Diffusion-Weighted Whole-Body Imaging with Background Body Signal Suppression (DWIBS): MRI Sequence for Metastatic Workup
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- Category: Vol. 81, June 2013
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Diffusion-Weighted Whole-Body Imaging with Background Body Signal Suppression (DWIBS): MRI Sequence for Metastatic Workup,MOHAMED ZIDAN, MOHAMMAD K. MAHMOUD and HAZEM A. YOUSEF
Abstract
Objectives: To assess the feasibility of DWIBS in screening patients for metastasis either in bone, solid organs or lymph nodes.
Patients and Methods: A total of 50 patients (27 men and 23 women) with their ages ranged from 27-69 years, mean age, 48 years. Forty five patients (25 men and 20 women) had distant metastases from a known primary malignancy, and five patients (2 men and 3 women) had no known primary malignancy. All of them underwent DWIBS, whole body T1WI and STIR reconstructed in the coronal plane and also whole body T2WI for only ten patients.
Results: Distant metastases were well depicted in lymph nodes, solid organs or bone marrow in T1WI, T2WI & STIR images and DWIBS but the later detected more bone marrow lesions than those detected in the former MRI sequences in only two patients. In the patients not known to have primary malignancy; abnormal bone marrow infiltration was depicted in DWIBS and was proved to be lymphoma. In another patient; a right breast mass was detected in DWIBS and was histo-pathologically proved as ductal adenocarcinoma. DWIBS and other conventional pulse sequences depicted recurrent tumors as well as distant metastases; however the conventional pulse sequences localized the lesions better. A high degree of agreement also existed between DWIBS and STIR more than other pulse sequences.
Conclusion: DWIBS satisfactorily shows the presence and the extent of bone as well soft tissue (solid organs and lymph nodes) metastases but not specific for the characteriza-tion of lesions. It needs no ionizing radiation or contrast media and also has better spatial resolution. The relative availability of this technique and local experience should first be taken into account.