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Lecouvet FE, Chabot C, Taihi L, Kirchgesner T, Triqueneaux P, Malghem J. Present and future of whole-body MRI in metastatic disease and myeloma: how and why you will do it. Skeletal Radiol 2024; 53:1815-1831. [PMID: 39007948 PMCID: PMC11303436 DOI: 10.1007/s00256-024-04723-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2024] [Revised: 06/05/2024] [Accepted: 06/05/2024] [Indexed: 07/16/2024]
Abstract
Metastatic disease and myeloma present unique diagnostic challenges due to their multifocal nature. Accurate detection and staging are critical for determining appropriate treatment. Bone scintigraphy, skeletal radiographs and CT have long been the mainstay for the assessment of these diseases, but have limitations, including reduced sensitivity and radiation exposure. Whole-body MRI has emerged as a highly sensitive and radiation-free alternative imaging modality. Initially developed for skeletal screening, it has extended tumor screening to all organs, providing morphological and physiological information on tumor tissue. Along with PET/CT, whole-body MRI is now accepted for staging and response assessment in many malignancies. It is the first choice in an ever increasing number of cancers (such as myeloma, lobular breast cancer, advanced prostate cancer, myxoid liposarcoma, bone sarcoma, …). It has also been validated as the method of choice for cancer screening in patients with a predisposition to cancer and for staging cancers observed during pregnancy. The current and future challenges for WB-MRI are its availability facing this number of indications, and its acceptance by patients, radiologists and health authorities. Guidelines have been developed to optimize image acquisition and reading, assessment of lesion response to treatment, and to adapt examination designs to specific cancers. The implementation of 3D acquisition, Dixon method, and deep learning-based image optimization further improve the diagnostic performance of the technique and reduce examination durations. Whole-body MRI screening is feasible in less than 30 min. This article reviews validated indications, recent developments, growing acceptance, and future perspectives of whole-body MRI.
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Affiliation(s)
- Frederic E Lecouvet
- Department of Medical Imaging, Institut de Recherche Expérimentale et Clinique (IREC), Institut du Cancer Roi Albert II, Cliniques Universitaires Saint Luc, Université Catholique de Louvain (UCL), Avenue Hippocrate, 10, B-1200, Brussels, Belgium.
| | - Caroline Chabot
- Department of Medical Imaging, Institut de Recherche Expérimentale et Clinique (IREC), Institut du Cancer Roi Albert II, Cliniques Universitaires Saint Luc, Université Catholique de Louvain (UCL), Avenue Hippocrate, 10, B-1200, Brussels, Belgium
| | - Lokmane Taihi
- Department of Medical Imaging, Institut de Recherche Expérimentale et Clinique (IREC), Institut du Cancer Roi Albert II, Cliniques Universitaires Saint Luc, Université Catholique de Louvain (UCL), Avenue Hippocrate, 10, B-1200, Brussels, Belgium
| | - Thomas Kirchgesner
- Department of Medical Imaging, Institut de Recherche Expérimentale et Clinique (IREC), Institut du Cancer Roi Albert II, Cliniques Universitaires Saint Luc, Université Catholique de Louvain (UCL), Avenue Hippocrate, 10, B-1200, Brussels, Belgium
| | - Perrine Triqueneaux
- Department of Medical Imaging, Institut de Recherche Expérimentale et Clinique (IREC), Institut du Cancer Roi Albert II, Cliniques Universitaires Saint Luc, Université Catholique de Louvain (UCL), Avenue Hippocrate, 10, B-1200, Brussels, Belgium
| | - Jacques Malghem
- Department of Medical Imaging, Institut de Recherche Expérimentale et Clinique (IREC), Institut du Cancer Roi Albert II, Cliniques Universitaires Saint Luc, Université Catholique de Louvain (UCL), Avenue Hippocrate, 10, B-1200, Brussels, Belgium
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Coelho FMA, Baroni RH. Strategies for improving image quality in prostate MRI. Abdom Radiol (NY) 2024:10.1007/s00261-024-04396-4. [PMID: 38940911 DOI: 10.1007/s00261-024-04396-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2024] [Revised: 05/15/2024] [Accepted: 05/17/2024] [Indexed: 06/29/2024]
Abstract
Prostate magnetic resonance imaging (MRI) stands as the cornerstone in diagnosing prostate cancer (PCa), offering superior detection capabilities while minimizing unnecessary biopsies. Despite its critical role, global disparities in MRI diagnostic performance persist, stemming from variations in image quality and radiologist expertise. This manuscript reviews the challenges and strategies for enhancing image quality in prostate MRI, spanning patient preparation, MRI unit optimization, and radiology team engagement. Quality assurance (QA) and quality control (QC) processes are pivotal, emphasizing standardized protocols, meticulous patient evaluation, MRI unit workflow, and radiology team performance. Additionally, artificial intelligence (AI) advancements offer promising avenues for improving image quality and reducing acquisition times. The Prostate-Imaging Quality (PI-QUAL) scoring system emerges as a valuable tool for assessing MRI image quality. A comprehensive approach addressing technical, procedural, and interpretative aspects is essential to ensure consistent and reliable prostate MRI outcomes.
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Affiliation(s)
| | - Ronaldo Hueb Baroni
- Department of Radiology, Hospital Israelita Albert Einstein, 627 Albert Einstein Ave., Sao Paulo, SP, 05652-900, Brazil.
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Gao J, Zhou J, Liu C, Pan Y, Lin X, Zhang Y. Outcome prediction of SSTR-RADS-3A and SSTR-RADS-3B lesions in patients with neuroendocrine tumors based on 68Ga-DOTATATE PET/MR. J Cancer Res Clin Oncol 2024; 150:272. [PMID: 38795250 PMCID: PMC11127844 DOI: 10.1007/s00432-024-05776-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Accepted: 05/03/2024] [Indexed: 05/27/2024]
Abstract
PURPOSE Somatostatin receptor (SSTR)-targeted PET imaging has emerged as a common approach to evaluating those patients with well-differentiated neuroendocrine tumors (NETs). The SSTR reporting and data system (SSTR-RADS) version 1.0 provides a means of categorizing lesions from 1 to 5 according to the likelihood of NET involvement, with SSTR-RADS-3A (soft-tissue) and SSTR-RADS-3B (bone) lesions being those suggestive of but without definitive NET involvement. The goal of the present study was to assess the ability of 68Ga-DOTATATE PET/MR imaging data to predict outcomes for indeterminate SSTR-RADS-3A and 3B lesions. METHODS NET patients with indeterminate SSTR-RADS-3A or SSTR-RADS-3B lesions who underwent 68Ga-DOTATATE PET/MR imaging from April 2020 through August 2023 were retrospectively evaluated. All patients underwent follow-up through December 2023 (median, 17 months; (3-31 months)), with imaging follow-up or biopsy findings ultimately being used to classify lesions as malignant or benign. Lesion maximum standardized uptake value (SUVmax) along with minimum and mean apparent diffusion coefficient (ADCmin and ADCmean) values were measured and assessed for correlations with outcomes on follow-up. RESULTS In total, 33 indeterminate SSTR-RADS-3 lesions from 22 patients (19 SSTR-RADS-3A and 14 SSTR-RADS-3B) were identified based upon baseline 68Ga-DOTATATE PET/MR findings. Over the course of follow-up, 16 of these lesions (48.5%) were found to exhibit true NET positivity, including 9 SSTR-RADS-3A and 7 SSTR-RADS-3B lesions. For SSTR-RADS-3A lymph nodes, a diameter larger than 0.7 cm and an ADCmin of 779 × 10-6mm2/s or lower were identified as being more likely to be associated with metastatic lesions. Significant differences in ADCmin and ADCmean were identified when comparing metastatic and non-metastatic SSTR-RADS-3B bone lesions (P < 0.05), with these parameters offering a high predictive ability (AUC = 0.94, AUC = 0.86). CONCLUSION Both diameter and ADCmin can aid in the accurate identification of the nature of lesions associated with SSTR-RADS-3A lymph nodes, whereas ADCmin and ADCmean values can inform the accurate interpretation of SSTR-RADS-3B bone lesions.
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Affiliation(s)
- Jing Gao
- Department of Nuclear Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197, Ruijin 2nd Road, Shanghai, 200025, China
| | - Jinxin Zhou
- Department of Nuclear Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197, Ruijin 2nd Road, Shanghai, 200025, China
| | - Chang Liu
- Department of Nuclear Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197, Ruijin 2nd Road, Shanghai, 200025, China
| | - Yu Pan
- Department of Nuclear Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197, Ruijin 2nd Road, Shanghai, 200025, China
| | - Xiaozhu Lin
- Department of Nuclear Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197, Ruijin 2nd Road, Shanghai, 200025, China.
| | - Yifan Zhang
- Department of Nuclear Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197, Ruijin 2nd Road, Shanghai, 200025, China.
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Hottat NA, Badr DA, Ben Ghanem M, Besse-Hammer T, Lecomte SM, Vansteelandt C, Lecomte SL, Khaled C, De Grove V, Salem Wehbe G, Cannie MM, Jani JC. Assessment of whole-body MRI including diffusion-weighted sequences in the initial staging of breast cancer patients at high risk of metastases in comparison with PET-CT: a prospective cohort study. Eur Radiol 2024; 34:165-178. [PMID: 37555959 DOI: 10.1007/s00330-023-10060-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 04/19/2023] [Accepted: 06/13/2023] [Indexed: 08/10/2023]
Abstract
OBJECTIVE The aim of this study was to assess the diffusion-weighted whole-body-MRI (WBMRI) in the initial staging of breast cancer at high risk of metastases in comparison with positron emission tomography (PET)-CT. METHODS Forty-five women were prospectively enrolled. The inclusion criteria were female gender, age >18, invasive breast cancer, an initial PET-CT, and a performance status of 0-2. The exclusion criteria were contraindication to WB-MRI and breast cancer recurrence. The primary outcome was the concordance of WB-MRI and PET-CT in the diagnosis of distant metastases, whereas secondary outcomes included their concordance for the primary tumor and regional lymph nodes (LN), as well as the agreement of WB-MRI interpretation between two radiologists. RESULTS The mean age was 51.2 years with a median size of the primary tumor of 30 mm. Concordance between the two modalities was almost perfect for metastases staging, all sites included (k = 0.862), with excellent interobserver agreement. The accuracy of WB-MRI for detecting regional LN, distant LN, lung, liver, or bone metastases ranged from 91 to 96%. In 2 patients, WB-MRI detected bone metastases that were overlooked by PET-CT. WB-MRI showed a substantial agreement with PET-CT for staging the primary tumor, regional LN status, and stage (k = 0.766, k = 0.756, and k = 0.785, respectively) with a high interobserver agreement. CONCLUSION WB-MRI including DWI could be a reliable and reproducible examination in the initial staging of breast cancer patients at high risk of metastases, especially for bone metastases and therefore could be used as a surrogate to PET-CT. CLINICAL RELEVANCE STATEMENT Whole-body-MRI including DWI is a promising technique for detecting metastases in the initial staging of breast cancer at high risk of metastases. KEY POINTS Whole-body-MRI (WB-MRI) was effective for detecting metastases in the initial staging of 45 breast cancer patients at high risk of metastases in comparison with PET-CT. Concordance between WB-MRI and PET-CT was almost perfect for metastases staging, all sites included, with excellent interobserver agreement. The accuracy of WB-MRI for detecting bone metastases was 92%.
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Affiliation(s)
- Nathalie A Hottat
- Department of Radiology, University Hospital Brugmann, Université Libre de Bruxelles, Place A. Van Gehuchten 4, 1020, Brussels, Belgium.
- Department of Radiology, UZ Brussel, Vrije Universiteit Brussel, Brussel, Belgium.
| | - Dominique A Badr
- Department of Obstetrics and Gynecology, University Hospital Brugmann, Université Libre de Bruxelles, Brussels, Belgium
| | - Meriem Ben Ghanem
- Department of Radiology, University Hospital Brugmann, Université Libre de Bruxelles, Place A. Van Gehuchten 4, 1020, Brussels, Belgium
| | - Tatiana Besse-Hammer
- Clinical Research Unit, University Hospital Brugmann, Université Libre de Bruxelles, Brussels, Belgium
| | - Sylvie M Lecomte
- Department of Oncology, University Hospital Brugmann, Université Libre de Bruxelles, Brussels, Belgium
| | - Catherine Vansteelandt
- Department of Oncology, University Hospital Brugmann, Université Libre de Bruxelles, Brussels, Belgium
| | - Sophie L Lecomte
- Department of Pathology, University Hospital Brugmann, Université Libre de Bruxelles, Brussels, Belgium
| | - Chirine Khaled
- Department of Pathology, University Hospital Brugmann, Université Libre de Bruxelles, Brussels, Belgium
| | - Veerle De Grove
- Department of Radiology, University Hospital Brugmann, Université Libre de Bruxelles, Place A. Van Gehuchten 4, 1020, Brussels, Belgium
| | - Georges Salem Wehbe
- Department of Obstetrics and Gynecology, University Hospital Brugmann, Université Libre de Bruxelles, Brussels, Belgium
| | - Mieke M Cannie
- Department of Radiology, University Hospital Brugmann, Université Libre de Bruxelles, Place A. Van Gehuchten 4, 1020, Brussels, Belgium
- Department of Radiology, UZ Brussel, Vrije Universiteit Brussel, Brussel, Belgium
| | - Jacques C Jani
- Department of Obstetrics and Gynecology, University Hospital Brugmann, Université Libre de Bruxelles, Brussels, Belgium
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Ceranka J, Wuts J, Chiabai O, Lecouvet F, Vandemeulebroucke J. Computer-aided diagnosis of skeletal metastases in multi-parametric whole-body MRI. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2023; 242:107811. [PMID: 37742486 DOI: 10.1016/j.cmpb.2023.107811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 09/07/2023] [Accepted: 09/11/2023] [Indexed: 09/26/2023]
Abstract
The confident detection of metastatic bone disease is essential to improve patients' comfort and increase life expectancy. Multi-parametric magnetic resonance imaging (MRI) has been successfully used for monitoring of metastatic bone disease, allowing for comprehensive and holistic evaluation of the total tumour volume and treatment response assessment. The major challenges of radiological reading of whole-body MRI come from the amount of data to be reviewed and the scattered distribution of metastases, often of complex shapes. This makes bone lesion detection and quantification demanding for a radiologist and prone to error. Additionally, whole-body MRI are often corrupted with multiple spatial and intensity distortions, which further degrade the performance of image reading and image processing algorithms. In this work we propose a fully automated computer-aided diagnosis system for the detection and segmentation of metastatic bone disease using whole-body multi-parametric MRI. The system consists of an extensive image preprocessing pipeline aiming at enhancing the image quality, followed by a deep learning framework for detection and segmentation of metastatic bone disease. The system outperformed state-of-the-art methodologies, achieving a detection sensitivity of 63% with a mean of 6.44 false positives per image, and an average lesion Dice coefficient of 0.53. A provided ablation study performed to investigate the relative importance of image preprocessing shows that introduction of region of interest mask and spatial registration have a significant impact on detection and segmentation performance in whole-body MRI. The proposed computer-aided diagnosis system allows for automatic quantification of disease infiltration and could provide a valuable tool during radiological examination of whole-body MRI.
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Affiliation(s)
- Jakub Ceranka
- Vrije Universiteit Brussel, Department of Electronics and Informatics, Pleinlaan 2, Brussels, 1050, Belgium; imec, Kapeldreef 75, Leuven, B-3001, Belgium.
| | - Joris Wuts
- Vrije Universiteit Brussel, Department of Electronics and Informatics, Pleinlaan 2, Brussels, 1050, Belgium; imec, Kapeldreef 75, Leuven, B-3001, Belgium; Cliniques universitaires Saint Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain (UCLouvain), Avenue Hippocrate 10, Brussels, 1200, Belgium.
| | - Ophélye Chiabai
- Cliniques universitaires Saint Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain (UCLouvain), Avenue Hippocrate 10, Brussels, 1200, Belgium
| | - Frédéric Lecouvet
- Cliniques universitaires Saint Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain (UCLouvain), Avenue Hippocrate 10, Brussels, 1200, Belgium
| | - Jef Vandemeulebroucke
- Vrije Universiteit Brussel, Department of Electronics and Informatics, Pleinlaan 2, Brussels, 1050, Belgium; imec, Kapeldreef 75, Leuven, B-3001, Belgium; Universitair Ziekenhuis Brussel, Department of Radiology, Laarbeeklaan 101, Brussels, 1090, Belgium
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Evaluating prostate cancer bone metastasis using accelerated whole-body isotropic 3D T1-weighted Dixon MRI with compressed SENSE: a feasibility study. Eur Radiol 2023; 33:1719-1728. [PMID: 36269371 DOI: 10.1007/s00330-022-09181-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 08/02/2022] [Accepted: 08/04/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVES The study aimed to assess the efficiency of whole-body high-resolution compressed sensing-sensitivity encoding isotropic T1-Weighted Dixon (CSI-T1W-Dixon) scans in evaluating bone metastasis. METHODS Forty-five high-risk prostate cancer patients with bone metastases were enrolled prospectively and underwent whole-body MRI sequences, which included the following: pre- and post-contrast CSI-T1W-Dixon and conventional multi-planar T1-Weighted Dixon (CMP-T1W-Dixon) (coronal, sagittal, and axial scans), short tau inversion recovery (STIR), and DWI. Comparison between the CMP-T1W-Dixon and CSI-T1W-Dixon images was done for the subjective image quality, the quantitative contrast-to-noise ratio (CNR), and signal-to-noise ratio (SNR). Furthermore, the diagnostic performance based on per-lesion and per-patient basis utilizing non-contrast T1-weighted (T1)/T1+ contrasted T1-weighted (T1C)/T1 + T1C + STIR + DWI sequences was compared between the CSI-T1W-Dixon and CMP-T1W-Dixon methods using reference standards (combining biopsy data and 6-month imaging follow-up). RESULT The CSI-T1W-Dixon images produced fewer image artifacts in the axial and coronal planes compared to the CMP-T1W-Dixon images. Also, the CSI-T1W-Dixon images provided better a CNR in fat-only images of all three planes and water-only images of the axial plane (p < 0.05). The CSI-T1W-Dixon showed a higher sensitivity than the CMP-T1W-Dixon techniques in analyzing T1-only images on a per-lesion basis (82.7% vs. 53.8% for sensitivity, p = 0.03). On a per-patient basis, no difference was found in the diagnostic capacity between the CSI-T1W-Dixon and CMP-T1W-Dixon sequences either alone or in combinations (p = 0.57-1). CONCLUSION High-resolution CSI-T1W-Dixon with higher image quality and diagnostic capacity can replace the CMP-T1W-Dixon method in evaluating bone metastasis in clinical practice. KEY POINTS • Compressed sensing isotropic acquisition for 3D T1-weighted Dixon images can improve the image quality with fewer artifacts compared to the anisotropic multiplanar acquisition. • Compressed sensing isotropic acquisition can save 67% of scanning time compared to anisotropic multiplanar acquisition. • Compressed sensing isotropic 3D T1-weighted Dixon images can offer better diagnostic performance with higher sensitivity compared to anisotropic multiplanar images.
