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.

Heidemeier, Anke; Thurner, Annette; Metz, Corona; Pabst, Thomas; Heidemeier, Heike; Rasche, Leo; Kortüm, K Martin; Einsele, Hermann; Grimm, Robert; Weiland, Elisabeth; Bley, Thorsten Alexander (2020). 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 Press). Academic radiology Elsevier 10.1016/j.acra.2020.09.016

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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.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Medical Oncology

UniBE Contributor:

Pabst Müller, Thomas Niklaus

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1076-6332

Publisher:

Elsevier

Language:

English

Submitter:

Rebeka Gerber

Date Deposited:

30 Dec 2020 11:40

Last Modified:

30 Dec 2020 11:40

Publisher DOI:

10.1016/j.acra.2020.09.016

PubMed ID:

33139155

Uncontrolled Keywords:

Diffusion-weighted MRI Multiple myeloma Plasma cell disease Whole-body MRI b 2000 s/mm(2) b-Value

BORIS DOI:

10.48350/149326

URI:

https://boris.unibe.ch/id/eprint/149326

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