Chiabai, O., Van Nieuwenhove, S., Vekemans, M.-C., Tombal, B., Peeters, F., Wuts, J., Triqueneaux, P., Omoumi, P., Kirchgesner, T., Michoux, N., & Lecouvet, F. E. (2022). Whole-body MRI in oncology: can a single anatomic T2 Dixon sequence replace the combination of T1 and STIR sequences to detect skeletal metastasis and myeloma? European Radiology, 33(1), 244-257. https://doi.org/10.1007/s00330-022-09007-8

@article{7ec8619434f746adbbaaa786a750e4a1,
title = "Whole-body MRI in oncology: can a single anatomic T2 Dixon sequence replace the combination of T1 and STIR sequences to detect skeletal metastasis and myeloma?",
abstract = "Objectives: To compare the diagnostic accuracy of a single T2 Dixon sequence to the combination T1+STIR as anatomical sequences used for detecting tumoral bone marrow lesions in whole-body MRI (WB-MRI) examinations. Methods: Between January 2019 and January 2020, seventy-two consecutive patients (55 men, 17 women, median age = 66 years) with solid (prostate, breast, neuroendocrine) cancers at high risk of metastasis or proven multiple myeloma (MM) prospectively underwent a WB-MRI examination including coronal T1, STIR, T2 Dixon and axial diffusion-weighted imaging sequences. Two radiologists independently assessed the combination of T1+STIR sequences and the fat+water reconstructions from the T2 Dixon sequence. The reference standard was established by consensus reading of WB-MRI and concurrent imaging available at baseline and at 6 months. Repeatability and reproducibility of MRI scores (presence and semi-quantitative count of lesions), image quality (SNR: signal-to-noise, CNR: contrast-to-noise, CRR: contrast-to-reference ratios), and diagnostic characteristics (Se: sensitivity, Sp: specificity, Acc: accuracy) were assessed per-skeletal region and per-patient. Results: Repeatability and reproducibility were at least good regardless of the score, region, and protocol (0.67 ≤ AC1 ≤ 0.98). CRR was higher on T2 Dixon fat compared to T1 (p < 0.0001) and on T2 Dixon water compared to STIR (p = 0.0128). In the per-patient analysis, Acc of the T2 Dixon fat+water was higher than that of T1+STIR for the senior reader (Acc = +0.027 [+0.025; +0.029], p < 0.0001) and lower for the junior reader (Acc = −0.029 [−0.031; −0.027], p < 0.0001). Conclusions: A single T2 Dixon sequence with fat+water reconstructions offers similar reproducibility and diagnostic accuracy as the recommended combination of T1+STIR sequences and can be used for skeletal screening in oncology, allowing significant time-saving. Key Points: • Replacement of the standard anatomic T1 + STIR WB-MRI protocol by a single T2 Dixon sequence drastically shortens the examination time without loss of diagnostic accuracy. • A protocol based on fat + water reconstructions from a single T2 Dixon sequence offers similar inter-reader agreement and a higher contrast-to-reference ratio for detecting lesions compared to the standard T1 + STIR protocol. • Differences in the accuracy between the two protocols are marginal (+ 3% in favor of the T2 Dixon with the senior reader; −3% against the T2 Dixon with the junior reader).",
keywords = "Magnetic resonance imaging, Whole-body imaging, Cancer, Metastasis, Multiple myeloma",
author = "Ophelye Chiabai and {Van Nieuwenhove}, Sandy and Marie-Christiane Vekemans and Bertrand Tombal and Frank Peeters and Joris Wuts and Perrine Triqueneaux and Patrick Omoumi and Thomas Kirchgesner and Nicolas Michoux and Lecouvet, {Frederic E.}",
year = "2022",
month = aug,
day = "4",
doi = "10.1007/s00330-022-09007-8",
language = "English",
volume = "33",
pages = "244--257",
journal = "European Radiology",
issn = "0938-7994",
publisher = "Springer Verlag",
number = "1",
}