Diffusion-weighted MRI (DWI) in the oncology patient: value of breathhold DWI compared to unenhanced and gadolinium-enhanced MRI.
OBJECTIVE
To evaluate the feasibility and added value of single breathhold diffusion-weighted (DW) imaging (DWI) in oncology patients undergoing abdominal MRI.


METHODS
A total of 169 patients with malignancy underwent abdominal MRI at 1.5T, including T1-weighted (T1W), T2-weighted (T2W), and dynamic gadolinium-enhanced imaging. Axial DWI was performed with a single-shot spin-echo (SE) echo-planar imaging (EPI) sequence using a b-value of 500 seconds/mm2. A total of 24 slices were obtained during a 20-second breathhold. Two observers reviewed the conventional MR images for tumor. Next, the DW images were reviewed for additional tumor not depicted on conventional MR images


RESULTS
For the 169 patients, additional tumors were noted on the DW images in 77 (0.46) for observer 1 and 67 (0.40) for observer 2. For observer 1 the additional tumor included lymphadenopathy (47), peritoneal metastases (15), renal (1), liver (12), and osseous (2), while for observer 2 the corresponding values were lymphadenopathy (40), peritoneal (12), renal (1), liver (6), osseous (4), and gastrointestinal (1). The DW images resolved as benign findings noted on the conventional MR images in three patients for observer 1 and four patients for observer 2. The conventional MR exam was entirely normal while the DW images showed tumor in 12 (0.07) patients for observer 1 and 10 (0.06) patients for observer 2.


CONCLUSIONS
DWI is feasible in a single breathhold and provides additional clinically important information in oncology patients when added to routine abdominal MR sequences.
Low
Russell N
RN
Children's MRI Center, San Diego, California 92123, USA. rlow@ucsd.edu
Gurney
Jonathan
J
D000008:Abdominal Neoplasms / Q000175:diagnosis* / Q000556:secondary; D003287:Contrast Media; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D005682:Gadolinium; D006801:Humans; D008223:Lymphoma / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
D003287:Contrast Media; D005682:Gadolinium