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.

Han, Sileny N;Amant, Frédéric;Michielsen, Katrijn;De Keyzer, Frederik;Vandecaveye, Vincent;et.al.
(2018) European Radiology : journal of the European Congress of Radiology — Vol. 28, n° 5, p. 1862-1874 (2018)

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Authors
  • Han, Sileny N
    Author
  • Amant, Frédéric
    Author
  • Michielsen, Katrijn
    Author
  • De Keyzer, Frederik
    Author
  • Mhallem Gziri, MinaUCLouvain
    Author
  • Vandecaveye, Vincent
    Author
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Abstract
OBJECTIVES: 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. METHODS: 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 κ statistics and accuracy was compared to conventional imaging for assessing primary tumour site, nodal and visceral metastases. RESULTS: Both WB-DWI/MRI readers showed good-very good agreement for lesion detection (primary lesions: κ=1; lymph nodes: κ=0.89; distant metastases: κ=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. CONCLUSIONS: WB-DWI/MRI is feasible for single-step non-invasive staging of cancer during pregnancy with additional value for conventional imaging procedures. KEY POINTS: • In our study, WB-DWI/MRI was more accurate than conventional imaging during pregnancy. • WB-DWI/MRI improves diagnostic assessment of patients with cancer during pregnancy. • Accurate imaging and oncologic staging improves treatment and outcome.
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Han, S. N., Amant, F., Michielsen, K., De Keyzer, F., Fieuws, S., Van Calsteren, K., Dresen, R. C., Mhallem Gziri, M., & Vandecaveye, V. (2018). 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. European Radiology : journal of the European Congress of Radiology, 28(5), 1862-1874. https://doi.org/10.1007/s00330-017-5126-z (Original work published 2018)