Whole-Body Magnetic Resonance Imaging (WB-MRI) is increasingly used for metastatic screening in oncology. This prospective single center study assesses the diagnostic value of WB-MRI including diffusion weighted imaging (DWI) and identifies the sufficient protocol for metastatic lymph node detection in patients with testicular germ cell cancer (TGCC). Forty-three patients underwent contrast enhanced thoraco-abdominopelvic CT (TAP-CT) and WB-MRI with DWI for metastatic lymph node screening. Two independent readers reviewed CTs and WB-MRIs. The diagnostic performance of different imaging protocols (CT, complete WB-MRI, T1W + DWI, T2W + DWI), the agreement between these protocols and the reference standard, the reproducibility of findings and the image quality (Signal and contrast to Noise Ratios, Likert scale) were studied. Reproducibility was very good regardless of both lesion locations (retroperitoneal vs distant lymph nodes, other lesions) and the reader. Diagnostic accuracy of MRI was ≥95% (regardless of the locations and imaging protocol); accuracy of CT was ≥93%. There was a strict overlap of 95% CIs associated with this accuracy between complete WB-MRI, T1W + DWI and T2W + DWI, regardless of the reader. Higher Likert score and SNR were observed for DWI, followed by T2W and T1W sequences. In conclusion, a fast WB-MRI protocol including T2W and DWI is a sufficient, accurate, non-irradiating alternative to TAP-CT for metastatic lymph node screening in TGCC.
Life (Basel, Switzerland). 2022 Jan 29*** epublish ***
Vassiliki Pasoglou, Sandy Van Nieuwenhove, Julien Van Damme, Nicolas Michoux, Aline Van Maanen, Laurence Annet, Jean-Pascal Machiels, Bertrand Tombal, Frederic E Lecouvet
Department of Radiology, Institut Roi Albert II Cancer Center, Cliniques Universitaires Saint-Luc & Institut de Recherche Expérimentale et Clinique (IREC), Pôle IMAG, Université Catholique de Louvain (UCLouvain), 1200 Brussels, Belgium., Division of Urology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain), 1200 Brussels, Belgium., Statistical Support Unit, Institut Roi Albert II Cancer Center, Cliniques Universitaires Saint-Luc, 1200 Brussels, Belgium., Department of Medical Oncology, Institut Roi Albert II Cancer Center, Cliniques Universitaires Saint-Luc & Institut de Recherche Expérimentale et Clinique (IREC), Pôle MIRO, Université Catholique de Louvain (UCLouvain), 1200 Brussels, Belgium.