Accuracy of whole-body dwi for metastases screening in a diverse group of malignancies

Comparison with conventional cross-sectional imaging and nuclear scintigraphy

Samir Mustaffa Paruthikunnan, Rajagopal Kadavigere, Lakshmikanth Halegubbi Karegowda

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

OBJECTIVE. The purpose of this study is to assess the role of whole-body (WB) DWI as a screening modality for the detection of metastases and to compare it to conventional crosssectional imaging modalities or nuclear scintigraphy in a population with various histopathologic malignancies. SUBJECTS AND METHODS. WB DWI and conventional imaging (CT, MRI, or scintigraphy) were performed for patients with known malignancies for metastatic workup, and these patients were followed up for a period of 1 year. Two radiologists assessed WB DW images separately, and conventional images were assessed by the senior radiologist. The metastatic lesions were classified into four regions: liver, lung, skeletal system, and lymph nodes. The reference standard was considered on the basis of histopathologic confirmation or clinical follow-up of the metastatic lesions. RESULTS. WB DWI was slightly inferior to conventional imaging modalities for the detection of hepatic metastases (sensitivity, 86.6% vs 93.3%; specificity, 91.6% vs 95.8%; and accuracy, 89.7% vs 94.8%) and skeletal metastases (sensitivity, 81.8% vs 89.4%; specificity, 86.4% vs 94.3%; and accuracy, 85.2% vs 93.0%); however, the differences were not statistically significant (p = 0.625 for hepatic metastases and p = 0.0953 for skeletal metastases, McNemar test). WB DWI was statistically significantly inferior to conventional imaging for the detection of lymph node metastases (sensitivity, 74.0% vs 81.5%; specificity, 87.9% vs 90.1%; accuracy, 81.4% vs 86.0%; p = 0.0389). WB DWI was statistically significantly inferior to conventional imaging for the detection of pulmonary metastases (sensitivity, 33.3% vs 100.0%; specificity, 90.9% vs 100.0%; accuracy, 60.8% vs 100.0%; p = 0.045). CONCLUSION. WB DWI can be used for screening hepatic and skeletal metastases, but its reliability as the sole imaging sequence for the detection of lymph nodal and pulmonary metastases is poor and, at present, it cannot replace conventional imaging modalities.

Original languageEnglish
Pages (from-to)477-490
Number of pages14
JournalAmerican Journal of Roentgenology
Volume209
Issue number3
DOIs
Publication statusPublished - 01-09-2017

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Radionuclide Imaging
Neoplasm Metastasis
Neoplasms
Liver
Lung
Lymph Nodes
Body Image
Lymph
Population

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging

Cite this

@article{9173ef25d53445bca8eab2d0bcfc939b,
title = "Accuracy of whole-body dwi for metastases screening in a diverse group of malignancies: Comparison with conventional cross-sectional imaging and nuclear scintigraphy",
abstract = "OBJECTIVE. The purpose of this study is to assess the role of whole-body (WB) DWI as a screening modality for the detection of metastases and to compare it to conventional crosssectional imaging modalities or nuclear scintigraphy in a population with various histopathologic malignancies. SUBJECTS AND METHODS. WB DWI and conventional imaging (CT, MRI, or scintigraphy) were performed for patients with known malignancies for metastatic workup, and these patients were followed up for a period of 1 year. Two radiologists assessed WB DW images separately, and conventional images were assessed by the senior radiologist. The metastatic lesions were classified into four regions: liver, lung, skeletal system, and lymph nodes. The reference standard was considered on the basis of histopathologic confirmation or clinical follow-up of the metastatic lesions. RESULTS. WB DWI was slightly inferior to conventional imaging modalities for the detection of hepatic metastases (sensitivity, 86.6{\%} vs 93.3{\%}; specificity, 91.6{\%} vs 95.8{\%}; and accuracy, 89.7{\%} vs 94.8{\%}) and skeletal metastases (sensitivity, 81.8{\%} vs 89.4{\%}; specificity, 86.4{\%} vs 94.3{\%}; and accuracy, 85.2{\%} vs 93.0{\%}); however, the differences were not statistically significant (p = 0.625 for hepatic metastases and p = 0.0953 for skeletal metastases, McNemar test). WB DWI was statistically significantly inferior to conventional imaging for the detection of lymph node metastases (sensitivity, 74.0{\%} vs 81.5{\%}; specificity, 87.9{\%} vs 90.1{\%}; accuracy, 81.4{\%} vs 86.0{\%}; p = 0.0389). WB DWI was statistically significantly inferior to conventional imaging for the detection of pulmonary metastases (sensitivity, 33.3{\%} vs 100.0{\%}; specificity, 90.9{\%} vs 100.0{\%}; accuracy, 60.8{\%} vs 100.0{\%}; p = 0.045). CONCLUSION. WB DWI can be used for screening hepatic and skeletal metastases, but its reliability as the sole imaging sequence for the detection of lymph nodal and pulmonary metastases is poor and, at present, it cannot replace conventional imaging modalities.",
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Accuracy of whole-body dwi for metastases screening in a diverse group of malignancies : Comparison with conventional cross-sectional imaging and nuclear scintigraphy. / Paruthikunnan, Samir Mustaffa; Kadavigere, Rajagopal; Karegowda, Lakshmikanth Halegubbi.

