4 years ago

Whole-body-MR imaging including DWIBS in the work-up of patients with head and neck squamous cell carcinoma: A feasibility study

To assess the feasibility of whole-body magnetic resonance imaging (WB-MRI) including diffusion-weighted whole-body imaging with background-body-signal-suppression (DWIBS) for the evaluation of distant malignancies in head and neck squamous cell carcinoma (HNSCC); and to compare WB-MRI findings with 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG-PET/CT) and chest-CT. Methods Thirty-three patients with high risk for metastatic spread (26 males; range 48–79 years, mean age 63±7.9 years (mean±standard deviation) years) were prospectively included with a follow-up of six months. WB-MRI protocol included short-TI inversion recovery and T1-weighted sequences in the coronal plane and half-fourier acquisition single-shot turbo spin-echo T2 and contrast-enhanced-T1-weighted sequences in the axial plane. Axial DWIBS was reformatted in the coronal plane. Interobserver variability was assessed using weighted kappa and the proportion specific agreement (PA). Results Two second primary tumors and one metastasis were detected on WB-MRI. WB-MRI yielded seven clinically indeterminate lesions which did not progress at follow-up. The metastasis and one second primary tumor were found when combining 18F-FDG-PET/CT and chest-CT findings. Interobserver variability for WB-MRI was κ =0.91 with PA ranging from 0.82 to 1.00. For 18F-FDG-PET/CT κ could not be calculated due to a constant variable in the table and PA ranged from 0.40 to 0.99. Conclusions Our WB-MRI protocol with DWIBS is feasible in the work-up of HNSCC patients for detection and characterization of distant pathology. WB-MRI can be complementary to 18F-FDG-PET/CT, especially in the detection of non 18F-FDG avid second primary tumors.

Publisher URL: www.sciencedirect.com/science

DOI: S0720048X14001570

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