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Mototugu Saeki
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P2.11 - Screening and Early Detection (ID 178)
- Event: WCLC 2019
- Type: Poster Viewing in the Exhibit Hall
- Track: Screening and Early Detection
- Presentations: 1
- Now Available
- Moderators:
- Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall
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P2.11-21 - Usefulness of Diffusion-Weighted Whole-Body Imaging with Background Suppression in the Postoperative Follow-up Period (Now Available) (ID 1185)
10:15 - 18:15 | Author(s): Mototugu Saeki
- Abstract
Background
Diffusion-weighted whole-body imaging with background suppression (DWIBS), a magnetic resonance diffusion-weighted imaging method of the whole body, has recently been adopted as a method for detecting malignant lesions, but there have been few reports discussing the usefulness of this technique with respect to the detection of recurrent postoperative lesions. Herein, we describe the usefulness of DWIBS for identifying recurrence, following surgery for primary lung cancer.
Method
We performed a retrospective investigation of the accuracy of detection of recurrent lesions using DWIBS in 76 patients (46 men, 30 women) between November 2016 and October 2018, who were being followed up after primary lung cancer surgery. Diagnosis of recurrence was made after comprehensive imaging findings, clinical findings, and histopathological findings. While performing DWIBS, photographs were taken using a SIEMENS MAGNETOM Skyra 3.0T device and no contrast agent was used. The b factors were set to 0 and 1000, and high signal and low apparent diffusion coefficient (ADC) values in the diffusion weighted image (b = 1000) were evaluated visually.
Result
The mean period from surgery to DWIBS was 1243 days (range: 116-3557 days) and the median period was 999 days. Of the 76 cases considered, recurrence was observed in 32 cases, of which DWIBS detected the lesion in 24 cases (75%). Of the 44 non-recurrent cases, 18 exhibited a strong signal in DWIBS. Of these 18 cases, 12 were false positives and 6 were primary lesions. Accuracy was 73.6%, sensitivity was 78.9%, and specificity was 68.4%, respectively. The breakdown of the location of lesions identified through DWIBS that were indicative of recurrence was as follows: Lymph nodes: 15 and bones: 8; with others located in the lungs, liver, and pancreas. In addition, the breakdown of the location of lesions identified in the chest through DWIBS that were not indicative of recurrence was as follows: Pulmonary recurrence: 6, hilar lymph node recurrence: 1, and mediastinal lymph node recurrence: 1. The reasons for performing DWIBS were elevated tumor marker values in 33 cases and whole-body testing for recurrence via computed tomography (CT) in 24 cases.
Conclusion
We believe that DWIBS is a useful technique when performing whole-body malignancy screenings after surgery for primary lung cancer. As this technique is less sensitive in identifying small recurrent lesions in the chest, it may be necessary to make a comprehensive diagnosis based on other findings as well, such as contrast-enhanced CT and PET results.