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Whole-body MRI in oncology: can a single anatomic T2 Dixon sequence replace the combination of T1 and STIR sequences to detect skeletal metastasis and myeloma? Eur Radiol 2022; 33:244-257. [PMID: 35925384 DOI: 10.1007/s00330-022-09007-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 06/21/2022] [Accepted: 06/30/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To compare the diagnostic accuracy of a single T2 Dixon sequence to the combination T1+STIR as anatomical sequences used for detecting tumoral bone marrow lesions in whole-body MRI (WB-MRI) examinations. METHODS Between January 2019 and January 2020, seventy-two consecutive patients (55 men, 17 women, median age = 66 years) with solid (prostate, breast, neuroendocrine) cancers at high risk of metastasis or proven multiple myeloma (MM) prospectively underwent a WB-MRI examination including coronal T1, STIR, T2 Dixon and axial diffusion-weighted imaging sequences. Two radiologists independently assessed the combination of T1+STIR sequences and the fat+water reconstructions from the T2 Dixon sequence. The reference standard was established by consensus reading of WB-MRI and concurrent imaging available at baseline and at 6 months. Repeatability and reproducibility of MRI scores (presence and semi-quantitative count of lesions), image quality (SNR: signal-to-noise, CNR: contrast-to-noise, CRR: contrast-to-reference ratios), and diagnostic characteristics (Se: sensitivity, Sp: specificity, Acc: accuracy) were assessed per-skeletal region and per-patient. RESULTS Repeatability and reproducibility were at least good regardless of the score, region, and protocol (0.67 ≤ AC1 ≤ 0.98). CRR was higher on T2 Dixon fat compared to T1 (p < 0.0001) and on T2 Dixon water compared to STIR (p = 0.0128). In the per-patient analysis, Acc of the T2 Dixon fat+water was higher than that of T1+STIR for the senior reader (Acc = +0.027 [+0.025; +0.029], p < 0.0001) and lower for the junior reader (Acc = -0.029 [-0.031; -0.027], p < 0.0001). CONCLUSIONS A single T2 Dixon sequence with fat+water reconstructions offers similar reproducibility and diagnostic accuracy as the recommended combination of T1+STIR sequences and can be used for skeletal screening in oncology, allowing significant time-saving. KEY POINTS • Replacement of the standard anatomic T1 + STIR WB-MRI protocol by a single T2 Dixon sequence drastically shortens the examination time without loss of diagnostic accuracy. • A protocol based on fat + water reconstructions from a single T2 Dixon sequence offers similar inter-reader agreement and a higher contrast-to-reference ratio for detecting lesions compared to the standard T1 + STIR protocol. • Differences in the accuracy between the two protocols are marginal (+ 3% in favor of the T2 Dixon with the senior reader; -3% against the T2 Dixon with the junior reader).
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Yoon MA, Chee CG, Chung HW, Lee DH, Kim KW. Diagnostic performance of computed tomography and diffusion-weighted imaging as first-line imaging modality according to the International Myeloma Working Group (IMWG) imaging algorithm for monoclonal plasma cell disorders. Acta Radiol 2022; 63:672-683. [PMID: 33853375 DOI: 10.1177/02841851211008383] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND The latest International Myeloma Working Group (IMWG) guideline recommends low-dose whole-body (WB) computed tomography (CT) as the first-line imaging technique for the initial diagnosis of plasma cell disorders. PURPOSE To evaluate diagnostic performances of CT and diffusion-weighted imaging (DWI) as the first-line imaging modalities and assess misclassification rates obtained following the guideline. MATERIAL AND METHODS Two independent radiologists analyzed CT (acquired as PET/CT) and DWI (3-T; b-values = 50 and 900 s/mm2) of patients newly diagnosed with plasma cell disorder, categorizing the number of bone lesions. Diagnostic performance of CT and DWI was compared using the McNemar test, and misclassification rates were calculated with a consensus WB-MRI reading as the reference standard. Differences in lesion number categories were assessed using marginal homogeneity and kappa statistics. RESULTS Of 56 patients (36 men; mean age = 63.5 years), 39 had myeloma lesions. DWI showed slightly higher sensitivity for detecting myeloma lesions (97.4%) than CT (84.6%-92.3%; P > 0.05). CT showed significantly higher specificity (88.2%) than DWI (52.9%-58.8%; P<0.05). CT had a higher additional study requirement rate than DWI (7.7%-15.4% vs. 2.6%), but a lower unnecessary treatment rate (11.8% vs. 41.2%-47.1%). Both readers showed significant differences in categorization of the number of lesions on CT compared with the reference standard (P < 0.001), and one reader showed a significant difference on DWI (P = 0.006 and 0.098). CONCLUSION CT interpreted according to the IMWG guideline is a diagnostically effective first-line modality with relatively high sensitivity and specificity. DWI alone may not be an acceptable first-line imaging modality because of low specificity.
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Affiliation(s)
- Min A Yoon
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Choong Guen Chee
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Hye Won Chung
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Dong Hyun Lee
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Kyung Won Kim
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
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Zhang-Yin J, Montravers F, Montagne S, Hennequin C, Renard-Penna R. Diagnosis of early biochemical recurrence after radical prostatectomy or radiation therapy in patients with prostate cancer: State of the art. Diagn Interv Imaging 2022; 103:191-199. [DOI: 10.1016/j.diii.2022.02.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 02/11/2022] [Accepted: 02/13/2022] [Indexed: 12/30/2022]
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Lecouvet FE, Vekemans MC, Van Den Berghe T, Verstraete K, Kirchgesner T, Acid S, Malghem J, Wuts J, Hillengass J, Vandecaveye V, Jamar F, Gheysens O, Vande Berg BC. Imaging of treatment response and minimal residual disease in multiple myeloma: state of the art WB-MRI and PET/CT. Skeletal Radiol 2022; 51:59-80. [PMID: 34363522 PMCID: PMC8626399 DOI: 10.1007/s00256-021-03841-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 05/28/2021] [Accepted: 06/06/2021] [Indexed: 02/02/2023]
Abstract
Bone imaging has been intimately associated with the diagnosis and staging of multiple myeloma (MM) for more than 5 decades, as the presence of bone lesions indicates advanced disease and dictates treatment initiation. The methods used have been evolving, and the historical radiographic skeletal survey has been replaced by whole body CT, whole body MRI (WB-MRI) and [18F]FDG-PET/CT for the detection of bone marrow lesions and less frequent extramedullary plasmacytomas.Beyond diagnosis, imaging methods are expected to provide the clinician with evaluation of the response to treatment. Imaging techniques are consistently challenged as treatments become more and more efficient, inducing profound response, with more subtle residual disease. WB-MRI and FDG-PET/CT are the methods of choice to address these challenges, being able to assess disease progression or response and to detect "minimal" residual disease, providing key prognostic information and guiding necessary change of treatment.This paper provides an up-to-date overview of the WB-MRI and PET/CT techniques, their observations in responsive and progressive disease and their role and limitations in capturing minimal residual disease. It reviews trials assessing these techniques for response evaluation, points out the limited comparisons between both methods and highlights their complementarity with most recent molecular methods (next-generation flow cytometry, next-generation sequencing) to detect minimal residual disease. It underlines the important role of PET/MRI technology as a research tool to compare the effectiveness and complementarity of both methods to address the key clinical questions.
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Affiliation(s)
- Frederic E. Lecouvet
- Radiology Department, Institut de Recherche Expérimentale et Clinique (IREC), Cliniques Universitaires Saint-Luc, UCLouvain, Hippocrate Avenue 10, 1200 Brussels, Belgium
| | - Marie-Christiane Vekemans
- Haematology Unit, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique (IREC), 1200 Brussels, Belgium
| | - Thomas Van Den Berghe
- Radiology Department, Universiteit Ghent, Sint-Pietersnieuwstraat 33, 9000 Gent, Belgium
| | - Koenraad Verstraete
- Radiology Department, Universiteit Ghent, Sint-Pietersnieuwstraat 33, 9000 Gent, Belgium
| | - Thomas Kirchgesner
- Radiology Department, Institut de Recherche Expérimentale et Clinique (IREC), Cliniques Universitaires Saint-Luc, UCLouvain, Hippocrate Avenue 10, 1200 Brussels, Belgium
| | - Souad Acid
- Radiology Department, Institut de Recherche Expérimentale et Clinique (IREC), Cliniques Universitaires Saint-Luc, UCLouvain, Hippocrate Avenue 10, 1200 Brussels, Belgium
| | - Jacques Malghem
- Radiology Department, Institut de Recherche Expérimentale et Clinique (IREC), Cliniques Universitaires Saint-Luc, UCLouvain, Hippocrate Avenue 10, 1200 Brussels, Belgium
| | - Joris Wuts
- Department of Electronics and Informatics (ETRO), Vrije Universiteit Brussel, Avenue du Laerbeek 101, 1090 Jette, Belgium
| | - Jens Hillengass
- Departement of Medicine, Myeloma Unit, Park Comprehensive Cancer Center, Buffalo, NY USA
| | - Vincent Vandecaveye
- Radiology Department, Katholieke Univesiteit Leuven, Oude Markt, 13, 3000 Leuven, Belgium
| | - François Jamar
- Nuclear Medicine Department, Institut de Recherche Expérimentale et Clinique (IREC), Cliniques Universitaires Saint-Luc, 1200 Brussels, Belgium
| | - Olivier Gheysens
- Nuclear Medicine Department, Institut de Recherche Expérimentale et Clinique (IREC), Cliniques Universitaires Saint-Luc, 1200 Brussels, Belgium
| | - Bruno C. Vande Berg
- Radiology Department, Institut de Recherche Expérimentale et Clinique (IREC), Cliniques Universitaires Saint-Luc, UCLouvain, Hippocrate Avenue 10, 1200 Brussels, Belgium
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11
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Van Damme J, Tombal B, Collette L, Van Nieuwenhove S, Pasoglou V, Gérard T, Jamar F, Lhommel R, Lecouvet FE. Comparison of 68Ga-Prostate Specific Membrane Antigen (PSMA) Positron Emission Tomography Computed Tomography (PET-CT) and Whole-Body Magnetic Resonance Imaging (WB-MRI) with Diffusion Sequences (DWI) in the Staging of Advanced Prostate Cancer. Cancers (Basel) 2021; 13:cancers13215286. [PMID: 34771449 PMCID: PMC8582508 DOI: 10.3390/cancers13215286] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 10/04/2021] [Accepted: 10/14/2021] [Indexed: 12/12/2022] Open
Abstract
Simple Summary Precise staging is key for the optimal management of advanced prostate cancer. PSMA PET-CT and WB-MRI outperform standard imaging technology for staging high-risk prostate cancer, but direct comparison between both modalities is lacking. The primary endpoint of our study was to compare the diagnostic accuracy of both techniques in the detection of lymph node, bone and visceral metastases against a best valuable comparator (BVC), defined as a consensus adjudication of all lesions on the basis of baseline and follow-up imaging, biological and clinical data and histopathologic confirmation when available. Knowing the diagnostic accuracy of both next generation imaging modalities might influence the diagnostic and therapeutic strategy in prostate cancer by tailoring therapy. However, the impact on treatment and patient outcome of an improved detection of metastases has not been determined yet. Abstract Background: Prostate specific membrane antigen (PSMA) positron emission tomography computed tomography (PET-CT) and whole-body magnetic resonance imaging (WB-MRI) outperform standard imaging technology for the detection of metastasis in prostate cancer (PCa). There are few direct comparisons between both modalities. This paper compares the diagnostic accuracy of PSMA PET-CT and WB-MRI for the detection of metastasis in PCa. One hundred thirty-four patients with newly diagnosed PCa (n = 81) or biochemical recurrence after curative treatment (n = 53) with high-risk features prospectively underwent PSMA PET-CT and WB-MRI. The diagnostic accuracy of both techniques for lymph node, skeletal and visceral metastases was compared against a best valuable comparator (BVC). Overall, no significant difference was detected between PSMA PET-CT and WB-MRI to identify metastatic patients when considering lymph nodes, skeletal and visceral metastases together (AUC = 0.96 (0.92–0.99) vs. 0.90 (0.85–0.95); p = 0.09). PSMA PET-CT, however, outperformed WB-MRI in the subgroup of patients with newly diagnosed PCa for the detection of lymph node metastases (AUC = 0.96 (0.92–0.99) vs. 0.86 (0.79–0.92); p = 0.0096). In conclusion, PSMA PET-CT outperforms WB-MRI for the detection of nodal metastases in primary staging of PCa.
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Affiliation(s)
- Julien Van Damme
- Department of Urology, Institut de Recherche Expérimentale et Clinique (IREC), Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, B-1200 Brussels, Belgium; (J.V.D.); (B.T.)
| | - Bertrand Tombal
- Department of Urology, Institut de Recherche Expérimentale et Clinique (IREC), Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, B-1200 Brussels, Belgium; (J.V.D.); (B.T.)
| | - Laurence Collette
- International Drug Development Institute (IDDI), B-1341 Louvain-la-Neuve, Belgium;
| | - Sandy Van Nieuwenhove
- Department of Radiology, Institut de Recherche Expérimentale et Clinique (IREC-IMAG), Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, B-1200 Brussels, Belgium; (S.V.N.); (V.P.)
| | - Vassiliki Pasoglou
- Department of Radiology, Institut de Recherche Expérimentale et Clinique (IREC-IMAG), Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, B-1200 Brussels, Belgium; (S.V.N.); (V.P.)
| | - Thomas Gérard
- Department of Nuclear Medicine, Institut de Recherche Expérimentale et Clinique (IREC-MIRO), Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, B-1200 Brussels, Belgium; (T.G.); (F.J.); (R.L.)
| | - François Jamar
- Department of Nuclear Medicine, Institut de Recherche Expérimentale et Clinique (IREC-MIRO), Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, B-1200 Brussels, Belgium; (T.G.); (F.J.); (R.L.)
| | - Renaud Lhommel
- Department of Nuclear Medicine, Institut de Recherche Expérimentale et Clinique (IREC-MIRO), Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, B-1200 Brussels, Belgium; (T.G.); (F.J.); (R.L.)
| | - Frédéric E. Lecouvet
- Department of Radiology, Institut de Recherche Expérimentale et Clinique (IREC-IMAG), Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, B-1200 Brussels, Belgium; (S.V.N.); (V.P.)
- Correspondence:
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12
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Pasoglou V, Van Nieuwenhove S, Peeters F, Duchêne G, Kirchgesner T, Lecouvet FE. 3D Whole-Body MRI of the Musculoskeletal System. Semin Musculoskelet Radiol 2021; 25:441-454. [PMID: 34547810 DOI: 10.1055/s-0041-1730401] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
With its outstanding soft tissue contrast, spatial resolution, and multiplanar capacities, magnetic resonance imaging (MRI) has become a widely used technique. Whole-body MRI (WB-MRI) has been introduced among diagnostic methods for the staging and follow-up assessment in oncologic patients, and international guidelines recommend its use. In nononcologic applications, WB-MRI is as a promising imaging tool in inflammatory diseases, such as seronegative arthritis and inflammatory myopathies. Technological advances have facilitated the introduction of three-dimensional (3D) almost isotropic sequences in MRI examinations covering the whole body. The possibility to reformat 3D images in any plane with equal or almost equal resolution offers comprehensive understanding of the anatomy, easier disease detection and characterization, and finally contributes to correct treatment planning. This article illustrates the basic principles, advantages, and limitations of the 3D approach in WB-MRI examinations and provides a short review of the literature.
