BACKGROUND: Computed tomography scan is the current standard cross-sectional imaging modality for neuroendocrine tumor (NET) workup. Diffusion-weighted magnetic resonance imaging (DW-MRI) has proven to be more sensitive than standard sequences to diagnose liver metastases; whole-body DW-MRI may be more sensitive than whole-body MRI. Clinical implications have not yet been assessed. Thus, we evaluated radiological and clinical contributions of liver and whole-body DW-MRI to manage NETs. METHODS: Twenty-five abnormal liver and 22 abnormal whole-body standard MRIs were first analyzed retrospectively. MR images were then reanalyzed after adding DW sequences. The standard of reference for metastasis confirmation was a combination of radiological follow-up and histological proof. Clinical impact was defined as MRI changes of liver invasion (unilobar to bilobar and/or <50 to >50% of liver) or therapeutic management changes made during a dedicated multidisciplinary meeting after whole-body MRI. RESULTS: Thirty-two patients with mainly small intestine NETs (24/32) were studied. Adding DW to standard liver MRI yielded additional findings for 45% of the patients with 1.78 times more new lesions, mainly infracentimetric; it induced a management change for 18% of the patients. DW sequences added to whole-body MRI yielded additional findings for 71% of the patients, with 1.72 times more lesions, mainly infracentimetric, and induced a change in management for 19% of the patients. CONCLUSION: Adding DW sequences to standard MRI revealed additional metastases and led to modifications of patient management. Prospective studies are needed to confirm these results.
BACKGROUND: Computed tomography scan is the current standard cross-sectional imaging modality for neuroendocrine tumor (NET) workup. Diffusion-weighted magnetic resonance imaging (DW-MRI) has proven to be more sensitive than standard sequences to diagnose liver metastases; whole-body DW-MRI may be more sensitive than whole-body MRI. Clinical implications have not yet been assessed. Thus, we evaluated radiological and clinical contributions of liver and whole-body DW-MRI to manage NETs. METHODS: Twenty-five abnormal liver and 22 abnormal whole-body standard MRIs were first analyzed retrospectively. MR images were then reanalyzed after adding DW sequences. The standard of reference for metastasis confirmation was a combination of radiological follow-up and histological proof. Clinical impact was defined as MRI changes of liver invasion (unilobar to bilobar and/or <50 to >50% of liver) or therapeutic management changes made during a dedicated multidisciplinary meeting after whole-body MRI. RESULTS: Thirty-two patients with mainly small intestine NETs (24/32) were studied. Adding DW to standard liver MRI yielded additional findings for 45% of the patients with 1.78 times more new lesions, mainly infracentimetric; it induced a management change for 18% of the patients. DW sequences added to whole-body MRI yielded additional findings for 71% of the patients, with 1.72 times more lesions, mainly infracentimetric, and induced a change in management for 19% of the patients. CONCLUSION: Adding DW sequences to standard MRI revealed additional metastases and led to modifications of patient management. Prospective studies are needed to confirm these results.
Authors: Rachel P Riechelmann; Rui F Weschenfelder; Frederico P Costa; Aline Chaves Andrade; Alessandro Bersch Osvaldt; Ana Rosa P Quidute; Allan Dos Santos; Ana Amélia O Hoff; Brenda Gumz; Carlos Buchpiguel; Bruno S Vilhena Pereira; Delmar Muniz Lourenço Junior; Duilio Reis da Rocha Filho; Eduardo Antunes Fonseca; Eduardo Linhares Riello Mello; Fabio Ferrari Makdissi; Fabio Luiz Waechter; Francisco Cesar Carnevale; George B Coura-Filho; Gustavo Andrade de Paulo; Gustavo Colagiovanni Girotto; João Evangelista Bezerra Neto; João Glasberg; Jose Claudio Casali-da-Rocha; Juliana Florinda M Rego; Luciana Rodrigues de Meirelles; Ludhmila Hajjar; Marcos Menezes; Marcello D Bronstein; Marcelo Tatit Sapienza; Maria Candida Barisson Villares Fragoso; Maria Adelaide Albergaria Pereira; Milton Barros; Nora Manoukian Forones; Paulo Cezar Galvão do Amaral; Raphael Salles Scortegagna de Medeiros; Raphael L C Araujo; Regis Otaviano França Bezerra; Renata D'Alpino Peixoto; Samuel Aguiar; Ulysses Ribeiro; Tulio Pfiffer; Paulo M Hoff; Anelisa K Coutinho Journal: Ecancermedicalscience Date: 2017-01-26
Authors: Abdelilah El Bakouri; Anas El Wassi; Yassine Eddaoudi; Mounir Bouali; Khalid El Hattabi; Fatimazahra Bensardi; Abdelaziz Fadil Journal: Ann Med Surg (Lond) Date: 2022-09-22
Authors: X Merino-Casabiel; J Aller; J Arbizu; R García-Figueiras; C González; E Grande; P Jiménez-Fonseca; M I Sevilla; J Capdevila Journal: Clin Transl Oncol Date: 2018-05-15 Impact factor: 3.405