Tumor detection by diffusion-weighted MRI and ADC-mapping—initial clinical experiences in comparison to PET-CT

Matthias P Lichy, Philip Aschoff, Christian Plathow, Alto Stemmer, Wilhelm Horger, Christian Mueller-Horvat, Gunter Steidle, Marius Horger, Jurgen Schafer, Susanne M Eschmann, Berthold Kiefer, Claus D Claussen, Christina Pfannenberg, Heinz-Peter Schlemmer
Investigative Radiology 2007, 42 (9): 605-13

OBJECTIVE: To evaluate the clinical potential of diffusion-weighted-imaging (DWI) with apparent diffusion coefficient (ADC)-mapping for tumor detection.

MATERIALS AND METHODS: A single-shot echo-planar-imaging DWI sequence with fat suppression and ability for navigator-based respiratory triggering was implemented. Nineteen patients (11 melanoma, 4 prostate cancer, 1 non-Hodgkin lymphoma, and 3 lung cancer) were examined by positron emission tomography (PET) with an integrated computed tomography scanner (PET-CT) and DWI. Images at b = 0, 400, and 1000 s/mm2 were acquired and ADC maps were generated. PET examinations were used as a reference for tumor detection. Four hundred twenty-four regions of interest were used for DWI and 73 for PET data evaluation.

RESULTS: DWI and ADC maps were of diagnostic quality. Metastases with increased tracer uptake were clearly visualized at b = 1000 s/mm2 with the exception of mediastinal lymph node metastases in cases of lung cancer. ADC mapping did not improve detection rates.

CONCLUSIONS: DWI is a feasible clinical technique, improving the assessment of metastatic spread in routine magnetic resonance imaging examinations.

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