Diffusion-weighted MRI for uveal melanoma liver metastasis detection.

Wagner, Mathilde; Mariani, Pascale; Bidard, François Clément; Rodrigues, Manuel Jorge; Farkhondeh, Fereshteh; Cassoux, Nathalie; Piperno-Neumann, Sophie; Petras, Slavomir; Servois, Vincent

<bold>Objectives: </bold>We aimed to assess the sensitivity of diffusion-weighted (DW) magnetic resonance (MR) imaging for the detection of pathologically confirmed uveal melanoma liver metastases (UMLM).<bold>Methods: </bold>Twenty patients who underwent complete surgical resection of their UMLM (N = 83) were included. Pre-surgery liver MR imaging included T2-weighted, T1-weighted, DW and dynamic-gadolinium-enhanced MR sequences. Two radiologists independently reviewed three sets of images (DW / morphologic-dynamic / combined) for each patient using intraoperative and pathological findings as a standard of reference.<bold>Results: </bold>The sensitivities of the morphologic-dynamic and DW images for UMLM detection were 63 % and 59 %, respectively, for reader #1 (R1) and 64 % and 53 %, for reader #2 (R2). Sensitivity of the combined set was higher than sensitivity in the two other sets (R1:69 %, R2:67 %), but was only significantly different than the sensitivity of the DW images (McNemar test). For the three sets and the two readers, the sensitivity for UMLM smaller than 5 mm (37-46 %) was significantly lower than that for UMLM larger than 5 mm (67-90 %). The sensitivity for UMLM located in the subcapsular area (41-54 %) was significantly lower than that for intraparenchymal UMLM (68-86 %) (Chi-square test).<bold>Conclusion: </bold>Our study shows that the addition of DW imaging to morphologic-dynamic images does not significantly increase MR sensitivities for UMLM detection.<bold>Key Points: </bold>• The MR imaging sensitivity for uveal melanoma liver metastases (UMLM) was 69 %. • Addition of DW imaging to morphologic-dynamic images does not increase sensitivity significantly. • Sensitivity for subcapsular UMLM was significantly lower than sensitivity for intraparenchymal UMLM. • The T2 shortening effect does not appear to influence lesion detection in DWI.

CHEMICAL elements; DIAGNOSTIC imaging; LIVER tumors; LONGITUDINAL method; MAGNETIC resonance imaging; COMPUTERS in medicine; MELANOMA; UVEA; CONTRAST media; RETROSPECTIVE studies; DIAGNOSIS; TUMORS

European Radiology, 2015, Vol 25, Issue 8, p2263

0938-7994

Academic Journal

10.1007/s00330-015-3662-y