Clinical Application Study For Diffusion-weighted Whole-body Imaging With Background Body Signal Suppression In The Diagnosis Of Malignant Tumors Metastasis

Part I A control study between DWIBS and bone scintigraphy mapping in the diagnosis of bone metastatic diseasesObjective:To compare the value of clinical application in the diagnosis of malignant metastatic osteopathis between MR diffusion-weighted whole-body imaging with background body signal suppression(DWIBS) and bone scintigraphy mapping. Materials and Methods:36patients confirmed with malignant tumors by the pathology of operation or biopsy underwent both DWIBS imaging and bone scintigraphy mapping, chi-square test was used for comparing the detection results of bone metastasis by this two imaging methods, and P<0.05was considered having statistical significance. Results:(1)30(165positions in all) of36malignant tumor patients were confirmed as having bone metastasis, and26patients(143positions) with DWIBS method and23patients(132positions) with bone scintigraphy mapping were detected, but there was no statistical significance between this two imaging methods (X2=1.002,P=0.506).(2) The sensitivity, positive predictive value(PPV) and accuracy of the detection rate of bone metastasis were similar in DWIBS and bone scintigraphy, with86.7%,96.3%,86.1%and76.7%,88.5%,72.2%, respectively; but the specificity and negative predictive value(NPV) in DWIBS(83.3%and55.6%) was higher than that of in bone scintigraphy(50.0%and30.0%).(3) The detection rates of different bone metastasis with DWIBS and bone scintigraphy were86.7%(143/165) and80.0%(132/165), and it was no significant difference(X2=2.640, P=0.104); while DWIBS method was better than bone scintigraphy in the detection of osseous metastasis on pelvis and limbs long bone, and there was different significant (X2=6.783and7.636, P=0.023and0.016). Conclusion:DWIBS could detect bone metastatic lesions effectively, and there is fine consistency with bone scintigraphy. Therefore, DWIBS is to hope to be extended and applicated on clinically. Part II Clinical application study on malignant metastatic diseases between DWIBS and PET/CTObjective:To evaluate the application value of MR diffusion-weighted whole-body imaging with background body signal suppression (DWIBS) and positron emission tomography with computed tomography (PET/CT) on malignant metastatic diseases. Materials and Methods:36patients confirmed with malignant tumors accompanying metastasis by the pathology of operation or biopsy underwent both DWIBS imaging and PET/CT, chi-square test and Kappa test were used for camparing the detection results of metastasis by this two imaging methods, and P<0.05was considered having statistical significance. Results:(1) Of36malignant tumor patients with238metastatic lesions,218(91.6%,218/238) lesions in DWIBS and209(87.8%,209/238) lesions in PET/CT were detected, with200lesions detected by the two methods simultaneously, and the concordance rate was88.7%(211/238); but there was no statistical significance between this two methods (X2=1.843, P=0.157). Kappa test showed a fair concordance rate between DWIBS and PET/CT(P=0.000).(2) There were different significance between DWIBS and PET/CT in detecting metastatic lesions of brain and bone (P=0.005and0.031); but there were no significant difference(P=0.309and1.000) in detecting metastatic lesions of lymph nodes and liver. Conclusion:DWIBS could detect metastatic lesions effectively, and there is fine consistency with PET/CT. DWIBS is more sensitive than PET/CT in detecting metastatic lesions of brain and bone, so DWIBS could be chose for screening metastatic lesions according to the characteristics of different primary tumors.