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23 April 2012

The clinical value of MRI using single-shot echoplanar DWI to identify liver involvement in patients with advanced gastroenteropancreatic-neuroendocrine tumors (GEP-NETs), compared to FSE T2 and FFE T1 weighted image after i.v. Gd-EOB-DTPA contrast enhancement

Artur J. SankowskiABCDEF, Jarosław B. ĆwiklaABCDEFG, Mirosław L. NowickiBDEF, Sławomir ChaberekBCD, Maciej PechADE, Anna LewczukBF, Jerzy WaleckiE

DOI: 10.12659/MSM.882719

Med Sci Monit 2012; 18(5): MT33-40

Abstract

Background: To assess the detection rate of liver lesions in patients with advanced gastroenteropancreatic neuroendocrine carcinomas (GEP-NETs) using echo planar (EP) DWI (diffusion weighted imaging) as compared to standard FSE T2 wi and FFE T1 wi with i.v. (Gd-EOB)-DTPA.
Material/Methods: This prospective single-institution study included 55 patients with liver involvement confirmed by GEP-NETs 1.5T MRI system, using FSE T2, EP DWI and FFE T1 with i.v. (Gd-EOB)-DTPA. The potential differences between detection rates of liver deposits using 3 different MR approaches and between groups of patients were compared.
Results: Mean number of liver deposits: FSE T2=20.7, FFE T1=25.7 and tested EP DWI=24.0. No significant difference was found in overall detection rate of liver deposits seen in 3 different techniques. A significant difference in detection rate of liver deposits was noted between male vs. female and secreting vs. non-secreting cancers. There was nearly perfect agreement between both observers, and each of the tested MRI approaches in regards to number of detected liver lesions (Cohen’s kappa=0.848–1).
Conclusions: There were no significant differences among the 3 different MRI approaches in detection rates of liver deposits. Perfect agreement with high detection rate of liver deposits provides a rationale for the use of EP DWI in follow-up studies in GEP-NET patients.

Keywords: Neuroendocrine Tumors - pathology, Liver Neoplasms - pathology, Infusions, Intravenous, Gastrointestinal Neoplasms - pathology, Gadolinium DTPA - administration & dosage, Echo-Planar Imaging - methods, Contrast Media - administration & dosage, Observer Variation, Prospective Studies

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750