Performed at one institution, Observational, Retrospective, Metastases, Education, MR-Diffusion/Perfusion, Paediatric, Oncology, Nuclear medicine, Oncologic Imaging
M. C. Colombo1, E. J. Inarejos Clemente2, J. Munuera1, A. Castañeda1, J. Mora1, I. Barber3; 1Barcelona/ES, 2Esplugues de Llobregat, Barcelona/ES, 3Esplugues de Llobregat (Barcelona)/ES
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 with b values of 0-1000 mm2/sec, with 3D DWIBS reconstruction. The ADC and exponential ADC images were automatically generated from both b values on the operating console.
Whole body MR and MIBG were evaluated independently for the detection of bone involvement. MR images were reviewed by two experienced paediatric radiologists. The presence of soft tissue mass was also recorded as part of the clinical work, but it was not considered for this review. SPECT MIBG were reported by a Nuclear Medicine specialist and reports were reviewed for analysis. The maximum interval between both studies was 7 days and the minimum interval was 0 days. The mean interval was 3 days.
A total of 18 patients were included. MRI criteria for bone lesions were: T1 hypointense and STIR T2 hyperintense focal bone lesion. Diffuse bilateral and symmetric bone areas with high T2 signal and low T1 signal and showing chemical shift artefact on In and Out T1 sequence (DIXON) were not considered as bone lesions. Quantitative ADC values of the bone lesions were obtained using Impax viewer software (AGFA) by using the minimum diameter ROI (4.2mm), corresponding to a 13.85mm2 area.