Comparison of a sequence of entire body MRI (DWIBS)
To FDG- PET scan
In metastases detection
Preliminary results on 11 young patients.
An emerging revolution of the role of MRI in oncology studies ?

• Raymond Poincaré hospital Garches France

• Eichwald f, Carre s, Lankri z, Alkhallaf s, Delepine n, Vallée c


» CTOS LONDRES 13 au 15 Novembre 2008 et EMSOS 2008




Long-term evaluation of a sequence of MRI diffusion (Diffusion Weighted Whole Body Imaging with Background body Signal Suppression: DWIBS) and comparison to the PET-scan


Material and method

11 patients- 6 girls, 5 boys,12 to 25 years, av 17
with metastases of a known cancer
average delay of 8.2 days (2 to 15) of an exploration by pet-scan and entire body MRI
following a standard protocol (axial cuttings T2, frontal STIR, T1 without and then after intravenous contrast) completed by the sequence DWIBS
exams were read in double blind by specialists

Cases

Tableau 2 – Grille de lecture.
La grille de lecture est identique pour le protocole 1, le protocole 2 et le PET-scanner

Tableau 4 – Délai de réalisation entre l’IRM et le PET Scanner
Tableau 5 - Nombre total de localisations suspectes par technique et par patient
Tableau 6 - Nombre de localisations osseuses suspectes de malignité par technique et par patient
Tableau 7 - Nombre de localisations ganglionnaires suspectes de malignité par technique et par patient
Tableau 8 - Nombre total de localisations par technique et par région anatomique
Tableau 9 – Comparaison des protocoles 1 et 2 par patient ; Comparaison du protocole 2 et du PET-Scanner par patient

Results

All organs examinated
The uncertain pictures were detected
34 times by the PET-scan
44 times by standard MRI (+ 23%)
51 times by the MRI DWIBS (+ 34%)

In the latter case
7/8 anomalies were not visible on the PET

For bony locations, the figures respectively were 20, 26 and 29


 Discussion


 In the literature
 The standard MRI is less sensitive in the
detection of lung metastasis or lymphnodes
 But more accurate for the detection of
cerebral, hepatic or bony lesions


 Discussion

 The addition to this "classical" protocol of a sequence DWIBS seems
– According to our results
• Bring a significant gain in the detection of
secondary locations
• Appears to increase the capacity of detection of
lymph nodes where it surpasses the one of the pet
scan
• For bony or hepatic locations, it increases the
detection of questionable lesions




• Eichwald f, Carre s, Lankri z, Delepine n, Vallée c
• Raymond Poincaré hospital Garches France



» EMSOS 2008


Goals:
long-term evaluation of a sequence of MRI diffusion (Diffusion Weighted Whole Body Imaging with Background body Signal Suppression: DWIBS)
and comparison to the PET-scan.



Material and method


11 patients- 6 girls, 5 boys,12 to 25 years, av 17
with metastases of a known cancer

average delay of 8.2 days (2 to 15) of an exploration by pet-scan and entire body MRI
following a standard protocol (axial cuttings T2, frontal STIR, T1 without and then after intravenous contrast) completed by the sequence DWIBS
exams were read in double blind by specialists.



cases

Tableau 2 – Grille de lecture.

La grille de lecture est identique pour le protocole 1, le protocole 2 et le PET-scanner
Tableau 4 – Délai de réalisation entre l’IRM et le PET Scanner
Tableau 5 - Nombre total de localisations suspectes par technique et par patient.
Tableau 6 - Nombre de localisations osseuses suspectes de malignité par technique et par patient.
Tableau 7 - Nombre de localisations ganglionnaires suspectes de malignité par technique et par patient.
Tableau 8 - Nombre total de localisations par technique et par région anatomique.
Tableau 9 – Comparaison des protocoles 1 et 2 par patient ; Comparaison du protocole 2 et du PET-Scanner par patient.
Results

All organs examinated
the uncertain pictures were detected
34 times by the PET-scan
44 times by standard MRI (+ 23%)
51 times by the MRI DWIBS (+ 34%)

in the latter case
7/8 anomalies were not visible on the PET

For bony locations, the figures respectively were 20, 26 and 29.



 Discussion


 in the literature
 the standard MRI is less sensitive in the detection of lung metastases or lymph nodes
 but more accurate for the detection of cerebral, hepatic or bony lesions


 Discussion:

 The addition to this "classical" protocol of a sequence DWIBS seems
– according to our results
• bring a significant gain in the detection of secondary locations.
• appears to increase the capacity of detection of lymph nodes where it surpasses the one of the pet-scan.
• For bony or hepatic locations, it increases the detection of questionable lesions.