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Affiliation(s)
- Vassiliki Pasoglou
- Department of Radiology and Medical Imaging, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium
| | - Sandy Van Nieuwenhove
- Department of Radiology and Medical Imaging, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium
| | - Frank Peeters
- Department of Radiology and Medical Imaging, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium
| | - Gaetan Duchêne
- MR applications, General Electric Healthcare, Diegem, Belgium
| | - Thomas Kirchgesner
- Department of Radiology and Medical Imaging, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium
| | - Frederic E Lecouvet
- Department of Radiology and Medical Imaging, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium
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13
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Switlyk MD. Magnetic resonance imaging for assessing treatment response in bone marrow metastases. Acta Radiol 2021; 62:483-499. [PMID: 31154803 DOI: 10.1177/0284185119851234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Cancer metastasis to bone is a frequent observation in malignancy that may result in complications such as pathological fractures and spinal cord compression. Monitoring treatment effects is the main concern in oncology; however, the evaluation of treatment response in bone is particularly challenging as it lacks well-established criteria. In addition, bone metastases have traditionally been considered non-measurable manifestations of cancer. Magnetic resonance imaging (MRI) is one of the most specific and sensitive methods for imaging skeletal metastases. The aim of this article is to highlight the diagnostic performance of MRI in the treatment monitoring of bone metastases, to review the current literature, and to provide an overview of recommendations for the evaluation of treatment response in bone.
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Affiliation(s)
- Marta D Switlyk
- Department of Radiology, Radiumhospitalet, Oslo University Hospital, Oslo, Norway
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14
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Whole-body MRI-based multivariate prediction model in the assessment of bone metastasis in prostate cancer. World J Urol 2021; 39:2937-2943. [PMID: 33521882 DOI: 10.1007/s00345-020-03571-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 12/12/2020] [Indexed: 12/24/2022] Open
Abstract
PURPOSE A whole-body MRI (WB-MRI) including T1, short time inversion recovery (STIR), diffusion-weighted imaging (high b value) was applied in our center for the detection of bone metastasis in prostate cancer (PCa) patients. We intended to assess the diagnostic performance of this examination. METHODS 547 cases of PCa patients with higher risk of metastasis were referred to bone scintigraphy with SPECT/CT (BS + SPECT/CT) and whole-body MRI in Shanghai Changhai Hospital. Best valuable comparator (BVC) was applied for the final diagnosis of metastasis. A panel of radiologists interpreted the results. Decision curve analysis (DCA) and receiver operating characteristic curve (ROC) analysis were applied. RESULTS Bone metastasis was diagnosed in 110 cases, and others were non-metastatic by BVC. The area under the receiver operating characteristic curve (AUC) was higher in WB-MRI (0.778) than BS + SPECT/CT (0.634, p < 0.001). A WB-MRI-based prediction model was established with AUC of 0.877. Internal validation showed that the predictive model was well-calibrated. The DCA demonstrated that the model had higher net benefit than the BS + SPECT/CT-based model. CONCLUSION WB-MRI is more effective in identifying metastasis in PCa patients than BS + SPECT/CT. The prediction model combined WB-MRI with clinical parameters may be a promising approach to the assessment of metastasis.
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15
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Michoux NF, Ceranka JW, Vandemeulebroucke J, Peeters F, Lu P, Absil J, Triqueneaux P, Liu Y, Collette L, Willekens I, Brussaard C, Debeir O, Hahn S, Raeymaekers H, de Mey J, Metens T, Lecouvet FE. Repeatability and reproducibility of ADC measurements: a prospective multicenter whole-body-MRI study. Eur Radiol 2021; 31:4514-4527. [PMID: 33409773 DOI: 10.1007/s00330-020-07522-0] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 08/31/2020] [Accepted: 11/13/2020] [Indexed: 12/13/2022]
Abstract
OBJECTIVES Multicenter oncology trials increasingly include MRI examinations with apparent diffusion coefficient (ADC) quantification for lesion characterization and follow-up. However, the repeatability and reproducibility (R&R) limits above which a true change in ADC can be considered relevant are poorly defined. This study assessed these limits in a standardized whole-body (WB)-MRI protocol. METHODS A prospective, multicenter study was performed at three centers equipped with the same 3.0-T scanners to test a WB-MRI protocol including diffusion-weighted imaging (DWI). Eight healthy volunteers per center were enrolled to undergo test and retest examinations in the same center and a third examination in another center. ADC variability was assessed in multiple organs by two readers using two-way mixed ANOVA, Bland-Altman plots, coefficient of variation (CoV), and the upper limit of the 95% CI on repeatability (RC) and reproducibility (RDC) coefficients. RESULTS CoV of ADC was not influenced by other factors (center, reader) than the organ. Based on the upper limit of the 95% CI on RC and RDC (from both readers), a change in ADC in an individual patient must be superior to 12% (cerebrum white matter), 16% (paraspinal muscle), 22% (renal cortex), 26% (central and peripheral zones of the prostate), 29% (renal medulla), 35% (liver), 45% (spleen), 50% (posterior iliac crest), 66% (L5 vertebra), 68% (femur), and 94% (acetabulum) to be significant. CONCLUSIONS This study proposes R&R limits above which ADC changes can be considered as a reliable quantitative endpoint to assess disease or treatment-related changes in the tissue microstructure in the setting of multicenter WB-MRI trials. KEY POINTS • The present study showed the range of R&R of ADC in WB-MRI that may be achieved in a multicenter framework when a standardized protocol is deployed. • R&R was not influenced by the site of acquisition of DW images. • Clinically significant changes in ADC measured in a multicenter WB-MRI protocol performed with the same type of MRI scanner must be superior to 12% (cerebrum white matter), 16% (paraspinal muscle), 22% (renal cortex), 26% (central zone and peripheral zone of prostate), 29% (renal medulla), 35% (liver), 45% (spleen), 50% (posterior iliac crest), 66% (L5 vertebra), 68% (femur), and 94% (acetabulum) to be detected with a 95% confidence level.
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Affiliation(s)
- Nicolas F Michoux
- Institut de Recherche Expérimentale & Clinique (IREC) - Radiology Department, Université Catholique de Louvain (UCLouvain) - Cliniques Universitaires Saint Luc, Avenue Hippocrate 10, B-1200, Brussels, Belgium.
| | - Jakub W Ceranka
- Department of Electronics and Informatics (ETRO), Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Jef Vandemeulebroucke
- Department of Electronics and Informatics (ETRO), Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Frank Peeters
- Institut de Recherche Expérimentale & Clinique (IREC) - Radiology Department, Université Catholique de Louvain (UCLouvain) - Cliniques Universitaires Saint Luc, Avenue Hippocrate 10, B-1200, Brussels, Belgium
| | - Pierre Lu
- Institut de Recherche Expérimentale & Clinique (IREC) - Radiology Department, Université Catholique de Louvain (UCLouvain) - Cliniques Universitaires Saint Luc, Avenue Hippocrate 10, B-1200, Brussels, Belgium
| | - Julie Absil
- Radiology Department, Université libre de Bruxelles, Hôpital Erasme, Brussels, Belgium
| | - Perrine Triqueneaux
- Institut de Recherche Expérimentale & Clinique (IREC) - Radiology Department, Université Catholique de Louvain (UCLouvain) - Cliniques Universitaires Saint Luc, Avenue Hippocrate 10, B-1200, Brussels, Belgium
| | - Yan Liu
- European Organisation for Research and Treatment of Cancer, Brussels, Belgium
| | - Laurence Collette
- European Organisation for Research and Treatment of Cancer, Brussels, Belgium
| | | | | | - Olivier Debeir
- LISA (Laboratories of Image Synthesis and Analysis), Ecole Polytechnique de Bruxelles, Université libre de Bruxelles, Brussels, Belgium
| | - Stephan Hahn
- LISA (Laboratories of Image Synthesis and Analysis), Ecole Polytechnique de Bruxelles, Université libre de Bruxelles, Brussels, Belgium
| | | | | | - Thierry Metens
- Radiology Department, Université libre de Bruxelles, Hôpital Erasme, Brussels, Belgium
| | - Frédéric E Lecouvet
- Institut de Recherche Expérimentale & Clinique (IREC) - Radiology Department, Université Catholique de Louvain (UCLouvain) - Cliniques Universitaires Saint Luc, Avenue Hippocrate 10, B-1200, Brussels, Belgium
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16
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Liu F, Dong J, Shen Y, Yun C, Wang R, Wang G, Tan J, Wang T, Yao Q, Wang B, Li L, Mi J, Zhou D, Xiong F. Comparison of PET/CT and MRI in the Diagnosis of Bone Metastasis in Prostate Cancer Patients: A Network Analysis of Diagnostic Studies. Front Oncol 2021; 11:736654. [PMID: 34671558 PMCID: PMC8522477 DOI: 10.3389/fonc.2021.736654] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 09/10/2021] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Accurate diagnosis of bone metastasis status of prostate cancer (PCa) is becoming increasingly more important in guiding local and systemic treatment. Positron emission tomography/computed tomography (PET/CT) and magnetic resonance imaging (MRI) have increasingly been utilized globally to assess the bone metastases in PCa. Our meta-analysis was a high-volume series in which the utility of PET/CT with different radioligands was compared to MRI with different parameters in this setting. MATERIALS AND METHODS Three databases, including Medline, Embase, and Cochrane Library, were searched to retrieve original trials from their inception to August 31, 2019 according to the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) statement. The methodological quality of the included studies was assessed by two independent investigators utilizing Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2). A Bayesian network meta-analysis was performed using an arm-based model. Absolute sensitivity and specificity, relative sensitivity and specificity, diagnostic odds ratio (DOR), and superiority index, and their associated 95% confidence intervals (CI) were used to assess the diagnostic value. RESULTS Forty-five studies with 2,843 patients and 4,263 lesions were identified. Network meta-analysis reveals that 68Ga-labeled prostate membrane antigen (68Ga-PSMA) PET/CT has the highest superiority index (7.30) with the sensitivity of 0.91 and specificity of 0.99, followed by 18F-NaF, 11C-choline, 18F-choline, 18F-fludeoxyglucose (FDG), and 18F-fluciclovine PET/CT. The use of high magnetic field strength, multisequence, diffusion-weighted imaging (DWI), and more imaging planes will increase the diagnostic value of MRI for the detection of bone metastasis in prostate cancer patients. Where available, 3.0-T high-quality MRI approaches 68Ga-PSMA PET/CT was performed in the detection of bone metastasis on patient-based level (sensitivity, 0.94 vs. 0.91; specificity, 0.94 vs. 0.96; superiority index, 4.43 vs. 4.56). CONCLUSIONS 68Ga-PSMA PET/CT is recommended for the diagnosis of bone metastasis in prostate cancer patients. Where available, 3.0-T high-quality MRI approaches 68Ga-PSMA PET/CT should be performed in the detection of bone metastasis.
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Affiliation(s)
- Fanxiao Liu
- Department of Orthopaedics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Jinlei Dong
- Department of Orthopaedics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Yelong Shen
- Department of Medical Imaging, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Canhua Yun
- Department of Nuclear Medicine, The Second Hospital of Shandong University, Jinan, China
| | - Ruixiao Wang
- Department of Urology Surgery, University Hospital of Munich, Ludwig-Maximilians-University, Munich, Germany
| | - Ganggang Wang
- Department of Urology Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China
| | - Jiyang Tan
- Department of Sports Medicine, Wuxi 9th People’s Hospital Affiliated to Soochow University, Wuxi, China
| | - Tao Wang
- Department of Sports Medicine, Wuxi 9th People’s Hospital Affiliated to Soochow University, Wuxi, China
| | - Qun Yao
- Department of Sports Medicine, Wuxi 9th People’s Hospital Affiliated to Soochow University, Wuxi, China
| | - Bomin Wang
- Department of Orthopaedics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Lianxin Li
- Department of Orthopaedics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Jingyi Mi
- Department of Sports Medicine, Wuxi 9th People’s Hospital Affiliated to Soochow University, Wuxi, China
| | - Dongsheng Zhou
- Department of Orthopaedics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Fei Xiong
- Department of Sports Medicine, Wuxi 9th People’s Hospital Affiliated to Soochow University, Wuxi, China
- Orthopaedic Institute, Medical College, Soochow University, Suzhou, China
- *Correspondence: Fei Xiong,
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Van Nieuwenhove S, Van Damme J, Padhani AR, Vandecaveye V, Tombal B, Wuts J, Pasoglou V, Lecouvet FE. Whole-body magnetic resonance imaging for prostate cancer assessment: Current status and future directions. J Magn Reson Imaging 2020; 55:653-680. [PMID: 33382151 DOI: 10.1002/jmri.27485] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 12/08/2020] [Accepted: 12/08/2020] [Indexed: 12/20/2022] Open
Abstract
Over the past decade, updated definitions for the different stages of prostate cancer and risk for distant disease, along with the advent of new therapies, have remarkably changed the management of patients. The two expectations from imaging are accurate staging and appropriate assessment of disease response to therapies. Modern, next-generation imaging (NGI) modalities, including whole-body magnetic resonance imaging (WB-MRI) and nuclear medicine (most often prostate-specific membrane antigen [PSMA] positron emission tomography [PET]/computed tomography [CT]) bring added value to these imaging tasks. WB-MRI has proven its superiority over bone scintigraphy (BS) and CT for the detection of distant metastasis, also providing reliable evaluations of disease response to treatment. Comparison of the effectiveness of WB-MRI and molecular nuclear imaging techniques with regard to indications and the definition of their respective/complementary roles in clinical practice is ongoing. This paper illustrates the evolution of WB-MRI imaging protocols, defines the current state-of-the art, and highlights the latest developments and future challenges. The paper presents and discusses WB-MRI indications in the care pathway of men with prostate cancer in specific key situations: response assessment of metastatic disease, "all in one" cancer staging, and oligometastatic disease.
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Affiliation(s)
- Sandy Van Nieuwenhove
- Department of Radiology and Medical Imaging, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium
| | - Julien Van Damme
- Department of Urology, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Anwar R Padhani
- Mount Vernon Cancer Centre, Mount Vernon Hospital, London, UK
| | - Vincent Vandecaveye
- Department of Radiology and Pathology, University Hospitals Leuven, Leuven, Belgium
| | - Bertrand Tombal
- Department of Urology, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Joris Wuts
- Department of Radiology and Medical Imaging, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium.,Department of Electronics and Informatics (ETRO), Vrije Universiteit Brussel, Brussels, Belgium
| | - Vassiliki Pasoglou
- Department of Radiology and Medical Imaging, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium
| | - Frederic E Lecouvet
- Department of Radiology and Medical Imaging, Cliniques Universitaires Saint-Luc, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium
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Mussi TC, Baroni RH, Zagoria RJ, Westphalen AC. Prostate magnetic resonance imaging technique. Abdom Radiol (NY) 2020; 45:2109-2119. [PMID: 31701190 DOI: 10.1007/s00261-019-02308-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Multiparametric magnetic resonance (MR) imaging of the prostate is an excellent tool to detect clinically significant prostate cancer, and it has widely been incorporated into clinical practice due to its excellent tissue contrast and image resolution. The aims of this article are to describe the prostate MR imaging technique for detection of clinically significant prostate cancer according to PI-RADS v2.1, as well as alternative sequences and basic aspects of patient preparation and MR imaging artifact avoidance.
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19
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Lecouvet FE, Pasoglou V, Van Nieuwenhove S, Van Haver T, de Broqueville Q, Denolin V, Triqueneaux P, Tombal B, Michoux N. Shortening the acquisition time of whole-body MRI: 3D T1 gradient echo Dixon vs fast spin echo for metastatic screening in prostate cancer. Eur Radiol 2020; 30:3083-3093. [PMID: 32065282 DOI: 10.1007/s00330-019-06515-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Revised: 09/30/2019] [Accepted: 10/15/2019] [Indexed: 12/14/2022]
Abstract
PURPOSE To compare 3D T1-weighted fast spin echo (FSE) and 3D T1-weighted gradient echo (GE) mDixon as morphologic sequences to complement diffusion-weighted imaging (DWI) for the metastatic screening in prostate cancer (PCa) patients. MATERIALS AND METHODS Thirty PCa patients at high risk of metastases prospectively underwent both a 3D T1 FSE (14 min) and a rapid 3D T1 GEmDixon (1 min 20 s) sequences within a WB-MRI protocol. Two readers assessed the diagnostic performance of the FSE/Fat/in-phase (IP)/IP+Fat sequences in detecting bone and node metastases. The reference standard was established by a panel of four physicians on the basis of all baseline and follow-up imaging, biological and clinical information. The reproducibility of readings, predictive accuracy (Acc) from ROC curves analysis, and contrast-to-reference ratio (CRR) in lesions were assessed for each sequence. RESULTS In bone and lymph nodes (per-region analysis), reproducibility was at least good for all sequences/readers, except for nodes in the common iliac/inguinal regions. In bone (per-organ analysis), Acc of FSE was superior to that of mDixon (difference + 4%, p < 0.0083). In nodes (per-organ analysis), Acc of Fat was superior to that of other sequences (difference + 4% to + 6% depending on reader, p < 0.0083). In the per-patient analysis, Acc of FSE was superior to that of mDixon (difference + 4% to + 6% depending on sequence, p < 0.0083). Fat images had higher CRR compared with FSE in the thoracic spine, the bony pelvis and lymph node metastases (p < 0.025). CONCLUSION 3D T1 GEmDixon may replace 3D T1 FSE to complement DWI in WB-MRI for metastatic screening in PCa. It demonstrates an Acc ranging from + 4% to + 6% (nodes) to - 4% to - 6% (bone and patient staging) compared with FSE and considerably reduces the examination time, offering the perspective of acquiring WB-MRI examinations in less than 20 min. KEY POINTS • The replacement of 3D T1 FSE by the 3D T1 GE mDixon as morphologic sequence to complement DWI drastically reduces the acquisition time of WB-MRI studies. • The 3D T1 GE mDixon sequence offers similar reproducibility of image readings compared with that of the 3D T1 FSE. • Differences in diagnostic accuracy are limited (+ 4%/+ 6% in favor of mDixon to detect node metastases; + 4%/+ 6% in favor of FSE to detect bone metastases/metastatic disease in a patient).
