Update on Whole-body MRI in Musculoskeletal Applications

Vilanova, Joan C.; García‐Figueiras, Roberto; Luna, Antonio; Baleato-González, Sandra; Tomás, Xavier; Narváez, José Antonio

doi:10.1055/s-0039-1685540

Cited by 15 publications

(15 citation statements)

References 48 publications

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“…Whole-body (WB)-MRI with diffusion-weighted imaging (DWI) is a sensitive tool for visual detection of abnormal foci within bones and soft tissue, in cancer and inflammatory diseases [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16]. The evaluation of apparent diffusion coefficient (ADC) derived from DWI is used for lesion characterization and assessment of the response to treatment [17].…”

Section: Introductionmentioning

confidence: 99%

Repeatability and reproducibility of ADC measurements: a prospective multicenter whole-body-MRI study

et al. 2021

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Objectives Multicenter oncology trials increasingly include MRI examinations with apparent diffusion coefficient (ADC) quantification for lesion characterization and follow-up. However, the repeatability and reproducibility (R&R) limits above which a true change in ADC can be considered relevant are poorly defined. This study assessed these limits in a standardized whole-body (WB)-MRI protocol. Methods A prospective, multicenter study was performed at three centers equipped with the same 3.0-T scanners to test a WB-MRI protocol including diffusion-weighted imaging (DWI). Eight healthy volunteers per center were enrolled to undergo test and retest examinations in the same center and a third examination in another center. ADC variability was assessed in multiple organs by two readers using two-way mixed ANOVA, Bland-Altman plots, coefficient of variation (CoV), and the upper limit of the 95% CI on repeatability (RC) and reproducibility (RDC) coefficients. Results CoV of ADC was not influenced by other factors (center, reader) than the organ. Based on the upper limit of the 95% CI on RC and RDC (from both readers), a change in ADC in an individual patient must be superior to 12% (cerebrum white matter), 16% (paraspinal muscle), 22% (renal cortex), 26% (central and peripheral zones of the prostate), 29% (renal medulla), 35% (liver), 45% (spleen), 50% (posterior iliac crest), 66% (L5 vertebra), 68% (femur), and 94% (acetabulum) to be significant. Conclusions This study proposes R&R limits above which ADC changes can be considered as a reliable quantitative endpoint to assess disease or treatment-related changes in the tissue microstructure in the setting of multicenter WB-MRI trials. Key Points• The present study showed the range of R&R of ADC in WB-MRI that may be achieved in a multicenter framework when a standardized protocol is deployed. • R&R was not influenced by the site of acquisition of DW images.• Clinically significant changes in ADC measured in a multicenter WB-MRI protocol performed with the same type of MRI scanner must be superior to 12% (cerebrum white matter), 16% (paraspinal muscle), 22% (renal cortex), 26% (central zone and peripheral zone of prostate), 29% (renal medulla), 35% (liver), 45% (spleen), 50% (posterior iliac crest), 66% (L5 vertebra), 68% (femur), and 94% (acetabulum) to be detected with a 95% confidence level.

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Section: Introductionmentioning

confidence: 99%

Repeatability and reproducibility of ADC measurements: a prospective multicenter whole-body-MRI study

et al. 2021

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“…A possible explanation is that water molecular diffusion is more restricted in nerve versus background tissue. 27,28 From b = 0 to b = 800, the signal decrease was less for nerve, so it was brighter than background on b = 800 map. Compared to T2 weighted image, diffusion weighted MR seemed more suitable for depicting peripheral nerve.…”

Section: Discussionmentioning

confidence: 99%

Readout-segmented diffusion tensor imaging for assessing sciatic nerve invasion by soft tissue tumor

Wan¹,

Wang²,

Chu³

et al. 2020

Preprint

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There are few publications regarding feasibility of readout-segmented diffusion tensor imaging (rsDTI) in assessing nerve invasion by soft tissue tumor. 64 patients with soft tissue mass in upper leg suspected of sciatic nerve invasion underwent rsDTI. Nerve invasion was confirmed in 28 cases by operation or electromyogram. The sciatic nerve was better depicted with diffusion weighted map versus b = 0 map of rsDTI. Inter-reader agreement in using rsDTI to rate nerve invasion was excellent. Sensitivity and specificity of rsDTI in identifying nerve invasion were 93% (26/28) and 92% (33/36) respectively. Apparent diffusion coefficient (ADC) was significantly higher in invaded nerves versus normal nerves (1.45 ± 0.67 × 10− 3mm2/s vs. 1.39 ± 0.46 × 10− 3mm2/s, P༜0.05). DTI derived FA was significantly lower in invaded nerves versus normal nerves (0.22 ± 0.11 vs. 0.37 ± 0.13, P༜0.05). Readout-segmented DTI was feasible in assessing sciatic nerve invasion by soft tissue tumor in selected patients.

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“…74 WB-MRI enables global assessment of active and chronic inflammatory changes in the axial and peripheral skeleton. 12,75,76 Consequently, there has been an increased interest in using WB-MRI for the comprehensive examination of systemic inflammatory/infective disorders, including but not limited to spondyloarthropathies, myopathies, sarcoidosis, Langerhans cell histiocytosis, chronic osteomyelitis or genetic disorders such as Hereditary Multiple Exostoses and metabolic storage disorders.…”

Section: Wb-mri In Non-oncological Applicationsmentioning

confidence: 99%

What’s New for Clinical Whole-body MRI (WB-MRI) in the 21st Century

Tunariu

Blackledge

Messiou

et al. 2020

BJR

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Whole body MRI (WB-MRI) has evolved since its first introduction in the 1970’s as an imaging technique to detect and survey disease across multiple sites and organ systems in the body. The development of diffusion-weighted MRI (DWI) has added a new dimension to the implementation of WB-MRI on modern scanners, offering excellent lesion-to-background contrast, while achieving acceptable spatial resolution to detect focal lesions 5 to 10 mm in size. MRI hardware and software advances have reduced acquisition times, with studies taking 40–50 min to complete. The rising awareness of medical radiation exposure coupled with the advantages of MRI, have resulted in increased utilization of WB-MRI in oncology, paediatrics, rheumatological and musculoskeletal conditions and more recently in population screening. There is recognition that WB-MRI can be used to track disease evolution and monitor response heterogeneity in patients with cancer. There are also opportunities to combine WB-MRI with molecular imaging on PET-MRI systems to harness the strengths of hybrid imaging. The advent of artificial intelligence and machine learning will shorten image acquisition times and image analyses, making the technique more competitive against other imaging technologies.

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Update on Whole-body MRI in Musculoskeletal Applications

Cited by 15 publications

References 48 publications

Repeatability and reproducibility of ADC measurements: a prospective multicenter whole-body-MRI study

Repeatability and reproducibility of ADC measurements: a prospective multicenter whole-body-MRI study

Readout-segmented diffusion tensor imaging for assessing sciatic nerve invasion by soft tissue tumor

What’s New for Clinical Whole-body MRI (WB-MRI) in the 21st Century

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