Whole-Body MRI with an Ultrahigh b-Value of 2000 s/mm2 Improves the Specificity of Diffusion-Weighted Imaging in Patients with Plasma Cell Dyscrasias
Heidemeier A, Thurner A, Metz C, Pabst T, Heidemeier H, Rasche L, Kortum KM, Einsele H, Grimm R, Weiland E, Bley TA (2022)
Publication Type: Journal article
Publication year: 2022
Journal
Book Volume: 29
Pages Range: e1-e8
Journal Issue: 1
DOI: 10.1016/j.acra.2020.09.016
Abstract
Rationale and Objectives: Our study compared sensitivity, specificity, and accuracy of whole-body diffusion-weighted imaging (WB-DWI) using a b-value of 2000 s/mm2 with that of the commonly used b-value of 800 s/mm2 for depiction of active tumor sites in patients with plasma cell diseases. We introduced an ultrahigh b-value to reduce interfering signals from benign and post-therapeutic inactive lesions by suppressing T2-shine-through effects. Materials and Methods: The prospective single-center study included patients when they went through a whole-body MRI (WB-MRI) staging or response evaluation procedure. The apparent diffusion coefficient (ADC) and morphologic appearance served as reference for classifying focal lesions on WB-DWI as vital or post-therapeutic. Additionally, we compared our classification with patients’ serological markers of disease activity. Results: One hundred participants (65 ± 10 years, 58 men) underwent WB-DWI between June and October 2019. The detection rate of vital focal lesions was similar for both b-values with a sensitivity of 0.99 using b = 800 s/mm2 and 0.98 using b = 2000 s/mm2. By contrast, specificity and accuracy were 0.09 and 0.71 when using a b-value of 800 s/mm2, and 0.96 and 0.98 when using a b-value of 2000 s/mm2, respectively. The difference in specificity and accuracy was statistically significant (p < 0.001). Conclusion: Using a b-value of 2000 s/mm2 significantly improved the specificity of lesion detection with WB-DWI as compared to the commonly used b-value of 800 s/mm2. The high b-value significantly reduced signal intensities of post-therapeutic or benign lesions and provided a significantly more accurate representation of active tumor load.
Involved external institutions
Universitätsklinikum Würzburg
Germany (DE)
Rheinisch-Westfälische Technische Hochschule (RWTH) Aachen
Germany (DE)
Siemens AG, Healthcare Sector
Germany (DE)
Germany (DE)
Rheinisch-Westfälische Technische Hochschule (RWTH) Aachen
Germany (DE)
Siemens AG, Healthcare Sector
Germany (DE)
How to cite
APA:
Heidemeier, A., Thurner, A., Metz, C., Pabst, T., Heidemeier, H., Rasche, L.,... Bley, T.A. (2022). Whole-Body MRI with an Ultrahigh b-Value of 2000 s/mm2 Improves the Specificity of Diffusion-Weighted Imaging in Patients with Plasma Cell Dyscrasias. Academic Radiology, 29(1), e1-e8. https://doi.org/10.1016/j.acra.2020.09.016
MLA:
Heidemeier, Anke, et al. "Whole-Body MRI with an Ultrahigh b-Value of 2000 s/mm2 Improves the Specificity of Diffusion-Weighted Imaging in Patients with Plasma Cell Dyscrasias." Academic Radiology 29.1 (2022): e1-e8.
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