Keywords:
Cancer, Imaging sequences, Decision analysis, MR-Diffusion/Perfusion, MR, Oncology, Haematologic, Bones, Haematologic diseases
Authors:
O. A. Westerland1, N. Sivarasan2, S. A. Natas1, H. Verma3, R. Neji4, M. kazmi1, I. El-Najjar1, M. Streetly1, V. Goh1; 1London/UK, 2Orpington, Kent/UK, 3London /UK, 4Erlangen/DE
DOI:
10.1594/ecr2018/C-1224
Methods and materials
wbMRI consisting of T2-HASTE,
T1-Dixon,
DWI (B=50 and 900 s/mm2) and single phase contrast-enhanced (CE) T1-W sequences from vertex to knees were performed at 1.5T (Siemens HealthCare,
Erlangen,
Germany) in 100 patients (see Table 1 below for MRI protocol).
Post-contrast sequences were obtained in 82/100 patients only,
owing to renal impairment in the remaining patients.
Imaging was reviewed by a staff radiologist with 7 years of MRI experience.
Image contrast |
Sequence |
Image plane |
Reconstructed slice thickness |
FOV |
TR |
TE |
T1-W |
DIXON 3D FLASH |
Axial |
5.0 |
500 |
6.62 |
TE1=2.39
TE2=4.77
|
DWI
(B values 50 & 900s/mm2)
|
DW-EPI |
Axial |
5.0 |
500 |
6270 |
67 |
T2-W |
HASTE |
Axial |
5.0 |
500 |
400 |
92 |
T1-W pre - & post-contrast |
DIXON 3D FLASH |
Coronal |
2.0 |
500 |
6.76 |
TE1=2.39
TE2=4.77
|
T2-HASTE sequences were reviewed initially for incidental findings,
followed by sequential review of T1-W,
CE T1-W and DWI sequences for lesion characterization.
Findings,
their site and likely diagnosis were recorded.
For each finding,
clinical significance was evaluated and categorised as either I - common in asymptomatic subjects/not clinically significant,
IIA - benign and potentially clinically significant,
IIB - indeterminate and potentially malignant or III - requiring urgent clinical input.
For indeterminate findings on T2-W sequences,
the malignancy likelihood was recorded for each additional sequence (grade I-V,
I = benign,
II = probably benign,
III = indeterminate,
IV = probably malignant,
V = malignant).
Electronic patient records were reviewed for final diagnosis.
Descriptive statistics were undertaken using SPSS (Version 24,
IBM,
Armonk,
New York,
USA).