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Affiliation(s)
- Frédéric E Lecouvet
- Department of Radiology an Medical Imaging, Centre du Cancer and Institut de Recherche Expérimentale et Clinique (IREC), Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain), Avenue Hippocrate 10/2942, B-1200, Brussels, Belgium.
| | - Vassiliki Pasoglou
- Department of Radiology an Medical Imaging, Centre du Cancer and Institut de Recherche Expérimentale et Clinique (IREC), Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain), Avenue Hippocrate 10/2942, B-1200, Brussels, Belgium
| | - Sandy Van Nieuwenhove
- Department of Radiology an Medical Imaging, Centre du Cancer and Institut de Recherche Expérimentale et Clinique (IREC), Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain), Avenue Hippocrate 10/2942, B-1200, Brussels, Belgium
| | - Thomas Van Haver
- Department of Radiology an Medical Imaging, Centre du Cancer and Institut de Recherche Expérimentale et Clinique (IREC), Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain), Avenue Hippocrate 10/2942, B-1200, Brussels, Belgium
| | - Quentin de Broqueville
- Department of Radiology an Medical Imaging, Centre du Cancer and Institut de Recherche Expérimentale et Clinique (IREC), Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain), Avenue Hippocrate 10/2942, B-1200, Brussels, Belgium
| | - Vincent Denolin
- Philips Medical Systems International BV, Veenpluis 4-6, 5684 PC, Best, The Netherlands
| | - Perrine Triqueneaux
- Department of Radiology an Medical Imaging, Centre du Cancer and Institut de Recherche Expérimentale et Clinique (IREC), Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain), Avenue Hippocrate 10/2942, B-1200, Brussels, Belgium
| | - Bertrand Tombal
- Department of Radiology an Medical Imaging, Centre du Cancer and Institut de Recherche Expérimentale et Clinique (IREC), Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain), Avenue Hippocrate 10/2942, B-1200, Brussels, Belgium
| | - Nicolas Michoux
- Department of Radiology an Medical Imaging, Centre du Cancer and Institut de Recherche Expérimentale et Clinique (IREC), Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain), Avenue Hippocrate 10/2942, B-1200, Brussels, Belgium
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Ceranka J, Verga S, Kvasnytsia M, Lecouvet F, Michoux N, Mey J, Raeymaekers H, Metens T, Absil J, Vandemeulebroucke J. Multi‐atlas segmentation of the skeleton from whole‐body MRI—Impact of iterative background masking. Magn Reson Med 2019; 83:1851-1862. [DOI: 10.1002/mrm.28042] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 08/27/2019] [Accepted: 09/24/2019] [Indexed: 12/23/2022]
Affiliation(s)
- Jakub Ceranka
- Department of Electronics and Informatics Vrije Universiteit Brussel Brussels Belgium
- IMEC Leuven Belgium
| | - Sabrina Verga
- Department of Electronics and Informatics Vrije Universiteit Brussel Brussels Belgium
- Department of Electronics, Information and Bioengineering Politecnico di Milano Milan Italy
| | - Maryna Kvasnytsia
- Department of Electronics and Informatics Vrije Universiteit Brussel Brussels Belgium
- IMEC Leuven Belgium
| | - Frédéric Lecouvet
- Cliniques universitaires Saint Luc Institut de Recherche Expérimentale et Clinique (IREC) Université catholique de Louvain (UCLouvain) Brussels Belgium
| | - Nicolas Michoux
- Cliniques universitaires Saint Luc Institut de Recherche Expérimentale et Clinique (IREC) Université catholique de Louvain (UCLouvain) Brussels Belgium
| | - Johan Mey
- Department of Radiology Universitair Ziekenhuis Brussel Brussels Belgium
| | - Hubert Raeymaekers
- Department of Radiology Universitair Ziekenhuis Brussel Brussels Belgium
| | - Thierry Metens
- Department of Radiology ULB‐Hôpital Erasme Université Libre de Bruxelles (ULB) Brussels Belgium
| | - Julie Absil
- Department of Radiology ULB‐Hôpital Erasme Université Libre de Bruxelles (ULB) Brussels Belgium
| | - Jef Vandemeulebroucke
- Department of Electronics and Informatics Vrije Universiteit Brussel Brussels Belgium
- IMEC Leuven Belgium
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Multiparametric MRI - local staging of prostate cancer and beyond. Radiol Oncol 2019; 53:159-170. [PMID: 31103999 PMCID: PMC6572496 DOI: 10.2478/raon-2019-0021] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Accepted: 04/15/2019] [Indexed: 02/07/2023] Open
Abstract
Background Accurate local staging is critical for treatment planning and prognosis in patients with prostate cancer (PCa). The primary aim is to differentiate between organ-confined and locally advanced disease with the latter carrying a worse clinical prognosis. Multiparametric MRI (mpMRI) is the imaging modality of choice for the local staging of PCa and has an incremental value in assessing pelvic nodal disease and bone involvement. It has shown superior performance compared to traditional staging based on clinical nomograms, and provides additional information on the site and extent of disease. MRI has a high specificity for diagnosing extracapsular extension (ECE), seminal vesicle invasion (SVI) and lymph node (LN) metastases, however, sensitivity remains poor. As a result, extended pelvic LN dissection remains the gold standard for assessing pelvic nodal involvement, and there has been recent progress in developing advanced imaging techniques for more distal staging. Conclusions T2W-weighted imaging is the cornerstone for local staging of PCa. Imaging at 3T and incorporating both diffusion weighted and dynamic contrast enhanced imaging can further increase accuracy. "Next generation" imaging including whole body MRI and PET-MRI imaging using prostate specific membrane antigen (68Ga-PSMA), has shown promising for assessment of LN and bone involvement as compared to the traditional work-up using bone scintigraphy and body CT.
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Pattern of metastatic deposit in recurrent prostate cancer: a whole-body MRI-based assessment of lesion distribution and effect of primary treatment. World J Urol 2019; 37:2585-2595. [PMID: 30826887 DOI: 10.1007/s00345-019-02700-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Accepted: 02/20/2019] [Indexed: 12/15/2022] Open
Abstract
PURPOSE It is generally accepted that when metastases develop in a patient with biochemical recurrence of prostate cancer (PCa), they follow a centrifuge pattern of seeding from the pelvis and that most patients enter the disease as oligometastatic. In this study, we used whole-body magnetic resonance imaging (WB-MRI) to assess the anatomical distribution of oligo- and polymetastatic disease and the impact of the initial treatment on this distribution in patients. MATERIALS AND METHODS WB-MRI examinations of patients with a rising prostate-specific antigen (PSA) after radical treatment by surgery or/and radiotherapy were analyzed for disease recurrence. The patients were separated into three groups, based on the primary treatment: patients treated by radical prostatectomy without radiotherapy and with/without lymph node dissection (RP), patients treated only by radiotherapy or hormono-radiotherapy (RT) and patients treated with radical prostatectomy and adjuvant or salvage radiotherapy (RP + RT). Patients with ≤ 5 bone or/and node metastases were considered oligometastatic. Regional distributions of bone and lymph nodes metastases were reported using anatomical diagrams. Univariate and multivariable logistic regressions were performed to identify prognostic factors of relapse. RESULTS The primary treatment (RP, RT, RP + RT), Gleason score, PSA at relapse, time between first diagnosis and recurrence did not influence the metastatic status (oligo vs. polymetastatic). Oligometastatic patients showed different distribution of bone metastases compared to the polymetastatic ones and the distribution of the oligometastatic disease was not influenced by the primary treatment. CONCLUSIONS In this WB-MRI-based study, there was no evidence that the primary treatment influenced the metastatic status of the patient or the distribution of the oligometastatic disease.
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Barakat E, Kirchgesner T, Triqueneaux P, Galant C, Stoenoiu M, Lecouvet FE. Whole-Body Magnetic Resonance Imaging in Rheumatic and Systemic Diseases. Magn Reson Imaging Clin N Am 2018; 26:581-597. [DOI: 10.1016/j.mric.2018.06.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Jacobs MA, Macura KJ, Zaheer A, Antonarakis ES, Stearns V, Wolff AC, Feiweier T, Kamel IR, Wahl RL, Pan L. Multiparametric Whole-body MRI with Diffusion-weighted Imaging and ADC Mapping for the Identification of Visceral and Osseous Metastases From Solid Tumors. Acad Radiol 2018; 25:1405-1414. [PMID: 29627288 DOI: 10.1016/j.acra.2018.02.010] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 01/25/2018] [Accepted: 02/03/2018] [Indexed: 12/31/2022]
Abstract
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 T2-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 T2-weighted (T2WI), T1-weighted (T1WI), and DWI images were acquired. Total MRI acquisition and set-up time was approximately 45 minutes. Metastatic disease on MRI was confirmed based on T2WI characteristics. The number of lesions was established on computed tomography (CT) or positron emission tomography (PET-CT). Whole-body ADC maps and T2WI 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.
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Comparison of MRI Sequences in Whole-Body PET/MRI for Staging of Patients With High-Risk Prostate Cancer. AJR Am J Roentgenol 2018; 212:377-381. [PMID: 30332285 DOI: 10.2214/ajr.18.20495] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE The purpose of this study is to investigate the diagnostic value of various MRI sequences used for whole-body (WB) 18F-fluorocholine (FCH) PET/MRI staging of patients with high-risk prostate cancer (PCa). SUBJECTS AND METHODS This analysis is based on data from a prospective study that included 58 patients with untreated high-risk PCa who underwent integrated WB FCH PET/MRI (n = 10) or FCH PET/CT and WB MRI (n = 48). Metastatic sites were recorded. The standard of reference was histopathologic findings or clinical and imaging follow-up, or both. For each MRI sequence (Dixon T1-weighted, turbo inversion recovery magnitude, WB DWI, and gadolinium-enhanced T1-weighted volumetric interpolated breath-hold examination [VIBE]), acquisition time was recorded, and conspicuity of metastatic lesions was qualitatively assessed by two radiologists using a 4-point ordinal scale (0-3). RESULTS Total WB acquisition times were 1 minute 25 seconds for Dixon T1-weighted, 15 minutes 7 seconds for turbo inversion recovery magnitude, 16 minutes 33 seconds for WB DWI, and 1 minute 28 seconds for gadolinium-enhanced T1-weighted VIBE. The lesion detection rates were 88.3% (68/77) for Dixon T1-weighted, 94.8% (73/77) for turbo inversion recovery magnitude, 95.2% (40/42) for WB DWI, and 97.4% (75/77) for gadolinium-enhanced T1-weighted VIBE sequences. Moderate or high conspicuity scores were assigned to 62.3% (48/77) of lesions for Dixon T1-weighted, 88.3% (68/77) of lesions for turbo inversion recovery magnitude, 90.5% (38/42) of lesions for WB DWI, and 92.2% (71/77) of lesions for gadolinium-enhanced T1-weighted VIBE sequences. Conspicuity of metastases on gadolinium-enhanced T1-weighted VIBE and WB DWI sequences was higher than that on Dixon T1-weighted sequences (p < 0.0001 and p = 0.0011, respectively). CONCLUSION Metastases from prostate cancer are best detected at DWI or gadolinium-enhanced T1-weighted VIBE sequences. The most time-efficient sequence with the highest lesion detection rate and conspicuity is gadolinium-enhanced T1-weighted VIBE.
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Delliaux C, Tian TV, Bouchet M, Fradet A, Vanpouille N, Flourens A, Deplus R, Villers A, Leroy X, Clézardin P, de Launoit Y, Bonnelye E, Duterque-Coquillaud M. TMPRSS2:ERG gene fusion expression regulates bone markers and enhances the osteoblastic phenotype of prostate cancer bone metastases. Cancer Lett 2018; 438:32-43. [PMID: 30201302 DOI: 10.1016/j.canlet.2018.08.027] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 07/31/2018] [Accepted: 08/26/2018] [Indexed: 12/11/2022]
Abstract
Prostate cancers have a strong propensity to metastasize to bone and promote osteoblastic lesions. TMPRSS2:ERG is the most frequent gene rearrangement identified in prostate cancer, but whether it is involved in prostate cancer bone metastases is largely unknown. We exploited an intratibial metastasis model to address this issue and we found that ectopic expression of the TMPRSS2:ERG fusion enhances the ability of prostate cancer cell lines to induce osteoblastic lesions by stimulating bone formation and inhibiting the osteolytic response. In line with these in vivo results, we demonstrate that the TMPRSS2:ERG fusion protein increases the expression of osteoblastic markers, including Collagen Type I Alpha 1 Chain and Alkaline Phosphatase, as well as Endothelin-1, a protein with a documented role in osteoblastic bone lesion formation. Moreover, we determined that the TMPRSS2:ERG fusion protein is bound to the regulatory regions of these genes in prostate cancer cell lines, and we report that the expression levels of these osteoblastic markers are correlated with the expression of the TMPRSS2:ERG fusion in patient metastasis samples. Taken together, our results reveal that the TMPRSS2:ERG gene fusion is involved in osteoblastic lesion formation induced by prostate cancer cells.
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Affiliation(s)
- Carine Delliaux
- Univ. Lille, CNRS, Institut Pasteur de Lille, UMR 8161 - Mechanisms of Tumorigenesis and Target Therapies, F-59021, Lille, France; Montreal Clinical Research Institute (IRCM), QC H2W 1R7, Montreal, Canada
| | - Tian V Tian
- Univ. Lille, CNRS, Institut Pasteur de Lille, UMR 8161 - Mechanisms of Tumorigenesis and Target Therapies, F-59021, Lille, France; Center for Genomic Regulation (CRG), The Barcelona Institute of Science and Technology, Universitat Pompeu Fabra (UPF), Dr. Aiguader 88, S-08003, Barcelona, Spain
| | - Mathilde Bouchet
- Unité INSERM U1033, F-69372, Lyon, France; Université Claude Bernard Lyon 1, F-69008, Lyon, France
| | - Anais Fradet
- Unité INSERM U1033, F-69372, Lyon, France; Université Claude Bernard Lyon 1, F-69008, Lyon, France
| | - Nathalie Vanpouille
- Univ. Lille, CNRS, Institut Pasteur de Lille, UMR 8161 - Mechanisms of Tumorigenesis and Target Therapies, F-59021, Lille, France
| | - Anne Flourens
- Univ. Lille, CNRS, Institut Pasteur de Lille, UMR 8161 - Mechanisms of Tumorigenesis and Target Therapies, F-59021, Lille, France
| | - Rachel Deplus
- Univ. Lille, CNRS, Institut Pasteur de Lille, UMR 8161 - Mechanisms of Tumorigenesis and Target Therapies, F-59021, Lille, France
| | - Arnauld Villers
- Département d'Urologie, CHRU, Université de Lille, F-59037, Lille, France
| | - Xavier Leroy
- Institut de Pathologie-Centre de Biologie-Pathologie, Centre Hospitalier Régional et Universitaire, F-59037, Lille, France
| | - Philippe Clézardin
- Unité INSERM U1033, F-69372, Lyon, France; Université Claude Bernard Lyon 1, F-69008, Lyon, France
| | - Yvan de Launoit
- Univ. Lille, CNRS, Institut Pasteur de Lille, UMR 8161 - Mechanisms of Tumorigenesis and Target Therapies, F-59021, Lille, France
| | - Edith Bonnelye
- Unité INSERM U1033, F-69372, Lyon, France; Université Claude Bernard Lyon 1, F-69008, Lyon, France
| | - Martine Duterque-Coquillaud
- Univ. Lille, CNRS, Institut Pasteur de Lille, UMR 8161 - Mechanisms of Tumorigenesis and Target Therapies, F-59021, Lille, France.
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Whole-Body MR Imaging: The Novel, "Intrinsically Hybrid," Approach to Metastases, Myeloma, Lymphoma, in Bones and Beyond. PET Clin 2018; 13:505-522. [PMID: 30219185 DOI: 10.1016/j.cpet.2018.05.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Whole-body MR imaging (WB-MR imaging) has become a modality of choice for detecting bone metastases in multiple cancers, and bone marrow involvement by multiple myeloma or lymphoma. Combination of anatomic and functional sequences imparts an inherently hybrid dimension to this nonirradiating tool and extends the screening of malignancies outside the skeleton. WB-MR imaging outperforms bone scintigraphy and CT and offers an alternative to PET in many tumors by time of lesion detection and assessment of treatment response. Much work has been done to standardize procedures, optimize sequences, validate indications, confirm preliminary research into new applications, rendering clinical application more user-friendly.
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28
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Altahawi F, Subhas N. 3D MRI in Musculoskeletal Imaging: Current and Future Applications. CURRENT RADIOLOGY REPORTS 2018. [DOI: 10.1007/s40134-018-0287-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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Cook GJ, Goh V. Functional and Hybrid Imaging of Bone Metastases. J Bone Miner Res 2018; 33:961-972. [PMID: 29665140 PMCID: PMC7616187 DOI: 10.1002/jbmr.3444] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2018] [Revised: 04/02/2018] [Accepted: 04/06/2018] [Indexed: 12/21/2022]
Abstract
Bone metastases are common, cause significant morbidity, and impact on healthcare resources. Although radiography, computed tomography (CT), magnetic resonance imaging (MRI), and bone scintigraphy have frequently been used for staging the skeleton, these methods are insensitive and nonspecific for monitoring treatment response in a clinically relevant time frame. We summarize several recent reports on new functional and hybrid imaging methods including single photon emission CT/CT, positron emission tomography/CT, and whole-body MRI with diffusion-weighted imaging. These modalities generally show improvements in diagnostic accuracy for staging and response assessment over standard imaging methods, with the ability to quantify biological processes related to the bone microenvironment as well as tumor cells. As some of these methods are now being adopted into routine clinical practice and clinical trials, further evaluation with comparative studies is required to guide optimal and cost-effective clinical management of patients with skeletal metastases. © 2018 American Society for Bone and Mineral Research.
