Mosavi Firas, Laurell Anna, Ahlström Håkan
a Section of Radiology, Department of Radiology , Oncology and Radiation Science, Uppsala University Hospital , Uppsala , Sweden.
b Section of Oncology, Department of Radiology , Oncology and Radiation Science, Uppsala University Hospital , Uppsala , Sweden.
Acta Oncol. 2015 Nov;54(10):1763-9. doi: 10.3109/0284186X.2015.1043027. Epub 2015 May 15.
Whole body (WB) magnetic resonance imaging (MRI), including diffusion-weighted imaging (DWI) has become increasingly utilized in cancer imaging, yet the clinical utility of these techniques in follow-up of testicular cancer patients has not been evaluated. The purpose of this study was to evaluate the feasibility of WB MRI with continuous table movement (CTM) technique, including multistep DWI in follow-up of patients with testicular cancer.
WB MRI including DWI was performed in follow-up of 71 consecutive patients (median age, 37 years; range 19-84) with histologically confirmed testicular cancer. WB MRI protocol included axial T1-Dixon and T2-BLADE sequences using CTM technique. Furthermore, multi-step DWI was performed using b-value 50 and 1000 s/mm(2). One criterion for feasibility was patient tolerance and satisfactory image quality. Another criterion was the accuracy in detection of any pathological mass, compared to standard of reference. Signal intensity in DWI was used for evaluation of residual mass activity. Clinical, laboratory and imaging follow-up were applied as standard of reference for the evaluation of WB MRI.
WB MRI was tolerated in nearly all patients (69/71 patients, 97%) and the image quality was satisfactory. Metal artifacts deteriorated the image quality in six patients, but it did not influence the overall results. No case of clinical relapse was observed during the follow-up time. There was a good agreement between conventional WB MRI and standard of reference in all patients. Three patients showed residual masses and DWI signal was not restricted in these patients. Furthermore, DWI showed abnormally high signal intensity in a normal-sized retroperitoneal lymph node indicating metastasis. The subsequent (18)F-FDG PET/CT could verify the finding.
WB MRI with CTM technique including multi-step DWI is feasible in follow-up of patients with testicular cancer. DWI may contribute to important added-value data to conventional MRI sequences regarding the activity of residual masses.
全身（WB）磁共振成像（MRI），包括扩散加权成像（DWI），在癌症成像中的应用越来越广泛，但这些技术在睾丸癌患者随访中的临床实用性尚未得到评估。本研究的目的是评估采用连续床移动（CTM）技术的WB MRI，包括多步DWI在睾丸癌患者随访中的可行性。
对71例经组织学证实的睾丸癌患者（中位年龄37岁；范围19 - 84岁）进行随访，均接受了包括DWI的WB MRI检查。WB MRI方案包括采用CTM技术的轴位T1 - Dixon和T2 - BLADE序列。此外，使用b值50和1000 s/mm²进行多步DWI。可行性的一个标准是患者耐受性和满意的图像质量。另一个标准是与参考标准相比，检测任何病理性肿块的准确性。DWI中的信号强度用于评估残留肿块的活性。临床、实验室和影像学随访作为评估WB MRI的参考标准。
几乎所有患者（69/71例患者，97%）都能耐受WB MRI，图像质量令人满意。6例患者的金属伪影使图像质量下降，但未影响总体结果。随访期间未观察到临床复发病例。所有患者的传统WB MRI与参考标准之间具有良好的一致性。3例患者显示有残留肿块，这些患者的DWI信号未受限。此外，DWI在一个正常大小的腹膜后淋巴结中显示出异常高的信号强度，提示转移。随后的（18）F - FDG PET/CT证实了这一发现。
采用CTM技术包括多步DWI的WB MRI在睾丸癌患者随访中是可行的。DWI可能为传统MRI序列提供有关残留肿块活性的重要附加价值数据。
