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. 2017 Jun;13(6):3509-3515.
doi: 10.3892/etm.2017.4432. Epub 2017 May 5.

Diagnostic accuracy of diffusion-weighted whole-body imaging with background body signal suppression/T2-weighted image fusion for the detection of abdominal solid cancer

Minoru Tomizawa  1 , Fuminobu Shinozaki  2 , Kazunori Fugo  3 , Satomi Tanaka  2 , Takafumi Sunaoshi  2 , Daisuke Kano  2 , Eriko Sugiyama  2 , Misaki Shite  2 , Ryouta Haga  2 , Yoshiya Fukamizu  2 , Toshiyuki Fujita  2 , Satoshi Kagayama  2 , Rumiko Hasegawa  4 , Akira Togawa  4 , Yoshinori Shirai  4 , Noboru Ichiki  4 , Yuji Oshima  5 , Naoto Koike  5 , Yasuko Toshimitsu  6 , Yasufumi Motoyoshi  7 , Takao Sugiyama  8 , Shigenori Yamamoto  9 , Takashi Kishimoto  3 , Naoki Ishige  10
Affiliations

Diagnostic accuracy of diffusion-weighted whole-body imaging with background body signal suppression/T2-weighted image fusion for the detection of abdominal solid cancer

Minoru Tomizawa et al. Exp Ther Med. 2017 Jun.

Abstract

Diffusion-weighted whole-body imaging with background body signal suppression (DWIBS) images show significant contrast for cancer tissues against non-cancerous tissues. Fusion of a DWIBS and a T2-weighted image (DWIBS/T2) can be used to obtain functional, as well as anatomic, information. In the present study, the performance of DWIBS/T2 in the diagnosis of abdominal solid cancer was evaluated. The records of 14 patients were retrospectively analyzed [5 patients with hepatocellular carcinoma (HCC), 4 with metastatic liver cancer, 3 with pancreatic cancer, 1 with renal cellular carcinoma and 1 with malignant lymphoma of the para-aortic lymph node]. T1WI and T2WI scans did not detect pancreatic cancer in certain cases, whereas DWIs and DWIBS/T2 clearly demonstrated pancreatic cancer in all cases. In addition, metastatic liver cancer and HCC were successfully detected with abdominal US and CECT; however, US did not detect pancreatic cancer in 1 case, while CECT and DWIBS/T2 detected pancreatic cancer in all cases. In conclusion, the diagnostic performance of DWIBS/T2 was the same as that of abdominal US and CECT in detecting primary and metastatic liver cancer. DWIBS/T2 enabled the diagnosis of pancreatic cancer in cases where it was not detected with US, T1WI or T2WI.

Keywords: abdominal ultrasonography; computed tomography; hepatocellular carcinoma; pancreatic cancer.

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Figures

Figure 1.
Figure 1.
Imaging examination in the representative case of a 73-year-old patient diagnosed with hepatocellular carcinoma. The tumor was successfully detected with DWIBS/T2. (A) CECT scanning demonstrated a space-occupying lesion with mixed enhancement (arrow). (B) T1WI showed an unclear mass-like lesion. (C) Detection of the lesion was difficult in a T2WI when compared with the CECT scan. (D) DWIBS/T2 clearly showed a high signal. DWIBS/T2, diffusion-weighted whole-body imaging with background body signal suppression/T2-weighted image fusion; CECT, contrast-enhanced computed tomography; WI, weighted image.
Figure 2.
Figure 2.
Imaging examination in the representative case of a 75-year-old female patient diagnosed with pancreatic cancer. The tumor was successfully detected by DWIBS/T2. (A) Magnetic resonance cholangiopancreatography showed obstruction of the common bile duct near the papilla of Vater (arrow). (B) Percutaneous transhepatic biliary drainage was performed. (C) A coronal section of DWIBS/T2 demonstrated a high signal on the obstruction. (D) CECT revealed an irregularly shaped low-density area in the head of the pancreas. (E) T1WI and (F) T2WI scans did not show clear presence of pancreatic cancer. (G) A transverse section of DWIBS/T2 demonstrated a high signal in the head of the pancreas. (H) Surgical specimens confirmed the diagnosis of pancreatic cancer in the head of the pancreas close to common bile duct (circled with arrowheads). Scale bar, 1 cm; b, common bile duct; d, duodenum; DWIBS/T2, diffusion-weighted whole-body imaging with background body signal suppression/T2-weighted image fusion; CECT, contrast-enhanced computed tomography; WI, weighted image.
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