Whole-body-MR imaging including DWIBS in the work-up of patients with head and neck squamous cell carcinoma: a feasibility study

Daniel P Noij; Els J Boerhout; Indra C Pieters-van den Bos; Emile F Comans; Daniela Oprea-Lager; Rinze Reinhard; Otto S Hoekstra; Remco de Bree; Pim de Graaf; Jonas A Castelijns

doi:10.1016/j.ejrad.2014.03.019

Whole-body-MR imaging including DWIBS in the work-up of patients with head and neck squamous cell carcinoma: a feasibility study

Eur J Radiol. 2014 Jul;83(7):1144-1151. doi: 10.1016/j.ejrad.2014.03.019. Epub 2014 Mar 30.

Authors

Affiliations

¹ Department of Radiology & Nuclear Medicine, VU University Medical Center, De Boelelaan 1117, PO Box 7057, 1007 MB Amsterdam, The Netherlands(1). Electronic address: d.noij@vumc.nl.
² Department of Radiology & Nuclear Medicine, VU University Medical Center, De Boelelaan 1117, PO Box 7057, 1007 MB Amsterdam, The Netherlands(1). Electronic address: e.boerhout@vumc.nl.
³ Department of Radiology & Nuclear Medicine, VU University Medical Center, De Boelelaan 1117, PO Box 7057, 1007 MB Amsterdam, The Netherlands(1). Electronic address: i.pieters@vumc.nl.
⁴ Department of Radiology & Nuclear Medicine, VU University Medical Center, De Boelelaan 1117, PO Box 7057, 1007 MB Amsterdam, The Netherlands(1). Electronic address: efi.comans@vumc.nl.
⁵ Department of Radiology & Nuclear Medicine, VU University Medical Center, De Boelelaan 1117, PO Box 7057, 1007 MB Amsterdam, The Netherlands(1). Electronic address: d.oprea-lager@vumc.nl.
⁶ Department of Radiology & Nuclear Medicine, VU University Medical Center, De Boelelaan 1117, PO Box 7057, 1007 MB Amsterdam, The Netherlands(1). Electronic address: r.reinhard@vumc.nl.
⁷ Department of Radiology & Nuclear Medicine, VU University Medical Center, De Boelelaan 1117, PO Box 7057, 1007 MB Amsterdam, The Netherlands(1). Electronic address: os.hoekstra@vumc.nl.
⁸ Department Otolaryngology/Head and Neck Surgery, VU University Medical Center, De Boelelaan 1117, PO Box 7057, 1007 MB Amsterdam, The Netherlands(2). Electronic address: r.debree@vumc.nl.
⁹ Department of Radiology & Nuclear Medicine, VU University Medical Center, De Boelelaan 1117, PO Box 7057, 1007 MB Amsterdam, The Netherlands(1). Electronic address: p.degraaf@vumc.nl.
¹⁰ Department of Radiology & Nuclear Medicine, VU University Medical Center, De Boelelaan 1117, PO Box 7057, 1007 MB Amsterdam, The Netherlands(1). Electronic address: j.castelijns@vumc.nl.

PMID: 24768188
DOI: 10.1016/j.ejrad.2014.03.019

Abstract

Objectives: To assess the feasibility of whole-body magnetic resonance imaging (WB-MRI) including diffusion-weighted whole-body imaging with background-body-signal-suppression (DWIBS) for the evaluation of distant malignancies in head and neck squamous cell carcinoma (HNSCC); and to compare WB-MRI findings with (18)F-fluorodeoxyglucose positron emission tomography/computed tomography ((18)F-FDG-PET/CT) and chest-CT.

Methods: Thirty-three patients with high risk for metastatic spread (26 males; range 48-79 years, mean age 63 ± 7.9 years (mean ± standard deviation) years) were prospectively included with a follow-up of six months. WB-MRI protocol included short-TI inversion recovery and T1-weighted sequences in the coronal plane and half-fourier acquisition single-shot turbo spin-echo T2 and contrast-enhanced-T1-weighted sequences in the axial plane. Axial DWIBS was reformatted in the coronal plane. Interobserver variability was assessed using weighted kappa and the proportion specific agreement (PA).

Results: Two second primary tumors and one metastasis were detected on WB-MRI. WB-MRI yielded seven clinically indeterminate lesions which did not progress at follow-up. The metastasis and one second primary tumor were found when combining (18)F-FDG-PET/CT and chest-CT findings. Interobserver variability for WB-MRI was κ=0.91 with PA ranging from 0.82 to 1.00. For (18)F-FDG-PET/CT κ could not be calculated due to a constant variable in the table and PA ranged from 0.40 to 0.99.

Conclusions: Our WB-MRI protocol with DWIBS is feasible in the work-up of HNSCC patients for detection and characterization of distant pathology. WB-MRI can be complementary to (18)F-FDG-PET/CT, especially in the detection of non (18)F-FDG avid second primary tumors.

Keywords: Diffusion magnetic resonance imaging; Feasibility studies; Head and neck neoplasms; Positron-emission tomography; Second primary neoplasms.

Publication types

Comparative Study
Evaluation Study

MeSH terms

Aged
Carcinoma, Squamous Cell / diagnosis*
Diffusion Magnetic Resonance Imaging / methods*
Female
Fluorodeoxyglucose F18
Head and Neck Neoplasms / diagnosis*
Humans
Male
Middle Aged
Multimodal Imaging / methods*
Observer Variation
Positron-Emission Tomography / methods*
Radiopharmaceuticals
Reproducibility of Results
Sensitivity and Specificity
Squamous Cell Carcinoma of Head and Neck
Tomography, X-Ray Computed / methods*
Whole Body Imaging / methods*

Substances

Radiopharmaceuticals
Fluorodeoxyglucose F18