In: American Journal of Roentgenology, Vol. 209, No. 3, 01.09.2017, p. 477-490.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Accuracy of whole-body dwi for metastases screening in a diverse group of malignancies

T2 - Comparison with conventional cross-sectional imaging and nuclear scintigraphy

AU - Paruthikunnan, Samir Mustaffa

AU - Kadavigere, Rajagopal

AU - Karegowda, Lakshmikanth Halegubbi

PY - 2017/9/1

Y1 - 2017/9/1

N2 - OBJECTIVE. The purpose of this study is to assess the role of whole-body (WB) DWI as a screening modality for the detection of metastases and to compare it to conventional crosssectional imaging modalities or nuclear scintigraphy in a population with various histopathologic malignancies. SUBJECTS AND METHODS. WB DWI and conventional imaging (CT, MRI, or scintigraphy) were performed for patients with known malignancies for metastatic workup, and these patients were followed up for a period of 1 year. Two radiologists assessed WB DW images separately, and conventional images were assessed by the senior radiologist. The metastatic lesions were classified into four regions: liver, lung, skeletal system, and lymph nodes. The reference standard was considered on the basis of histopathologic confirmation or clinical follow-up of the metastatic lesions. RESULTS. WB DWI was slightly inferior to conventional imaging modalities for the detection of hepatic metastases (sensitivity, 86.6% vs 93.3%; specificity, 91.6% vs 95.8%; and accuracy, 89.7% vs 94.8%) and skeletal metastases (sensitivity, 81.8% vs 89.4%; specificity, 86.4% vs 94.3%; and accuracy, 85.2% vs 93.0%); however, the differences were not statistically significant (p = 0.625 for hepatic metastases and p = 0.0953 for skeletal metastases, McNemar test). WB DWI was statistically significantly inferior to conventional imaging for the detection of lymph node metastases (sensitivity, 74.0% vs 81.5%; specificity, 87.9% vs 90.1%; accuracy, 81.4% vs 86.0%; p = 0.0389). WB DWI was statistically significantly inferior to conventional imaging for the detection of pulmonary metastases (sensitivity, 33.3% vs 100.0%; specificity, 90.9% vs 100.0%; accuracy, 60.8% vs 100.0%; p = 0.045). CONCLUSION. WB DWI can be used for screening hepatic and skeletal metastases, but its reliability as the sole imaging sequence for the detection of lymph nodal and pulmonary metastases is poor and, at present, it cannot replace conventional imaging modalities.

AB - OBJECTIVE. The purpose of this study is to assess the role of whole-body (WB) DWI as a screening modality for the detection of metastases and to compare it to conventional crosssectional imaging modalities or nuclear scintigraphy in a population with various histopathologic malignancies. SUBJECTS AND METHODS. WB DWI and conventional imaging (CT, MRI, or scintigraphy) were performed for patients with known malignancies for metastatic workup, and these patients were followed up for a period of 1 year. Two radiologists assessed WB DW images separately, and conventional images were assessed by the senior radiologist. The metastatic lesions were classified into four regions: liver, lung, skeletal system, and lymph nodes. The reference standard was considered on the basis of histopathologic confirmation or clinical follow-up of the metastatic lesions. RESULTS. WB DWI was slightly inferior to conventional imaging modalities for the detection of hepatic metastases (sensitivity, 86.6% vs 93.3%; specificity, 91.6% vs 95.8%; and accuracy, 89.7% vs 94.8%) and skeletal metastases (sensitivity, 81.8% vs 89.4%; specificity, 86.4% vs 94.3%; and accuracy, 85.2% vs 93.0%); however, the differences were not statistically significant (p = 0.625 for hepatic metastases and p = 0.0953 for skeletal metastases, McNemar test). WB DWI was statistically significantly inferior to conventional imaging for the detection of lymph node metastases (sensitivity, 74.0% vs 81.5%; specificity, 87.9% vs 90.1%; accuracy, 81.4% vs 86.0%; p = 0.0389). WB DWI was statistically significantly inferior to conventional imaging for the detection of pulmonary metastases (sensitivity, 33.3% vs 100.0%; specificity, 90.9% vs 100.0%; accuracy, 60.8% vs 100.0%; p = 0.045). CONCLUSION. WB DWI can be used for screening hepatic and skeletal metastases, but its reliability as the sole imaging sequence for the detection of lymph nodal and pulmonary metastases is poor and, at present, it cannot replace conventional imaging modalities.

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