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Affiliation(s)
- Gary Jr Cook
- Department of Cancer Imaging, School of Biomedical Engineering and Imaging Sciences, King's College London, St Thomas' Hospital, London SE1 7EH, United Kingdom
- King's College London and Guy's & St Thomas' PET Centre, St Thomas' Hospital, London SE1 7EH, United Kingdom
| | - Vicky Goh
- Department of Cancer Imaging, School of Biomedical Engineering and Imaging Sciences, King's College London, St Thomas' Hospital, London SE1 7EH, United Kingdom
- Radiology Department, Guy's & St Thomas' Hospitals, London SE1 7EH, United Kingdom
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Pasoglou V, Michoux N, Larbi A, Van Nieuwenhove S, Lecouvet F. Whole Body MRI and oncology: recent major advances. Br J Radiol 2018; 91:20170664. [PMID: 29334236 DOI: 10.1259/bjr.20170664] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
MRI is a very attractive approach for tumour detection and oncological staging with its absence of ionizing radiation, high soft tissue contrast and spatial resolution. Less than 10 years ago the use of Whole Body MRI (WB-MRI) protocols was uncommon due to many limitations, such as the forbidding acquisition times and limited availability. This decade has marked substantial progress in WB-MRI protocols. This very promising technique is rapidly arising from the research world and is becoming a commonly used examination for tumour detection due to recent technological developments and validation of WB-MRI by multiple studies and consensus papers. As a result, WB-MRI is progressively proposed by radiologists as an efficient examination for an expanding range of indications. As the spectrum of its uses becomes wider, radiologists will soon be confronted with the challenges of this technique and be urged to be trained in order to accurately read and report these examinations. The aim of this review is to summarize the validated indications of WB-MRI and present an overview of its most recent advances. This paper will briefly discuss how this examination is performed and which are the recommended sequences along with the future perspectives in the field.
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Affiliation(s)
- Vassiliki Pasoglou
- 1 Department of Radiology, Centre du Cancer et Institut de Recherche Expérimentale et Clinique (IREC), Cliniques Universitaires Saint Luc, Université Catholique de Louvain , Brussels , Belgium
| | - Nicolas Michoux
- 1 Department of Radiology, Centre du Cancer et Institut de Recherche Expérimentale et Clinique (IREC), Cliniques Universitaires Saint Luc, Université Catholique de Louvain , Brussels , Belgium
| | - Ahmed Larbi
- 1 Department of Radiology, Centre du Cancer et Institut de Recherche Expérimentale et Clinique (IREC), Cliniques Universitaires Saint Luc, Université Catholique de Louvain , Brussels , Belgium.,2 Department of Radiology, Nimes University Hospital , Nimes , France
| | - Sandy Van Nieuwenhove
- 1 Department of Radiology, Centre du Cancer et Institut de Recherche Expérimentale et Clinique (IREC), Cliniques Universitaires Saint Luc, Université Catholique de Louvain , Brussels , Belgium
| | - Frédéric Lecouvet
- 1 Department of Radiology, Centre du Cancer et Institut de Recherche Expérimentale et Clinique (IREC), Cliniques Universitaires Saint Luc, Université Catholique de Louvain , Brussels , Belgium
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31
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The Diagnostic Performance of MRI for Detection of Lymph Node Metastasis in Bladder and Prostate Cancer: An Updated Systematic Review and Diagnostic Meta-Analysis. AJR Am J Roentgenol 2018; 210:W95-W109. [DOI: 10.2214/ajr.17.18481] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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32
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Pasoglou V, Michoux N, Larbi A, Van Nieuwenhove S, Lecouvet F. Whole Body MRI and oncology: recent major advances. Br J Radiol 2018. [PMID: 29334236 DOI: 10.1259/bjr.20170664%0a] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
MRI is a very attractive approach for tumour detection and oncological staging with its absence of ionizing radiation, high soft tissue contrast and spatial resolution. Less than 10 years ago the use of Whole Body MRI (WB-MRI) protocols was uncommon due to many limitations, such as the forbidding acquisition times and limited availability. This decade has marked substantial progress in WB-MRI protocols. This very promising technique is rapidly arising from the research world and is becoming a commonly used examination for tumour detection due to recent technological developments and validation of WB-MRI by multiple studies and consensus papers. As a result, WB-MRI is progressively proposed by radiologists as an efficient examination for an expanding range of indications. As the spectrum of its uses becomes wider, radiologists will soon be confronted with the challenges of this technique and be urged to be trained in order to accurately read and report these examinations. The aim of this review is to summarize the validated indications of WB-MRI and present an overview of its most recent advances. This paper will briefly discuss how this examination is performed and which are the recommended sequences along with the future perspectives in the field.
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Affiliation(s)
- Vassiliki Pasoglou
- 1 Department of Radiology, Centre du Cancer et Institut de Recherche Expérimentale et Clinique (IREC), Cliniques Universitaires Saint Luc, Université Catholique de Louvain , Brussels , Belgium
| | - Nicolas Michoux
- 1 Department of Radiology, Centre du Cancer et Institut de Recherche Expérimentale et Clinique (IREC), Cliniques Universitaires Saint Luc, Université Catholique de Louvain , Brussels , Belgium
| | - Ahmed Larbi
- 1 Department of Radiology, Centre du Cancer et Institut de Recherche Expérimentale et Clinique (IREC), Cliniques Universitaires Saint Luc, Université Catholique de Louvain , Brussels , Belgium.,2 Department of Radiology, Nimes University Hospital , Nimes , France
| | - Sandy Van Nieuwenhove
- 1 Department of Radiology, Centre du Cancer et Institut de Recherche Expérimentale et Clinique (IREC), Cliniques Universitaires Saint Luc, Université Catholique de Louvain , Brussels , Belgium
| | - Frédéric Lecouvet
- 1 Department of Radiology, Centre du Cancer et Institut de Recherche Expérimentale et Clinique (IREC), Cliniques Universitaires Saint Luc, Université Catholique de Louvain , Brussels , Belgium
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Woo S, Suh CH, Kim SY, Cho JY, Kim SH. Diagnostic Performance of Magnetic Resonance Imaging for the Detection of Bone Metastasis in Prostate Cancer: A Systematic Review and Meta-analysis. Eur Urol 2018; 73:81-91. [DOI: 10.1016/j.eururo.2017.03.042] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2017] [Accepted: 03/28/2017] [Indexed: 10/19/2022]
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Ponti E, Lancia A, Ost P, Trippa F, Triggiani L, Detti B, Ingrosso G. Exploring All Avenues for Radiotherapy in Oligorecurrent Prostate Cancer Disease Limited to Lymph Nodes: A Systematic Review of the Role of Stereotactic Body Radiotherapy. Eur Urol Focus 2017; 3:538-544. [DOI: 10.1016/j.euf.2017.07.006] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Revised: 07/18/2017] [Accepted: 07/28/2017] [Indexed: 01/05/2023]
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35
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Maeder Y, Dunet V, Richard R, Becce F, Omoumi P. Bone Marrow Metastases: T2-weighted Dixon Spin-Echo Fat Images Can Replace T1-weighted Spin-Echo Images. Radiology 2017; 286:948-959. [PMID: 29095674 DOI: 10.1148/radiol.2017170325] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Purpose To test the potential of Dixon T2-weighted fat-only sequences to replace T1-weighted sequences for the detection of bone metastases, with the hypothesis that diagnostic performance with an alternative magnetic resonance (MR) imaging protocol (sagittal spin-echo Dixon T2-weighted fat-only and water-only imaging) would not be inferior to that with the standard protocol (sagittal spin-echo T1-weighted and spin-echo Dixon T2-weighted water-only imaging). Materials and Methods A total of 121 consecutive whole-spine MR imaging examinations (63 men; mean age ± standard deviation, 61.4 years ± 11.8) performed for suspected vertebral bone metastases were included in this retrospective, institutional review board-approved study. Quantitative image analysis was performed for 30 randomly selected spine levels. Qualitative analysis was performed separately by two musculoskeletal radiologists, who registered the number of metastases for each spine level. Areas under the curve with the protocols were compared on the basis of nonparametric receiver operating characteristic curve estimations by using a noninferiority test on paired data, with a best valuable comparator as a reference. Interobserver and interprotocol agreement was assessed by using κ statistics. Results Contrast-to-noise ratio was significantly higher on the alternative protocol images than on the standard protocol images (181.1 [95% confidence interval: 140.4, 221.7] vs 84.7 [95% confidence interval: 66.3, 103.1] respectively; P < .001). Diagnostic performance was not significantly inferior with the alternative protocol than with the standard protocol for both readers in a per-patient analysis (sensitivity, 97.9%-98.9% vs 93.6%-97.9%; specificity, 85.2%-92.6% vs 92.6%-96.3%; area under the curve, 0.92-0.96 vs 0.95, respectively; all P ≤ .02) and a per-spine level analysis (all P < .01). Interobserver and interprotocol agreement was good to very good (κ = 0.70-0.81). Conclusion Dixon T2-weighted fat-only and water-only imaging provide, in one sequence, diagnostic performance similar to that of the standard combination of morphologic sequences for the detection of probable spinal bone metastases, thereby providing an opportunity to reduce imaging time by eliminating the need to perform T1 sequences. © RSNA, 2017 An earlier incorrect version of this article appeared online. This article was corrected on November 6, 2017.
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Affiliation(s)
- Yaël Maeder
- From the Department of Diagnostic and Interventional Radiology, Lausanne University Hospital, Rue du Bugnon 46, 1011 Lausanne, Switzerland
| | - Vincent Dunet
- From the Department of Diagnostic and Interventional Radiology, Lausanne University Hospital, Rue du Bugnon 46, 1011 Lausanne, Switzerland
| | - Raphael Richard
- From the Department of Diagnostic and Interventional Radiology, Lausanne University Hospital, Rue du Bugnon 46, 1011 Lausanne, Switzerland
| | - Fabio Becce
- From the Department of Diagnostic and Interventional Radiology, Lausanne University Hospital, Rue du Bugnon 46, 1011 Lausanne, Switzerland
| | - Patrick Omoumi
- From the Department of Diagnostic and Interventional Radiology, Lausanne University Hospital, Rue du Bugnon 46, 1011 Lausanne, Switzerland
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Sakamoto R, Yakami M, Fujimoto K, Nakagomi K, Kubo T, Emoto Y, Akasaka T, Aoyama G, Yamamoto H, Miller MI, Mori S, Togashi K. Temporal Subtraction of Serial CT Images with Large Deformation Diffeomorphic Metric Mapping in the Identification of Bone Metastases. Radiology 2017; 285:629-639. [PMID: 28678671 DOI: 10.1148/radiol.2017161942] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Purpose To determine the improvement of radiologist efficiency and performance in the detection of bone metastases at serial follow-up computed tomography (CT) by using a temporal subtraction (TS) technique based on an advanced nonrigid image registration algorithm. Materials and Methods This retrospective study was approved by the institutional review board, and informed consent was waived. CT image pairs (previous and current scans of the torso) in 60 patients with cancer (primary lesion location: prostate, n = 14; breast, n = 16; lung, n = 20; liver, n = 10) were included. These consisted of 30 positive cases with a total of 65 bone metastases depicted only on current images and confirmed by two radiologists who had access to additional imaging examinations and clinical courses and 30 matched negative control cases (no bone metastases). Previous CT images were semiautomatically registered to current CT images by the algorithm, and TS images were created. Seven radiologists independently interpreted CT image pairs to identify newly developed bone metastases without and with TS images with an interval of at least 30 days. Jackknife free-response receiver operating characteristics (JAFROC) analysis was conducted to assess observer performance. Reading time was recorded, and usefulness was evaluated with subjective scores of 1-5, with 5 being extremely useful and 1 being useless. Significance of these values was tested with the Wilcoxon signed-rank test. Results The subtraction images depicted various types of bone metastases (osteolytic, n = 28; osteoblastic, n = 26; mixed osteolytic and blastic, n = 11) as temporal changes. The average reading time was significantly reduced (384.3 vs 286.8 seconds; Wilcoxon signed rank test, P = .028). The average figure-of-merit value increased from 0.758 to 0.835; however, this difference was not significant (JAFROC analysis, P = .092). The subjective usefulness survey response showed a median score of 5 for use of the technique (range, 3-5). Conclusion TS images obtained from serial CT scans using nonrigid registration successfully depicted newly developed bone metastases and showed promise for their efficient detection. © RSNA, 2017 Online supplemental material is available for this article.
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Affiliation(s)
- Ryo Sakamoto
- From the Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan (R.S., M.Y., K.F., T.K., T.A., K.T.); Advanced Information & Real-world Technology Development Center 1, Canon, Kyoto, Japan (K.N., G.A., H.Y.); Clinical Research Center for Medical Equipment Development, Kyoto University Hospital, Shogoin, Sakyo-ku, Kyoto, Japan (K.N., G.A., H.Y.); Department of Medical Science, Kyoto College of Medical Science, Oyama-Higashimachi, Sonobe-cho, Nantan, Kyoto, Japan (Y.E.); Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Md (M.I.M.); Center for Imaging Science, Johns Hopkins University, Baltimore, Md (M.I.M.); Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, Md (S.M.); and F.M. Kirby Functional Imaging Center, Kennedy Krieger Institute, Johns Hopkins University, Baltimore, Md (S.M.)
| | - Masahiro Yakami
- From the Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan (R.S., M.Y., K.F., T.K., T.A., K.T.); Advanced Information & Real-world Technology Development Center 1, Canon, Kyoto, Japan (K.N., G.A., H.Y.); Clinical Research Center for Medical Equipment Development, Kyoto University Hospital, Shogoin, Sakyo-ku, Kyoto, Japan (K.N., G.A., H.Y.); Department of Medical Science, Kyoto College of Medical Science, Oyama-Higashimachi, Sonobe-cho, Nantan, Kyoto, Japan (Y.E.); Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Md (M.I.M.); Center for Imaging Science, Johns Hopkins University, Baltimore, Md (M.I.M.); Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, Md (S.M.); and F.M. Kirby Functional Imaging Center, Kennedy Krieger Institute, Johns Hopkins University, Baltimore, Md (S.M.)
| | - Koji Fujimoto
- From the Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan (R.S., M.Y., K.F., T.K., T.A., K.T.); Advanced Information & Real-world Technology Development Center 1, Canon, Kyoto, Japan (K.N., G.A., H.Y.); Clinical Research Center for Medical Equipment Development, Kyoto University Hospital, Shogoin, Sakyo-ku, Kyoto, Japan (K.N., G.A., H.Y.); Department of Medical Science, Kyoto College of Medical Science, Oyama-Higashimachi, Sonobe-cho, Nantan, Kyoto, Japan (Y.E.); Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Md (M.I.M.); Center for Imaging Science, Johns Hopkins University, Baltimore, Md (M.I.M.); Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, Md (S.M.); and F.M. Kirby Functional Imaging Center, Kennedy Krieger Institute, Johns Hopkins University, Baltimore, Md (S.M.)
| | - Keita Nakagomi
- From the Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan (R.S., M.Y., K.F., T.K., T.A., K.T.); Advanced Information & Real-world Technology Development Center 1, Canon, Kyoto, Japan (K.N., G.A., H.Y.); Clinical Research Center for Medical Equipment Development, Kyoto University Hospital, Shogoin, Sakyo-ku, Kyoto, Japan (K.N., G.A., H.Y.); Department of Medical Science, Kyoto College of Medical Science, Oyama-Higashimachi, Sonobe-cho, Nantan, Kyoto, Japan (Y.E.); Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Md (M.I.M.); Center for Imaging Science, Johns Hopkins University, Baltimore, Md (M.I.M.); Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, Md (S.M.); and F.M. Kirby Functional Imaging Center, Kennedy Krieger Institute, Johns Hopkins University, Baltimore, Md (S.M.)
| | - Takeshi Kubo
- From the Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan (R.S., M.Y., K.F., T.K., T.A., K.T.); Advanced Information & Real-world Technology Development Center 1, Canon, Kyoto, Japan (K.N., G.A., H.Y.); Clinical Research Center for Medical Equipment Development, Kyoto University Hospital, Shogoin, Sakyo-ku, Kyoto, Japan (K.N., G.A., H.Y.); Department of Medical Science, Kyoto College of Medical Science, Oyama-Higashimachi, Sonobe-cho, Nantan, Kyoto, Japan (Y.E.); Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Md (M.I.M.); Center for Imaging Science, Johns Hopkins University, Baltimore, Md (M.I.M.); Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, Md (S.M.); and F.M. Kirby Functional Imaging Center, Kennedy Krieger Institute, Johns Hopkins University, Baltimore, Md (S.M.)
| | - Yutaka Emoto
- From the Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan (R.S., M.Y., K.F., T.K., T.A., K.T.); Advanced Information & Real-world Technology Development Center 1, Canon, Kyoto, Japan (K.N., G.A., H.Y.); Clinical Research Center for Medical Equipment Development, Kyoto University Hospital, Shogoin, Sakyo-ku, Kyoto, Japan (K.N., G.A., H.Y.); Department of Medical Science, Kyoto College of Medical Science, Oyama-Higashimachi, Sonobe-cho, Nantan, Kyoto, Japan (Y.E.); Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Md (M.I.M.); Center for Imaging Science, Johns Hopkins University, Baltimore, Md (M.I.M.); Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, Md (S.M.); and F.M. Kirby Functional Imaging Center, Kennedy Krieger Institute, Johns Hopkins University, Baltimore, Md (S.M.)
