Evaluation of metastatic bone disease, including response assessment to chemotherapy, in patients with stage IV neuroblastoma is key for the correct management of these patients (1).
Diffusion-weighted MR allows the assessment of Brownian motion in various tissue water molecules.Using different b values allows for the quantification of signal loss in diffusion-sensitive sequences by means of apparent diffusion coefficient (ADC) maps. It has been proved that highly dense cellular areas restrict motion of extracellular water molecules. High cellularity is related to restricted diffusion and low...
Methods and materials
METHODS AND MATERIALS
A retrospective review of patients with Stage IV NBL admitted to our hospital after completing conventional chemotherapy between January 2018 and January 2019. All patients were re-staged using Whole Body MR imaging, including DWI, and SPECT MIBG.
MRI imaging protocol: Whole-body MR was performed with a 3 Tesla MR (Philips Ingenia) using specific head and body surface coils. Coronal T1 weighted images (multipoint DIXON), coronal T2 weighted images STIR, abdomen and pelvis transverse T2 fat-suppressed weighted images SPAIR, and transverse whole-body DWI...
A total of 171 bone lesions were demonstrated by MR on 18 patients between 2 months and 9.2 years of age (mean age: 4 years and 2 months) with a male/female ratio of 3/1.
On MIBG, a total of 73 bone lesions were reported as positive. 9 MIBG positive bone lesions did not have representation on MR.
Based on the topography of each bone lesion, coincidence between MR and MIBG was observed in 62 lesions. Mean ADC values of positive MIBG bone lesions was...
This is, to our knowledge, the first study comparing MIBG and MR DWI in the evaluation of bone metastatic disease in NBL in children. On the one hand, several papers have demonstrated the value of MR and DWI in the evaluation of skeletal metastasis in other malignancies and population groups. On the other hand, evaluation of bone involvement in paediatric neuroblastoma has been considered a drawback of MR with limitation in the differentiation between viable tumour and non-viable residual lesion.
Our results suggest that...
Personal information and conflict of interest
M. C. Colombo; Barcelona/ES - nothing to disclose E. J. Inarejos Clemente; Esplugues de Llobregat, Barcelona/ES - nothing to disclose J. Munuera; Barcelona/ES - nothing to disclose A. Castañeda; Barcelona/ES - nothing to disclose J. Mora; Barcelona/ES - nothing to disclose I. Barber Martinez; Esplugues de Llobregat (Barcelona)/ES - nothing to disclose