Diffusion-weighted whole-body imaging with background suppression (DWIBS) is effective and economical for detection of metastasis or recurrence of lung cancer

Katsuo Usuda; Shun Iwai; Aika Yamagata; Yoshihito Iijima; Nozomu Motono; Munetaka Matoba; Mariko Doai; Sohsuke Yamada; Yoshimichi Ueda; Keiya Hirata; Hidetaka Uramoto

doi:10.1111/1759-7714.13820

Diffusion-weighted whole-body imaging with background suppression (DWIBS) is effective and economical for detection of metastasis or recurrence of lung cancer

Thorac Cancer. 2021 Mar;12(5):676-684. doi: 10.1111/1759-7714.13820. Epub 2021 Jan 21.

Authors

Affiliations

¹ Department of Thoracic Surgery, Kanazawa Medical University, Kahoku-gun, Japan.
² Department of Radiology, Kanazawa Medical University, Kahoku-gun, Japan.
³ Department of Pathology and Laboratory Medicine, Kanazawa Medical University, Kahoku-gun, Japan.
⁴ Department of Pathophysiological and Experimental Pathology, Kanazawa Medical University, Kahoku-gun, Japan.
⁵ MRI Center, Kanazawa Medical University, Kahoku-gun, Japan.

Abstract

Background: Diffusion-weighted whole-body imaging with background suppression (DWIBS) is used for the diagnosis and staging of cancers. The medical cost of an MR examination including DWIBS is $123, which is 80% less expensive than the cost ($798) of F18-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) examination.

Methods: This study examined the efficacy of DWIBS for relapses after lung cancer resection. A total of 55 patients who had pulmonary resection of lung cancer, postoperative computed tomography (CT) every six months, and DWIBS and FDG-PET/CT (every year) were enrolled in this study. If a metastatic lesion was detected on CT scan, DWIBS and FDG-PET/CT were also used.

Results: A total of 55 patients who underwent pulmonary resections for lung cancer, and had CT, DWIBS and FDG-PET/CT examination during follow-up after pulmonary resection were enrolled in this study. Lung cancer in 32 patients relapsed. Postoperative radiographic examinations revealed pulmonary metastases in 17 patients, bone metastases in seven, liver metastases in five, lymph node metastases in five, pleural metastases in four, metastases to the chest wall in two, brain metastases in two, adrenal gland metastasis in one, and renal metastasis in one. The mean apparent diffusion coefficient (ADC) value of the relapse was 0.9 to 1.70 × 10^-3 mm² /s. The accuracy 0.98 (54/55) of DWIBS for detecting multiple metastatic lesions was likely to be higher than 0.94 (52/55) of CT or 0.94 (52/55) of FDG-PET/CT, but there were no significant differences.

Conclusions: DWIBS can detect multiple metastatic lesions throughout the entire body and differentiate malignancy from benignity in only one examination. DWIBS has benefits of diagnostic accuracy and is less expensive in medical costs for the detection of a relapse. DWIBS could potentially replace FDG-PET/CT after lung cancer resection.

Keywords: DWIBS (diffusion-weighted whole-body imaging with background suppression); lung cancer; magnetic resonance imaging; metastasis; positron emission tomography-computed tomography.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Aged, 80 and over
Female
Humans
Lung Neoplasms / diagnostic imaging*
Lung Neoplasms / pathology
Male
Middle Aged
Neoplasm Metastasis
Neoplasm Recurrence, Local
Whole Body Imaging / methods*