| | - Thai Akasaka
- From the Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan (R.S., M.Y., K.F., T.K., T.A., K.T.); Advanced Information & Real-world Technology Development Center 1, Canon, Kyoto, Japan (K.N., G.A., H.Y.); Clinical Research Center for Medical Equipment Development, Kyoto University Hospital, Shogoin, Sakyo-ku, Kyoto, Japan (K.N., G.A., H.Y.); Department of Medical Science, Kyoto College of Medical Science, Oyama-Higashimachi, Sonobe-cho, Nantan, Kyoto, Japan (Y.E.); Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Md (M.I.M.); Center for Imaging Science, Johns Hopkins University, Baltimore, Md (M.I.M.); Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, Md (S.M.); and F.M. Kirby Functional Imaging Center, Kennedy Krieger Institute, Johns Hopkins University, Baltimore, Md (S.M.)
| | - Gakuto Aoyama
- From the Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan (R.S., M.Y., K.F., T.K., T.A., K.T.); Advanced Information & Real-world Technology Development Center 1, Canon, Kyoto, Japan (K.N., G.A., H.Y.); Clinical Research Center for Medical Equipment Development, Kyoto University Hospital, Shogoin, Sakyo-ku, Kyoto, Japan (K.N., G.A., H.Y.); Department of Medical Science, Kyoto College of Medical Science, Oyama-Higashimachi, Sonobe-cho, Nantan, Kyoto, Japan (Y.E.); Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Md (M.I.M.); Center for Imaging Science, Johns Hopkins University, Baltimore, Md (M.I.M.); Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, Md (S.M.); and F.M. Kirby Functional Imaging Center, Kennedy Krieger Institute, Johns Hopkins University, Baltimore, Md (S.M.)
| | - Hiroyuki Yamamoto
- From the Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan (R.S., M.Y., K.F., T.K., T.A., K.T.); Advanced Information & Real-world Technology Development Center 1, Canon, Kyoto, Japan (K.N., G.A., H.Y.); Clinical Research Center for Medical Equipment Development, Kyoto University Hospital, Shogoin, Sakyo-ku, Kyoto, Japan (K.N., G.A., H.Y.); Department of Medical Science, Kyoto College of Medical Science, Oyama-Higashimachi, Sonobe-cho, Nantan, Kyoto, Japan (Y.E.); Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Md (M.I.M.); Center for Imaging Science, Johns Hopkins University, Baltimore, Md (M.I.M.); Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, Md (S.M.); and F.M. Kirby Functional Imaging Center, Kennedy Krieger Institute, Johns Hopkins University, Baltimore, Md (S.M.)
| | - Michael I Miller
- From the Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan (R.S., M.Y., K.F., T.K., T.A., K.T.); Advanced Information & Real-world Technology Development Center 1, Canon, Kyoto, Japan (K.N., G.A., H.Y.); Clinical Research Center for Medical Equipment Development, Kyoto University Hospital, Shogoin, Sakyo-ku, Kyoto, Japan (K.N., G.A., H.Y.); Department of Medical Science, Kyoto College of Medical Science, Oyama-Higashimachi, Sonobe-cho, Nantan, Kyoto, Japan (Y.E.); Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Md (M.I.M.); Center for Imaging Science, Johns Hopkins University, Baltimore, Md (M.I.M.); Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, Md (S.M.); and F.M. Kirby Functional Imaging Center, Kennedy Krieger Institute, Johns Hopkins University, Baltimore, Md (S.M.)
| | - Susumu Mori
- From the Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan (R.S., M.Y., K.F., T.K., T.A., K.T.); Advanced Information & Real-world Technology Development Center 1, Canon, Kyoto, Japan (K.N., G.A., H.Y.); Clinical Research Center for Medical Equipment Development, Kyoto University Hospital, Shogoin, Sakyo-ku, Kyoto, Japan (K.N., G.A., H.Y.); Department of Medical Science, Kyoto College of Medical Science, Oyama-Higashimachi, Sonobe-cho, Nantan, Kyoto, Japan (Y.E.); Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Md (M.I.M.); Center for Imaging Science, Johns Hopkins University, Baltimore, Md (M.I.M.); Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, Md (S.M.); and F.M. Kirby Functional Imaging Center, Kennedy Krieger Institute, Johns Hopkins University, Baltimore, Md (S.M.)
| | - Kaori Togashi
- From the Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan (R.S., M.Y., K.F., T.K., T.A., K.T.); Advanced Information & Real-world Technology Development Center 1, Canon, Kyoto, Japan (K.N., G.A., H.Y.); Clinical Research Center for Medical Equipment Development, Kyoto University Hospital, Shogoin, Sakyo-ku, Kyoto, Japan (K.N., G.A., H.Y.); Department of Medical Science, Kyoto College of Medical Science, Oyama-Higashimachi, Sonobe-cho, Nantan, Kyoto, Japan (Y.E.); Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Md (M.I.M.); Center for Imaging Science, Johns Hopkins University, Baltimore, Md (M.I.M.); Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, Md (S.M.); and F.M. Kirby Functional Imaging Center, Kennedy Krieger Institute, Johns Hopkins University, Baltimore, Md (S.M.)
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Kakehi Y, Sugimoto M, Taoka R. Evidenced-based clinical practice guideline for prostate cancer (summary: Japanese Urological Association, 2016 edition). Int J Urol 2017; 24:648-666. [PMID: 28667698 DOI: 10.1111/iju.13380] [Citation(s) in RCA: 103] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Accepted: 04/11/2017] [Indexed: 12/18/2022]
Abstract
These guidelines cover a wide range of topics from prostate cancer epidemiology to palliative care. Questions arising in daily clinical practice have been extracted and formulated as clinical questions. In the 4 years since the previous edition, there have been major changes - for example, robot-assisted prostatectomy has rapidly come into widespread use, and new hormones and anticancer drugs have been developed for castration-resistant prostate cancer. In response to these developments, the number of fields included in this guideline was increased from 11 in the 2012 edition to 16, and the number of clinical questions was increased from 63 to 70. The number of papers identified in searches of the existing literature increased from 4662 in the first edition, published in 2006, to 10 490 in the 2012 edition. The number of references has reached 29 448 just during this review period, indicating the exponential increase in research on the topic of prostate cancer. Clinical answers have been prepared based on the latest evidence. Recommendation grades for the clinical answers were determined by radiologists, pathologists, and other specialists in addition to urologists in order to reflect the recent advances and diversity of prostate cancer treatment. Here, we present a short English version of the original guideline, and overview its key clinical issues.
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Affiliation(s)
- Yoshiyuki Kakehi
- Department of Urology, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | - Mikio Sugimoto
- Department of Urology, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | - Rikiya Taoka
- Department of Urology, Faculty of Medicine, Kagawa University, Kagawa, Japan
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Ceranka J, Polfliet M, Lecouvet F, Michoux N, de Mey J, Vandemeulebroucke J. Registration strategies for multi-modal whole-body MRI mosaicing. Magn Reson Med 2017. [PMID: 28639338 DOI: 10.1002/mrm.26787] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
PURPOSE To test and compare different registration approaches for performing whole-body diffusion-weighted (wbDWI) image station mosaicing, and its alignment to corresponding anatomical T1 whole-body image. METHODS Four different registration strategies aiming at mosaicing of diffusion-weighted image stations, and their alignment to the corresponding whole-body anatomical image, were proposed and evaluated. These included two-step approaches, where diffusion-weighted stations are first combined in a pairwise (Strategy 1) or groupwise (Strategy 2) manner and later non-rigidly aligned to the anatomical image; a direct pairwise mapping of DWI stations onto the anatomical image (Strategy 3); and simultaneous mosaicing of DWI and alignment to the anatomical image (Strategy 4). Additionally, different images driving the registration were investigated. Experiments were performed for 20 whole-body images of patients with bone metastases. RESULTS Strategies 1 and 2 showed significant improvement in mosaicing accuracy with respect to the non-registered images (P < 0.006). Strategy 2 based on ADC images increased the alignment accuracy between DWI stations and the T1 whole-body image (P = 0.0009). CONCLUSIONS A two-step registration strategy, relying on groupwise mosaicing of the ADC stations and subsequent registration to T1 , provided the best compromise between whole-body DWI image quality and multi-modal alignment. Magn Reson Med 79:1684-1695, 2018. © 2017 International Society for Magnetic Resonance in Medicine.
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Affiliation(s)
- Jakub Ceranka
- Vrije Universiteit Brussel (VUB), Department of Electronics and Informatics (ETRO), Brussels, Belgium.,imec, Leuven, Belgium
| | - Mathias Polfliet
- Vrije Universiteit Brussel (VUB), Department of Electronics and Informatics (ETRO), Brussels, Belgium.,imec, Leuven, Belgium.,Biomedical Imaging Group, Department of Radiology and Medical Informatics, Erasmus MC, Rotterdam, The Netherlands
| | - Frédéric Lecouvet
- Department of Radiology, Centre du Cancer and Institut de Recherche Expérimentale et Clinique (IREC-IMAG), Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Nicolas Michoux
- Department of Radiology, Centre du Cancer and Institut de Recherche Expérimentale et Clinique (IREC-IMAG), Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Johan de Mey
- Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Department of Radiology, Brussels, Belgium
| | - Jef Vandemeulebroucke
- Vrije Universiteit Brussel (VUB), Department of Electronics and Informatics (ETRO), Brussels, Belgium.,imec, Leuven, Belgium
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Taylor SA, Mallett S, Miles A, Beare S, Bhatnagar G, Bridgewater J, Glynne-Jones R, Goh V, Groves AM, Janes SM, Koh DM, Morris S, Morton A, Navani N, Oliver A, Padhani AR, Punwani S, Rockall AG, Halligan S. Streamlining staging of lung and colorectal cancer with whole body MRI; study protocols for two multicentre, non-randomised, single-arm, prospective diagnostic accuracy studies (Streamline C and Streamline L). BMC Cancer 2017; 17:299. [PMID: 28464835 PMCID: PMC5412056 DOI: 10.1186/s12885-017-3281-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2016] [Accepted: 04/13/2017] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND AND AIMS Rapid and accurate cancer staging following diagnosis underpins patient management, in particular the identification of distant metastatic disease. Current staging guidelines recommend sequential deployment of various imaging platforms such as computerised tomography (CT) and positron emission tomography (PET) which can be time and resource intensive and onerous for patients. Recent studies demonstrate that whole body magnetic resonance Imaging (WB-MRI) may stage cancer efficiently in a single visit, with potentially greater accuracy than current staging investigations. The Streamline trials aim to evaluate whether WB-MRI increases per patient detection of metastases in non-small cell lung and colorectal cancer compared to standard staging pathways. METHODS The Streamline trials are multicentre, non-randomised, single-arm, prospective diagnostic accuracy studies with a novel design to capture patient management decisions during staging pathways. The two trials recruit adult patients with proven or highly suspected new diagnosis of primary colorectal (Streamline C) or non-small cell lung cancer (Streamline L) referred for staging. Patients undergo WB-MRI in addition to standard staging investigations. Strict blinding protocols are enforced for those interpreting the imaging. A first major treatment decision is made by the multi-disciplinary team prior to WB-MRI revelation based on standard staging investigations only, then based on the WB-MRI and any additional tests precipitated by WB-MRI, and finally based on all available test results. The reference standard is derived by a multidisciplinary consensus panel who assess 12 months of follow-up data to adjudicate on the TNM stage at diagnosis. Health psychology assessment of patients' experiences of the cancer staging pathway will be undertaken via interviews and questionnaires. A cost (effectiveness) analysis of WB-MRI compared to standard staging pathways will be performed. DISCUSSION We describe a novel approach to radiologist and clinician blinding to ascertain the 'true' diagnostic accuracy of differing imaging pathways and discuss our approach to assessing the impact of WB-MRI on clinical decision making in real-time. The Streamline trials will compare WB-MRI and standard imaging pathways in the same patients, thereby informing the most accurate and efficient approach to staging. TRIAL REGISTRATION Streamline C ISRCTN43958015 (registered 25/7/2012). Streamline L ISRCTN50436483 (registered 31/7/2012).
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Affiliation(s)
- Stuart A. Taylor
- Centre for Medical Imaging, University College London, 250 Euston Road, London, NW1 2BU UK
| | - Sue Mallett
- School of Health and Population Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT UK
| | - Anne Miles
- Birkbeck, University of London, Malet Street, London, WC1E 7HX UK
| | - Sandy Beare
- Cancer Research UK & UCL Cancer Trials Centre, 90 Tottenham Court Road, London, W1T 4TJ UK
| | - Gauraang Bhatnagar
- Centre for Medical Imaging, University College London, 250 Euston Road, London, NW1 2BU UK
| | - John Bridgewater
- UCL Cancer Institute, Paul O Gorman Building, 72 Huntley Street London, London, WC1E 6DD UK
| | - Rob Glynne-Jones
- Mount Vernon Centre for Cancer Treatment, Rickmansworth Road, Northwood, MIDDX, HA6 2RN UK
| | - Vicky Goh
- Cancer Imaging, Division of Imaging Sciences & Biomedical Engineering Kings College London, St Thomas Hospital, Westminster Bridge Road, London, SE1 7EH UK
| | - Ashley M. Groves
- Institute of Nuclear Medicine, University College London, Euston Rd, London, UK
| | - Sam M. Janes
- Lungs for Living Research Centre, UCL Respiratory, University College London, 5 University Street, London, WC1E 6JF UK
| | - Dow Mu Koh
- Department of Radiology, Royal Marsden Hospital, Downs Road, Sutton, SM2 5PT UK
| | - Steve Morris
- Department of Applied Health Research, University College London, 1-19 Torrington Pl, Fitzrovia, London, WC1E 7HB UK
| | - Alison Morton
- C/O National Cancer Research Institute, 407 St Johns Street, London, EC1V 4AD UK
| | - Neal Navani
- Lungs for Living Research Centre, UCL Respiratory, University College London, 5 University Street, London, WC1E 6JF UK
- Department of Thoracic Medicine, University College London Hospital, 250 Euston Road, London, NW1 2PG UK
| | - Alf Oliver
- C/O National Cancer Research Institute, 407 St Johns Street, London, EC1V 4AD UK
| | - Anwar R. Padhani
- Paul Strickland Scanner Centre, Mount Vernon Hospital, Middlesex, UK
| | - Shonit Punwani
- Centre for Medical Imaging, University College London, 250 Euston Road, London, NW1 2BU UK
| | - Andrea G. Rockall
- Department of Radiology, Royal Marsden NHS Foundation Trust, Fulham Rd London, London, SW3 6JJ UK
- Division of Cancer and Surgery, Faculty of Medicine, Hammersmith Campus, Imperial College London, London, W12 ONN UK
| | - Steve Halligan
- Centre for Medical Imaging, University College London, 250 Euston Road, London, NW1 2BU UK
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Ahlawat S, Fayad LM, Khan MS, Bredella MA, Harris GJ, Evans DG, Farschtschi S, Jacobs MA, Chhabra A, Salamon JM, Wenzel R, Mautner VF, Dombi E, Cai W, Plotkin SR, Blakeley JO. Current whole-body MRI applications in the neurofibromatoses: NF1, NF2, and schwannomatosis. Neurology 2017; 87:S31-9. [PMID: 27527647 DOI: 10.1212/wnl.0000000000002929] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Accepted: 05/26/2016] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES The Response Evaluation in Neurofibromatosis and Schwannomatosis (REiNS) International Collaboration Whole-Body MRI (WB-MRI) Working Group reviewed the existing literature on WB-MRI, an emerging technology for assessing disease in patients with neurofibromatosis type 1 (NF1), neurofibromatosis type 2 (NF2), and schwannomatosis (SWN), to recommend optimal image acquisition and analysis methods to enable WB-MRI as an endpoint in NF clinical trials. METHODS A systematic process was used to review all published data about WB-MRI in NF syndromes to assess diagnostic accuracy, feasibility and reproducibility, and data about specific techniques for assessment of tumor burden, characterization of neoplasms, and response to therapy. RESULTS WB-MRI at 1.5T or 3.0T is feasible for image acquisition. Short tau inversion recovery (STIR) sequence is used in all investigations to date, suggesting consensus about the utility of this sequence for detection of WB tumor burden in people with NF. There are insufficient data to support a consensus statement about the optimal imaging planes (axial vs coronal) or 2D vs 3D approaches. Functional imaging, although used in some NF studies, has not been systematically applied or evaluated. There are no comparative studies between regional vs WB-MRI or evaluations of WB-MRI reproducibility. CONCLUSIONS WB-MRI is feasible for identifying tumors using both 1.5T and 3.0T systems. The STIR sequence is a core sequence. Additional investigation is needed to define the optimal approach for volumetric analysis, the reproducibility of WB-MRI in NF, and the diagnostic performance of WB-MRI vs regional MRI.
