol. 2012 Aug;199(2):252-62
pubmed: 22826385
Eur Radiol. 2020 Apr;30(4):1927-1937
pubmed: 31844960
Radiology. 2016 May;279(2):345-65
pubmed: 27089188
J Clin Oncol. 2015 Feb 20;33(6):657-64
pubmed: 25605835
Eur Radiol. 2010 Dec;20(12):2973-82
pubmed: 20661742
Radiology. 1984 Oct;153(1):189-94
pubmed: 6089263
Br J Haematol. 2008 Apr;141(1):60-8
pubmed: 18324967
Radiology. 2015 Apr;275(1):155-66
pubmed: 25513855
Radiology. 2008 Aug;248(2):643-54
pubmed: 18539889
Radiology. 2019 Apr;291(1):5-13
pubmed: 30806604
Eur Radiol. 2021 Apr;31(4):1843-1852
pubmed: 32965573
Ann Oncol. 2020 Dec;31(12):1623-1649
pubmed: 32979513
Eur J Radiol. 2005 Jul;55(1):56-63
pubmed: 15950101
Radiology. 2005 Nov;237(2):590-6
pubmed: 16244268
Radiology. 2004 Oct;233(1):139-48
pubmed: 15317952
J Magn Reson Imaging. 2010 Jan;31(1):4-18
pubmed: 20027567
Biometrics. 1977 Mar;33(1):159-74
pubmed: 843571
J Magn Reson Imaging. 2009 Aug;30(2):298-308
pubmed: 19629984
J Magn Reson Imaging. 2011 Feb;33(2):390-400
pubmed: 21274981
J Magn Reson Imaging. 2017 Dec;46(6):1619-1630
pubmed: 28301099