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Title: Feasibility of whole-body diffusion-weighted MRI for detection of primary tumour, nodal and distant metastases in women with cancer during pregnancy: a pilot study
Authors: Han, Sileny N.
Amant, Frederic
Michielsen, Katrijn
De Keyzer, Frederik
FIEUWS, Steffen 
Van Calsteren, Kristel
Dresen, Raphaela C.
Gziri, Mina Mhallem
Vandecaveye, Vincent
Issue Date: 2018
Source: EUROPEAN RADIOLOGY, 28(5), p. 1862-1874
Abstract: To evaluate the feasibility of whole-body diffusion-weighted MRI (WB-DWI/MRI) for detecting primary tumour, nodal and distant metastases in pregnant women with cancer. Twenty pregnant patients underwent WB-DWI/MRI in additional to conventional imaging. Reproducibility of WB-DWI/MRI between two readers was evaluated using Cohen's kappa statistics and accuracy was compared to conventional imaging for assessing primary tumour site, nodal and visceral metastases. Both WB-DWI/MRI readers showed good-very good agreement for lesion detection (primary lesions: kappa=1; lymph nodes: kappa=0.89; distant metastases: kappa=0.61). Eight (40 %) patients were upstaged after WB-DWI/MRI. For nodal metastases, WB-DWI/MRI showed 100 % (95 % CI: 83.2-100) sensitivity for both readers with specificity of 99.4 % (96.9-100) and 100 % (80.5-100) for readers 1 and 2, respectively. For distant metastases, WB-DWI/MRI showed 66.7 % (9.4-99.2) and 100 % (29.2-100) sensitivity and specificity of 94.1 % (71.3-99.9) and 100 % (80.5-100) for readers 1 and 2, respectively. Conventional imaging showed sensitivity of 50 % (27.2-72.8) and 33.3 % (0.8-90.6); specificity of 100 % (98-100) and 100 % (80.5-100), for nodal and distant metastases respectively. WB-DWI/MRI is feasible for single-step non-invasive staging of cancer during pregnancy with additional value for conventional imaging procedures. aEuro cent In our study, WB-DWI/MRI was more accurate than conventional imaging during pregnancy. aEuro cent WB-DWI/MRI improves diagnostic assessment of patients with cancer during pregnancy. aEuro cent Accurate imaging and oncologic staging improves treatment and outcome.
Notes: Amant, F (reprint author), Univ Hosp Leuven, Dept Obstet, Herestr 49, B-3000 Leuven, Belgium,
Keywords: magnetic resonance imaging; diffusion magnetic resonance imaging; cancer; pregnancy; staging
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ISSN: 0938-7994
e-ISSN: 1432-1084
DOI: 10.1007/s00330-017-5126-z
ISI #: 000429104200009
Rights: (C) European Society of Radiology 2017
Category: A1
Type: Journal Contribution
Validations: ecoom 2019
Appears in Collections:Research publications

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