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Affiliation(s)
- Shivani Ahlawat
- From The Russell H. Morgan Department of Radiology and Radiological Science (S.A., L.M.F., M.A.J.), Sidney Kimmel Comprehensive Cancer Center (M.A.J.), and Department of Neurology (J.O.B.), Johns Hopkins University, Baltimore, MD; Khyber Medical College (M.S.K.), Peshawar, Pakistan; Department of Radiology (M.A.B., G.J.H., W.C.), Massachusetts General Hospital and Harvard Medical School, Boston; Genomic Medicine (D.G.E.), Manchester Academic Health Science Centre, The University of Manchester, UK; Department of Neurology (S.F., V.F.M.), University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Radiology & Orthopedic Surgery (A.C.), UT Southwestern Medical Center, Dallas, TX; Department of Diagnostic and Interventional Radiology (J.M.S.), University Hospital Hamburg-Eppendorf; Radiological Practice Altona (R.W.), Hamburg, Germany; Pediatric Oncology Branch (E.D.), National Cancer Institute, Bethesda, MD; and Department of Neurology and Cancer Center (S.R.P.), Massachusetts General Hospital, Boston.
| | - Laura M Fayad
- From The Russell H. Morgan Department of Radiology and Radiological Science (S.A., L.M.F., M.A.J.), Sidney Kimmel Comprehensive Cancer Center (M.A.J.), and Department of Neurology (J.O.B.), Johns Hopkins University, Baltimore, MD; Khyber Medical College (M.S.K.), Peshawar, Pakistan; Department of Radiology (M.A.B., G.J.H., W.C.), Massachusetts General Hospital and Harvard Medical School, Boston; Genomic Medicine (D.G.E.), Manchester Academic Health Science Centre, The University of Manchester, UK; Department of Neurology (S.F., V.F.M.), University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Radiology & Orthopedic Surgery (A.C.), UT Southwestern Medical Center, Dallas, TX; Department of Diagnostic and Interventional Radiology (J.M.S.), University Hospital Hamburg-Eppendorf; Radiological Practice Altona (R.W.), Hamburg, Germany; Pediatric Oncology Branch (E.D.), National Cancer Institute, Bethesda, MD; and Department of Neurology and Cancer Center (S.R.P.), Massachusetts General Hospital, Boston
| | - Muhammad Shayan Khan
- From The Russell H. Morgan Department of Radiology and Radiological Science (S.A., L.M.F., M.A.J.), Sidney Kimmel Comprehensive Cancer Center (M.A.J.), and Department of Neurology (J.O.B.), Johns Hopkins University, Baltimore, MD; Khyber Medical College (M.S.K.), Peshawar, Pakistan; Department of Radiology (M.A.B., G.J.H., W.C.), Massachusetts General Hospital and Harvard Medical School, Boston; Genomic Medicine (D.G.E.), Manchester Academic Health Science Centre, The University of Manchester, UK; Department of Neurology (S.F., V.F.M.), University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Radiology & Orthopedic Surgery (A.C.), UT Southwestern Medical Center, Dallas, TX; Department of Diagnostic and Interventional Radiology (J.M.S.), University Hospital Hamburg-Eppendorf; Radiological Practice Altona (R.W.), Hamburg, Germany; Pediatric Oncology Branch (E.D.), National Cancer Institute, Bethesda, MD; and Department of Neurology and Cancer Center (S.R.P.), Massachusetts General Hospital, Boston
| | - Miriam A Bredella
- From The Russell H. Morgan Department of Radiology and Radiological Science (S.A., L.M.F., M.A.J.), Sidney Kimmel Comprehensive Cancer Center (M.A.J.), and Department of Neurology (J.O.B.), Johns Hopkins University, Baltimore, MD; Khyber Medical College (M.S.K.), Peshawar, Pakistan; Department of Radiology (M.A.B., G.J.H., W.C.), Massachusetts General Hospital and Harvard Medical School, Boston; Genomic Medicine (D.G.E.), Manchester Academic Health Science Centre, The University of Manchester, UK; Department of Neurology (S.F., V.F.M.), University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Radiology & Orthopedic Surgery (A.C.), UT Southwestern Medical Center, Dallas, TX; Department of Diagnostic and Interventional Radiology (J.M.S.), University Hospital Hamburg-Eppendorf; Radiological Practice Altona (R.W.), Hamburg, Germany; Pediatric Oncology Branch (E.D.), National Cancer Institute, Bethesda, MD; and Department of Neurology and Cancer Center (S.R.P.), Massachusetts General Hospital, Boston
| | - Gordon J Harris
- From The Russell H. Morgan Department of Radiology and Radiological Science (S.A., L.M.F., M.A.J.), Sidney Kimmel Comprehensive Cancer Center (M.A.J.), and Department of Neurology (J.O.B.), Johns Hopkins University, Baltimore, MD; Khyber Medical College (M.S.K.), Peshawar, Pakistan; Department of Radiology (M.A.B., G.J.H., W.C.), Massachusetts General Hospital and Harvard Medical School, Boston; Genomic Medicine (D.G.E.), Manchester Academic Health Science Centre, The University of Manchester, UK; Department of Neurology (S.F., V.F.M.), University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Radiology & Orthopedic Surgery (A.C.), UT Southwestern Medical Center, Dallas, TX; Department of Diagnostic and Interventional Radiology (J.M.S.), University Hospital Hamburg-Eppendorf; Radiological Practice Altona (R.W.), Hamburg, Germany; Pediatric Oncology Branch (E.D.), National Cancer Institute, Bethesda, MD; and Department of Neurology and Cancer Center (S.R.P.), Massachusetts General Hospital, Boston
| | - D Gareth Evans
- From The Russell H. Morgan Department of Radiology and Radiological Science (S.A., L.M.F., M.A.J.), Sidney Kimmel Comprehensive Cancer Center (M.A.J.), and Department of Neurology (J.O.B.), Johns Hopkins University, Baltimore, MD; Khyber Medical College (M.S.K.), Peshawar, Pakistan; Department of Radiology (M.A.B., G.J.H., W.C.), Massachusetts General Hospital and Harvard Medical School, Boston; Genomic Medicine (D.G.E.), Manchester Academic Health Science Centre, The University of Manchester, UK; Department of Neurology (S.F., V.F.M.), University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Radiology & Orthopedic Surgery (A.C.), UT Southwestern Medical Center, Dallas, TX; Department of Diagnostic and Interventional Radiology (J.M.S.), University Hospital Hamburg-Eppendorf; Radiological Practice Altona (R.W.), Hamburg, Germany; Pediatric Oncology Branch (E.D.), National Cancer Institute, Bethesda, MD; and Department of Neurology and Cancer Center (S.R.P.), Massachusetts General Hospital, Boston
| | - Said Farschtschi
- From The Russell H. Morgan Department of Radiology and Radiological Science (S.A., L.M.F., M.A.J.), Sidney Kimmel Comprehensive Cancer Center (M.A.J.), and Department of Neurology (J.O.B.), Johns Hopkins University, Baltimore, MD; Khyber Medical College (M.S.K.), Peshawar, Pakistan; Department of Radiology (M.A.B., G.J.H., W.C.), Massachusetts General Hospital and Harvard Medical School, Boston; Genomic Medicine (D.G.E.), Manchester Academic Health Science Centre, The University of Manchester, UK; Department of Neurology (S.F., V.F.M.), University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Radiology & Orthopedic Surgery (A.C.), UT Southwestern Medical Center, Dallas, TX; Department of Diagnostic and Interventional Radiology (J.M.S.), University Hospital Hamburg-Eppendorf; Radiological Practice Altona (R.W.), Hamburg, Germany; Pediatric Oncology Branch (E.D.), National Cancer Institute, Bethesda, MD; and Department of Neurology and Cancer Center (S.R.P.), Massachusetts General Hospital, Boston
| | - Michael A Jacobs
- From The Russell H. Morgan Department of Radiology and Radiological Science (S.A., L.M.F., M.A.J.), Sidney Kimmel Comprehensive Cancer Center (M.A.J.), and Department of Neurology (J.O.B.), Johns Hopkins University, Baltimore, MD; Khyber Medical College (M.S.K.), Peshawar, Pakistan; Department of Radiology (M.A.B., G.J.H., W.C.), Massachusetts General Hospital and Harvard Medical School, Boston; Genomic Medicine (D.G.E.), Manchester Academic Health Science Centre, The University of Manchester, UK; Department of Neurology (S.F., V.F.M.), University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Radiology & Orthopedic Surgery (A.C.), UT Southwestern Medical Center, Dallas, TX; Department of Diagnostic and Interventional Radiology (J.M.S.), University Hospital Hamburg-Eppendorf; Radiological Practice Altona (R.W.), Hamburg, Germany; Pediatric Oncology Branch (E.D.), National Cancer Institute, Bethesda, MD; and Department of Neurology and Cancer Center (S.R.P.), Massachusetts General Hospital, Boston
| | - Avneesh Chhabra
- From The Russell H. Morgan Department of Radiology and Radiological Science (S.A., L.M.F., M.A.J.), Sidney Kimmel Comprehensive Cancer Center (M.A.J.), and Department of Neurology (J.O.B.), Johns Hopkins University, Baltimore, MD; Khyber Medical College (M.S.K.), Peshawar, Pakistan; Department of Radiology (M.A.B., G.J.H., W.C.), Massachusetts General Hospital and Harvard Medical School, Boston; Genomic Medicine (D.G.E.), Manchester Academic Health Science Centre, The University of Manchester, UK; Department of Neurology (S.F., V.F.M.), University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Radiology & Orthopedic Surgery (A.C.), UT Southwestern Medical Center, Dallas, TX; Department of Diagnostic and Interventional Radiology (J.M.S.), University Hospital Hamburg-Eppendorf; Radiological Practice Altona (R.W.), Hamburg, Germany; Pediatric Oncology Branch (E.D.), National Cancer Institute, Bethesda, MD; and Department of Neurology and Cancer Center (S.R.P.), Massachusetts General Hospital, Boston
| | - Johannes M Salamon
- From The Russell H. Morgan Department of Radiology and Radiological Science (S.A., L.M.F., M.A.J.), Sidney Kimmel Comprehensive Cancer Center (M.A.J.), and Department of Neurology (J.O.B.), Johns Hopkins University, Baltimore, MD; Khyber Medical College (M.S.K.), Peshawar, Pakistan; Department of Radiology (M.A.B., G.J.H., W.C.), Massachusetts General Hospital and Harvard Medical School, Boston; Genomic Medicine (D.G.E.), Manchester Academic Health Science Centre, The University of Manchester, UK; Department of Neurology (S.F., V.F.M.), University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Radiology & Orthopedic Surgery (A.C.), UT Southwestern Medical Center, Dallas, TX; Department of Diagnostic and Interventional Radiology (J.M.S.), University Hospital Hamburg-Eppendorf; Radiological Practice Altona (R.W.), Hamburg, Germany; Pediatric Oncology Branch (E.D.), National Cancer Institute, Bethesda, MD; and Department of Neurology and Cancer Center (S.R.P.), Massachusetts General Hospital, Boston
| | - Ralph Wenzel
- From The Russell H. Morgan Department of Radiology and Radiological Science (S.A., L.M.F., M.A.J.), Sidney Kimmel Comprehensive Cancer Center (M.A.J.), and Department of Neurology (J.O.B.), Johns Hopkins University, Baltimore, MD; Khyber Medical College (M.S.K.), Peshawar, Pakistan; Department of Radiology (M.A.B., G.J.H., W.C.), Massachusetts General Hospital and Harvard Medical School, Boston; Genomic Medicine (D.G.E.), Manchester Academic Health Science Centre, The University of Manchester, UK; Department of Neurology (S.F., V.F.M.), University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Radiology & Orthopedic Surgery (A.C.), UT Southwestern Medical Center, Dallas, TX; Department of Diagnostic and Interventional Radiology (J.M.S.), University Hospital Hamburg-Eppendorf; Radiological Practice Altona (R.W.), Hamburg, Germany; Pediatric Oncology Branch (E.D.), National Cancer Institute, Bethesda, MD; and Department of Neurology and Cancer Center (S.R.P.), Massachusetts General Hospital, Boston
| | - Victor F Mautner
- From The Russell H. Morgan Department of Radiology and Radiological Science (S.A., L.M.F., M.A.J.), Sidney Kimmel Comprehensive Cancer Center (M.A.J.), and Department of Neurology (J.O.B.), Johns Hopkins University, Baltimore, MD; Khyber Medical College (M.S.K.), Peshawar, Pakistan; Department of Radiology (M.A.B., G.J.H., W.C.), Massachusetts General Hospital and Harvard Medical School, Boston; Genomic Medicine (D.G.E.), Manchester Academic Health Science Centre, The University of Manchester, UK; Department of Neurology (S.F., V.F.M.), University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Radiology & Orthopedic Surgery (A.C.), UT Southwestern Medical Center, Dallas, TX; Department of Diagnostic and Interventional Radiology (J.M.S.), University Hospital Hamburg-Eppendorf; Radiological Practice Altona (R.W.), Hamburg, Germany; Pediatric Oncology Branch (E.D.), National Cancer Institute, Bethesda, MD; and Department of Neurology and Cancer Center (S.R.P.), Massachusetts General Hospital, Boston
| | - Eva Dombi
- From The Russell H. Morgan Department of Radiology and Radiological Science (S.A., L.M.F., M.A.J.), Sidney Kimmel Comprehensive Cancer Center (M.A.J.), and Department of Neurology (J.O.B.), Johns Hopkins University, Baltimore, MD; Khyber Medical College (M.S.K.), Peshawar, Pakistan; Department of Radiology (M.A.B., G.J.H., W.C.), Massachusetts General Hospital and Harvard Medical School, Boston; Genomic Medicine (D.G.E.), Manchester Academic Health Science Centre, The University of Manchester, UK; Department of Neurology (S.F., V.F.M.), University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Radiology & Orthopedic Surgery (A.C.), UT Southwestern Medical Center, Dallas, TX; Department of Diagnostic and Interventional Radiology (J.M.S.), University Hospital Hamburg-Eppendorf; Radiological Practice Altona (R.W.), Hamburg, Germany; Pediatric Oncology Branch (E.D.), National Cancer Institute, Bethesda, MD; and Department of Neurology and Cancer Center (S.R.P.), Massachusetts General Hospital, Boston
| | - Wenli Cai
- From The Russell H. Morgan Department of Radiology and Radiological Science (S.A., L.M.F., M.A.J.), Sidney Kimmel Comprehensive Cancer Center (M.A.J.), and Department of Neurology (J.O.B.), Johns Hopkins University, Baltimore, MD; Khyber Medical College (M.S.K.), Peshawar, Pakistan; Department of Radiology (M.A.B., G.J.H., W.C.), Massachusetts General Hospital and Harvard Medical School, Boston; Genomic Medicine (D.G.E.), Manchester Academic Health Science Centre, The University of Manchester, UK; Department of Neurology (S.F., V.F.M.), University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Radiology & Orthopedic Surgery (A.C.), UT Southwestern Medical Center, Dallas, TX; Department of Diagnostic and Interventional Radiology (J.M.S.), University Hospital Hamburg-Eppendorf; Radiological Practice Altona (R.W.), Hamburg, Germany; Pediatric Oncology Branch (E.D.), National Cancer Institute, Bethesda, MD; and Department of Neurology and Cancer Center (S.R.P.), Massachusetts General Hospital, Boston
| | - Scott R Plotkin
- From The Russell H. Morgan Department of Radiology and Radiological Science (S.A., L.M.F., M.A.J.), Sidney Kimmel Comprehensive Cancer Center (M.A.J.), and Department of Neurology (J.O.B.), Johns Hopkins University, Baltimore, MD; Khyber Medical College (M.S.K.), Peshawar, Pakistan; Department of Radiology (M.A.B., G.J.H., W.C.), Massachusetts General Hospital and Harvard Medical School, Boston; Genomic Medicine (D.G.E.), Manchester Academic Health Science Centre, The University of Manchester, UK; Department of Neurology (S.F., V.F.M.), University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Radiology & Orthopedic Surgery (A.C.), UT Southwestern Medical Center, Dallas, TX; Department of Diagnostic and Interventional Radiology (J.M.S.), University Hospital Hamburg-Eppendorf; Radiological Practice Altona (R.W.), Hamburg, Germany; Pediatric Oncology Branch (E.D.), National Cancer Institute, Bethesda, MD; and Department of Neurology and Cancer Center (S.R.P.), Massachusetts General Hospital, Boston
| | - Jaishri O Blakeley
- From The Russell H. Morgan Department of Radiology and Radiological Science (S.A., L.M.F., M.A.J.), Sidney Kimmel Comprehensive Cancer Center (M.A.J.), and Department of Neurology (J.O.B.), Johns Hopkins University, Baltimore, MD; Khyber Medical College (M.S.K.), Peshawar, Pakistan; Department of Radiology (M.A.B., G.J.H., W.C.), Massachusetts General Hospital and Harvard Medical School, Boston; Genomic Medicine (D.G.E.), Manchester Academic Health Science Centre, The University of Manchester, UK; Department of Neurology (S.F., V.F.M.), University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Radiology & Orthopedic Surgery (A.C.), UT Southwestern Medical Center, Dallas, TX; Department of Diagnostic and Interventional Radiology (J.M.S.), University Hospital Hamburg-Eppendorf; Radiological Practice Altona (R.W.), Hamburg, Germany; Pediatric Oncology Branch (E.D.), National Cancer Institute, Bethesda, MD; and Department of Neurology and Cancer Center (S.R.P.), Massachusetts General Hospital, Boston
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Longitudinal Computed Tomography Monitoring of Pelvic Bones in Patients With Breast Cancer Using Automated Bone Subtraction Software. Invest Radiol 2017; 52:288-294. [DOI: 10.1097/rli.0000000000000343] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Bamberg F, Hetterich H, Rospleszcz S, Lorbeer R, Auweter SD, Schlett CL, Schafnitzel A, Bayerl C, Schindler A, Saam T, Müller-Peltzer K, Sommer W, Zitzelsberger T, Machann J, Ingrisch M, Selder S, Rathmann W, Heier M, Linkohr B, Meisinger C, Weber C, Ertl-Wagner B, Massberg S, Reiser MF, Peters A. Subclinical Disease Burden as Assessed by Whole-Body MRI in Subjects With Prediabetes, Subjects With Diabetes, and Normal Control Subjects From the General Population: The KORA-MRI Study. Diabetes 2017; 66:158-169. [PMID: 27999110 DOI: 10.2337/db16-0630] [Citation(s) in RCA: 93] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Accepted: 10/04/2016] [Indexed: 11/13/2022]
Abstract
Detailed pathophysiological manifestations of early disease in the context of prediabetes are poorly understood. This study aimed to evaluate the extent of early signs of metabolic and cardio-cerebrovascular complications affecting multiple organs in individuals with prediabetes. Subjects without a history of stroke, coronary artery disease, or peripheral artery disease were enrolled in a case-control study nested within the Cooperative Health Research in the Region of Augsburg (KORA) FF4 cohort and underwent comprehensive MRI assessment to characterize cerebral parameters (white matter lesions, microbleeds), cardiovascular parameters (carotid plaque, left ventricular function, and myocardial late gadolinium enhancement [LGE]), and metabolic parameters (hepatic proton-density fat fraction [PDFF] and subcutaneous and visceral abdominal fat). Among 400 subjects who underwent MRI, 103 subjects had prediabetes and 54 had established diabetes. Subjects with prediabetes had an increased risk for carotid plaque and adverse functional cardiac parameters, including reduced early diastolic filling rates as well as a higher prevalence of LGE compared with healthy control subjects. In addition, people with prediabetes had significantly elevated levels of PDFF and total and visceral fat. Thus, subjects with prediabetes show early signs of subclinical disease that include vascular, cardiac, and metabolic changes, as measured by whole-body MRI after adjusting for cardiometabolic risk factors.
