全身多参数 MRI 弥散加权成像及 ADC 图在识别实体瘤内脏及骨转移中的应用。
Multiparametric Whole-body MRI with Diffusion-weighted Imaging and ADC Mapping for the Identification of Visceral and Osseous Metastases From Solid Tumors.
机构信息
The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD 21205; Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins University School of Medicine, Baltimore, MD 21205.
The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD 21205; Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins University School of Medicine, Baltimore, MD 21205.
出版信息
Acad Radiol. 2018 Nov;25(11):1405-1414. doi: 10.1016/j.acra.2018.02.010. Epub 2018 Apr 4.
RATIONALE AND OBJECTIVES
The purpose of this study was to investigate the use of multiparametric, whole-body, diffusion-weighted imaging (WB-DWI) and apparent diffusion coefficient (ADC) maps with T-weighted magnetic resonance imaging (MRI) at 3T for the detection and monitoring of metastatic disease in patients.
MATERIALS AND METHODS
Fifty-four participants (32 healthy subjects and 22 patients) were scanned with WB-DWI methods using a 3T MRI scanner. Axial, sagittal, or coronal fat-suppressed T-weighted (TWI), T-weighted (TWI), and DWI images were acquired. Total MRI acquisition and set-up time was approximately 45 minutes. Metastatic disease on MRI was confirmed based on TWI characteristics. The number of lesions was established on computed tomography (CT) or positron emission tomography (PET-CT). Whole-body ADC maps and TWI were constructed, and region-of-interests were drawn in normal and abnormal-appearing tissue for quantitative analysis. Statistical analysis was performed using a paired t tests and P < .05 was considered statistically significant.
RESULTS
There were 91 metastatic lesions detected from the CT or PET-CT with a missed recurrent lesion in the prostate. Multiparametric WB-MRI had excellent sensitivity (96%) for detection of metastatic lesions compared to CT. ADC map values and the ADC ratio in metastatic bone lesions were significantly increased (P < .05) compared to normal bone. In soft tissue, ADC map values and ratios in metastatic lesions were decreased compared to normal soft tissue.
CONCLUSION
We have demonstrated that multiparametric WB-MRI is feasible for oncologic staging to identify bony and visceral metastasis in breast, prostate, pancreatic, and colorectal cancers. WB-MRI can be tailored to fit the patient, such that an "individualized patient sequence" can be developed for a comprehensive evaluation for staging and response during treatment.
背景与目的
本研究旨在探讨使用全身磁共振扩散加权成像（WB-DWI）和表观扩散系数（ADC）图与 3T 磁共振 T 加权成像（TWI）检测和监测转移性疾病的方法。
材料与方法
54 名参与者（32 名健康受试者和 22 名患者）使用 3T MRI 扫描仪进行全身 WB-DWI 方法扫描。获取轴向、矢状或冠状脂肪抑制 TWI（TWI）、TWI 和 DWI 图像。总 MRI 采集和设置时间约为 45 分钟。根据 TWI 特征确认 MRI 上的转移性疾病。根据计算机断层扫描（CT）或正电子发射断层扫描（PET-CT）确定病变数量。构建全身 ADC 图和 TWI，并在正常和异常表现组织中画出感兴趣区进行定量分析。使用配对 t 检验进行统计分析，P<0.05 被认为具有统计学意义。
结果
CT 或 PET-CT 检测到 91 个转移性病变，前列腺有一个遗漏的复发性病变。与 CT 相比，多参数全身 MRI 对转移性病变的检测具有优异的敏感性（96%）。与正常骨相比，转移性骨病变的 ADC 图值和 ADC 比值显著增加（P<0.05）。在软组织中，与正常软组织相比，转移性病变的 ADC 图值和比值降低。
结论
我们已经证明，多参数全身 MRI 可用于肿瘤分期，以识别乳腺癌、前列腺癌、胰腺癌和结直肠癌的骨和内脏转移。全身 MRI 可以根据患者进行定制，例如可以为全面评估分期和治疗期间的反应开发“个体化患者序列”。
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