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Affiliation(s)
- Fabian Bamberg
- Institute of Clinical Radiology, Ludwig-Maximilian-University Hospital, Munich, Germany
- Department of Diagnostic and Interventional Radiology, University of Tübingen, Tübingen, Germany
- German Center for Cardiovascular Disease Research, Munich, Germany
| | - Holger Hetterich
- Institute of Clinical Radiology, Ludwig-Maximilian-University Hospital, Munich, Germany
- German Center for Cardiovascular Disease Research, Munich, Germany
| | - Susanne Rospleszcz
- Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Roberto Lorbeer
- Institute of Clinical Radiology, Ludwig-Maximilian-University Hospital, Munich, Germany
- German Center for Cardiovascular Disease Research, Munich, Germany
| | - Sigrid D Auweter
- Institute of Clinical Radiology, Ludwig-Maximilian-University Hospital, Munich, Germany
| | - Christopher L Schlett
- Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany
| | - Anina Schafnitzel
- Institute of Clinical Radiology, Ludwig-Maximilian-University Hospital, Munich, Germany
| | - Christian Bayerl
- Institute of Clinical Radiology, Ludwig-Maximilian-University Hospital, Munich, Germany
| | - Andreas Schindler
- Institute of Clinical Radiology, Ludwig-Maximilian-University Hospital, Munich, Germany
| | - Tobias Saam
- Institute of Clinical Radiology, Ludwig-Maximilian-University Hospital, Munich, Germany
| | | | - Wieland Sommer
- Institute of Clinical Radiology, Ludwig-Maximilian-University Hospital, Munich, Germany
| | - Tanja Zitzelsberger
- Department of Diagnostic and Interventional Radiology, University of Tübingen, Tübingen, Germany
| | - Jürgen Machann
- Department of Diagnostic and Interventional Radiology, University of Tübingen, Tübingen, Germany
- Institute for Diabetes Research and Metabolic Diseases, Helmholtz Centre Tübingen, Tübingen, Germany
- German Centre for Diabetes Research, Tübingen, Germany
| | - Michael Ingrisch
- Institute of Clinical Radiology, Ludwig-Maximilian-University Hospital, Munich, Germany
| | - Sonja Selder
- Institute of Clinical Radiology, Ludwig-Maximilian-University Hospital, Munich, Germany
| | - Wolfgang Rathmann
- Department of Biometry and Epidemiology, German Diabetes Center, Düsseldorf, Germany
| | - Margit Heier
- Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
- KORA Myocardial Infarction Registry, Central Hospital of Augsburg, Augsburg, Germany
| | - Birgit Linkohr
- Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Christa Meisinger
- Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
- KORA Myocardial Infarction Registry, Central Hospital of Augsburg, Augsburg, Germany
| | - Christian Weber
- German Center for Cardiovascular Disease Research, Munich, Germany
- Institute for Cardiovascular Prevention, Ludwig-Maximilian-University Hospital, Munich, Germany
| | - Birgit Ertl-Wagner
- Institute of Clinical Radiology, Ludwig-Maximilian-University Hospital, Munich, Germany
| | - Steffen Massberg
- Department of Cardiology, Ludwig-Maximilian-University Hospital, Munich, Germany
| | - Maximilian F Reiser
- Institute of Clinical Radiology, Ludwig-Maximilian-University Hospital, Munich, Germany
| | - Annette Peters
- German Center for Cardiovascular Disease Research, Munich, Germany
- Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
- Institute for Cardiovascular Prevention, Ludwig-Maximilian-University Hospital, Munich, Germany
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Abstract
Multiparametric Magnetic Resonance Imaging (mp-MRI) is the current standard of reference for the local staging of prostate cancer (PCa). On the other hand, despite the low sensitivity and specificity of Technetium Bone Scanning (BS) for the detection of bone metastases (BM) and of Body Computed Tomography CT for the detection of lymph node metastases (LNM), these techniques are routinely used, in the current clinical practice. Nevertheless, whole Body MRI (WB-MRI) and Positron Emission Tomography Computed Tomography (PET-CT) are emerging as robust tools for the staging of oncologic patients, including those with (PCa). The available techniques (BS, WB-MRI, PET, CT) for the detection of BM in oncologic patients were compared and showed striking center differences in terms of anatomic sequences and planes used. This heterogeneity and the long acquisition time of WB-MRI protocols – due to the addition of multiple anatomic sequences in different planes – questioned whether a single three dimensional (3D) sequence could replace the multiple anatomic sequences used for node and bone staging of PCa. We demonstrated that WB-MRI is a credible tool for the detection of bone and node metastasis. The second question addressed the possibility to obtain a complete TNM staging of PCa in a single MRI session. A WB-MRI protocol was developed to enable complete, T (local), N (regional) and M (distant) staging of PCa in a single session, in less than an hour. This ‘all-in-one’ protocol proved to be as efficient as the sum of exams currently in use for the staging of PCa (ie: mp-MRI of the prostate for ‘T’ staging, Thoraco-abdominal CT for ‘N’ staging and bone scintigraphy for ‘M’ staging).
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The oncologists’ unmet clinical needs for imaging in advanced prostate cancer. Clin Transl Imaging 2016. [DOI: 10.1007/s40336-016-0204-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Larbi A, Dallaudière B, Pasoglou V, Padhani A, Michoux N, Vande Berg BC, Tombal B, Lecouvet FE. Whole body MRI (WB-MRI) assessment of metastatic spread in prostate cancer: Therapeutic perspectives on targeted management of oligometastatic disease. Prostate 2016; 76:1024-33. [PMID: 27197649 DOI: 10.1002/pros.23196] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Accepted: 04/19/2016] [Indexed: 11/10/2022]
Abstract
OBJECTIVES To determine the proportion of prostate cancer (PCa) patients with oligometastatic disease (≤3 synchronous lesions) using whole body magnetic resonance imaging with diffusion-weighted imaging (WB-MRI/DWI). To determine the proportion of patients with nodal disease confined within currently accepted target areas for extended lymph node dissection (eLND) and pelvic external beam radiation therapy (EBRT). SUBJECTS AND METHODS Two radiologists reviewed WB-MRI/DWI studies in 96 consecutive newly diagnosed metastatic PCa patients; 46 patients with newly diagnosed castration naive PCa (mHNPC) and 50 patients with first appearance of metastasis during monitoring for non-metastatic castration resistant PCa (M0 to mCRPC). The distribution of metastatic deposits was assessed and the proportions of patients with oligometastatic disease and with LN metastases located within eLND and EBRT targets were determined. RESULTS Twenty-eight percent of mHNPC and 50% of mCPRC entered the metastatic disease with ≤3 sites. Bone metastases (BM) were identified in 68.8% patients; 71.7% of mHNPC and 66% mCRPC patients. Most commonly involved areas were iliac bones and lumbar spine. Enlarged lymph nodes (LN) were detected in 68.7% of patients; 69.6% of mHNPC and 68.0% of mCRPC. Most commonly involved areas were para-aortic, inter-aortico-cava, and external iliac areas. BM and LN were detected concomitantly in 41% of mHNPC and 34% of mCRPC. Visceral metastases were detected in 6.7%. Metastatic disease was confined to LN located within the accepted boundaries of eLND or pelvic EBRT target areas in only ≤25% and ≤30% of patients, respectively. CONCLUSIONS Non-invasive mapping of metastatic landing sites in PCa using WB-MRI/DWI shows that 28% of the mHNPC patients, and 52% of the mCRPC can be classified as oligometastatic, thus challenging the concept of metastatic targeted therapy. More than two thirds of metastatic patients have LN located outside the usually recommended targets of eLND and pelvic EBRT. Prophylactic or salvage treatments of these sole areas in patients with high-risk prostate cancer may not prevent the emergence of subsequent metastases. Prostate 76:1024-1033, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Ahmed Larbi
- Department of Radiology, Institut de Recherche Expérimentale et Clinique (IREC), Cliniques universitaires Saint Luc, Université catholique de Louvain, Brussels, Belgium
| | - Benjamin Dallaudière
- Department of Radiology, Institut de Recherche Expérimentale et Clinique (IREC), Cliniques universitaires Saint Luc, Université catholique de Louvain, Brussels, Belgium
| | - Vasiliki Pasoglou
- Department of Radiology, Institut de Recherche Expérimentale et Clinique (IREC), Cliniques universitaires Saint Luc, Université catholique de Louvain, Brussels, Belgium
| | - Anwar Padhani
- Paul Strickland Scanner Centre, Mount Vernon Hospital, Northwood, Middlesex, United Kingdom
| | - Nicolas Michoux
- Department of Radiology, Institut de Recherche Expérimentale et Clinique (IREC), Cliniques universitaires Saint Luc, Université catholique de Louvain, Brussels, Belgium
| | - Bruno C Vande Berg
- Department of Radiology, Institut de Recherche Expérimentale et Clinique (IREC), Cliniques universitaires Saint Luc, Université catholique de Louvain, Brussels, Belgium
| | - Bertrand Tombal
- Urology Unit, Institut de Recherche Expérimentale et Clinique (IREC), Cliniques universitaires Saint Luc, Université catholique de Louvain, Brussels, Belgium
| | - Frédéric E Lecouvet
- Department of Radiology, Institut de Recherche Expérimentale et Clinique (IREC), Cliniques universitaires Saint Luc, Université catholique de Louvain, Brussels, Belgium
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Vargas HA, Martin-Malburet AG, Takeda T, Corradi RB, Eastham J, Wibmer A, Sala E, Zelefsky MJ, Weber WA, Hricak H. Localizing sites of disease in patients with rising serum prostate-specific antigen up to 1ng/ml following prostatectomy: How much information can conventional imaging provide? Urol Oncol 2016; 34:482.e5-482.e10. [PMID: 27346339 DOI: 10.1016/j.urolonc.2016.05.026] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Revised: 05/17/2016] [Accepted: 05/24/2016] [Indexed: 02/01/2023]
Abstract
PURPOSE Accurate identification of the source of a detectable serum prostate-specific antigen (PSA) in the postprostatectomy setting is a major challenge among the urologic community. The aim of this study was to assess positivity rates of imaging examinations performed in patients with early PSA rise after prostatectomy and to summarize the management strategies adopted in this clinical scenario. METHODS Institutional Review Board-approved retrospective study of 142 postprostatectomy patients with PSA rise up to 1ng/ml who underwent evaluation with combination of multiparametric pelvic magnetic resonance imaging (MRI)±whole-body or bone MRI, bone scintigraphy, computed tomography (CT) chest-abdomen-pelvis, 18F-fludeoxyglucose-positron emission tomography (PET)/CT or 18F-sodium fluoride-PET/CT at a single tertiary cancer center. Imaging results were summarized per modality and compared with pathology findings. RESULTS Pelvic MRI was positive in 15/142 (11%) patients (14 patients with local recurrence in the surgical bed and 1 patient with pelvic osseous metastases). Of these 15, 10 patients underwent additional imaging examinations; none revealed positive findings. Of the 127 patients with negative pelvic MRI, 54 (43%) underwent additional imaging examinations; only 1/54 had positive findings (false-positive T8 lesion on bone scintigraphy and FDG-PET/CT; biopsy was negative for cancer). Overall, 12/16 patients with positive imaging findings and 75/126 (60%) patients with negative imaging received treatment (radiation, hormones or chemotherapy). CONCLUSION The conventional imaging identified sites of disease, almost always in the form of local recurrence, in a minority of patients with early PSA rise postprostatectomy.
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Affiliation(s)
| | | | - Toshikazu Takeda
- Department of Surgery (Urology Service), Memorial Sloan Kettering Cancer Center, New York, NY
| | - Renato B Corradi
- Department of Surgery (Urology Service), Memorial Sloan Kettering Cancer Center, New York, NY
| | - James Eastham
- Department of Surgery (Urology Service), Memorial Sloan Kettering Cancer Center, New York, NY
| | - Andreas Wibmer
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Evis Sala
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Michael J Zelefsky
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Wolfgang A Weber
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Hedvig Hricak
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY
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48
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Starobinets O, Korn N, Iqbal S, Noworolski SM, Zagoria R, Kurhanewicz J, Westphalen AC. Practical aspects of prostate MRI: hardware and software considerations, protocols, and patient preparation. Abdom Radiol (NY) 2016; 41:817-30. [PMID: 27193785 DOI: 10.1007/s00261-015-0590-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The use of multiparametric MRI scans for the evaluation of men with prostate cancer has increased dramatically and is likely to continue expanding as new developments come to practice. However, it has not yet gained the same level of acceptance of other imaging tests. Partly, this is because of the use of suboptimal protocols, lack of standardization, and inadequate patient preparation. In this manuscript, we describe several practical aspects of prostate MRI that may facilitate the implementation of new prostate imaging programs or the expansion of existing ones.
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Affiliation(s)
- Olga Starobinets
- Graduate Group of Bioengineering, Department of Radiology and Biomedical Imaging, University of California San Francisco, 185 Berry Street, Box 0946, San Francisco, CA, 94143, USA
| | - Natalie Korn
- Graduate Group of Bioengineering, Department of Radiology and Biomedical Imaging, University of California San Francisco, 185 Berry Street, Box 0946, San Francisco, CA, 94143, USA
| | - Sonam Iqbal
- Graduate Group of Bioengineering, Department of Radiology and Biomedical Imaging, University of California San Francisco, 185 Berry Street, Box 0946, San Francisco, CA, 94143, USA
| | - Susan M Noworolski
- Graduate Group of Bioengineering, Department of Radiology and Biomedical Imaging, University of California San Francisco, 185 Berry Street, Box 0946, San Francisco, CA, 94143, USA
| | - Ronald Zagoria
- Department of Radiology and Biomedical Imaging, University of California San Francisco, 505 Parnassus Avenue, M372, Box 0628, San Francisco, CA, 94143, USA
| | - John Kurhanewicz
- Graduate Group of Bioengineering, Department of Radiology and Biomedical Imaging, University of California San Francisco, 1700 4th Street, Ste. 203, San Francisco, CA, 94158, USA
| | - Antonio C Westphalen
- Department of Radiology and Biomedical Imaging, University of California San Francisco, 505 Parnassus Avenue, M372, Box 0628, San Francisco, CA, 94143, USA.
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Abstract
Recurrent prostate cancer following primary treatment is common, and the population of men with biochemical recurrence is complex. Conventional management of recurrent prostate cancer involves nontargeted and/or systemic therapies, without defining an individual patient's specific disease. However, recent advances in imaging enable a shift in the management of recurrent prostate cancer to targeted, patient-specific approaches. Specifically, MRI can detect and define local prostate cancer recurrence early in the course of disease, and prostate-specific PET imaging greatly improves nodal staging and can detect previously unknown distant metastases. The significant advances in the imaging of both local and distant tumor recurrences allows for specific selection of treatment options tailored to patients and their disease with less associated morbidity.
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JOURNAL CLUB: Identification of Bone Metastasis With Routine Prostate MRI: A Study of Patients With Newly Diagnosed Prostate Cancer. AJR Am J Roentgenol 2016; 206:1156-63. [PMID: 27043655 DOI: 10.2214/ajr.15.15761] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The purpose of this study was to evaluate whether routine prostate MRI is adequate for detection of bone metastasis in patients with newly diagnosed prostate cancer. MATERIALS AND METHODS The study included 308 patients with newly diagnosed prostate cancer who underwent prostate MRI. Two radiologists categorized MRI findings as normal, metastasis, or equivocal. Histologic analysis or best valuable comparator based on comprehensive review of images and clinical follow-up studies were used as reference standards. Clinicopathologic variables and MRI findings were compared between patients with and those without bone metastasis by use of chi-square and t tests. The diagnostic performance of prostate MRI for detecting bone metastasis was assessed by ROC analysis. Subgroup analysis was performed for patients at high risk of bone metastasis. RESULTS Twenty-one (6.8%) patients had bone metastasis. They had significantly higher prostate-specific antigen levels (p = 0.015) and Gleason scores (p < 0.001) than those without bone metastasis. The diagnostic performance of MRI was as follows: sensitivity, 95.2%; specificity, 99-100%; positive predictive value, 86.9-100%; negative predictive value, 99.7%. For 119 patients at high risk of bone metastasis, these values were 95%, 100%, 100%, and 99%. Only 1 of the 21 (4.8%) patients had bone metastasis only in an area not explored with prostate MRI, that is, the thoracic spine. CONCLUSION The diagnostic performance of routine prostate MRI for identifying bone metastasis in patients with newly diagnosed prostate cancer was excellent.
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