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Research ArticleOriginal Article

Diagnostic value of whole-body MRI with diffusion-weighted sequence for detection of peritoneal metastases in colorectal malignancy

Huan Zhang, Weixing Dai, Caixia Fu, Xu Yan, Alto Stemmer, Tong Tong and Guoxiang Cai
Cancer Biology & Medicine May 2018, 15 (2) 165-170; DOI: https://doi.org/10.20892/j.issn.2095-3941.2017.0162
Huan Zhang
1Department of Radiology, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
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Weixing Dai
2Department of Colorectal Surgery, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
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Caixia Fu
3Siemens Shenzhen Magnetic Resonance Ltd, Shenzhen 518000, China
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Xu Yan
4MR Collaboration NE Asia, Siemens Healthcare, Shanghai 210318, China
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Alto Stemmer
5MR Applications Development, Siemens Healthcare, Erlangen 91052, Germany
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Tong Tong
1Department of Radiology, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
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  • For correspondence: t983352{at}126.com gxcai{at}fudan.edu.cn
Guoxiang Cai
2Department of Colorectal Surgery, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
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  • For correspondence: t983352{at}126.com gxcai{at}fudan.edu.cn
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    1

    A 34-year-old man with a history of resection of adenocarcinoma of left colon. WB-DWI showed anterior abdominal wall with focal nodular of hyperintensity during postoperative follow-up, which was confirmed as PM in the subsequent cytoreductive surgery. The preoperative PCI of WB-DWI was 5. The surgery PCI was 2. The PCI Types were matched.

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    2

    A 36-year-old man with signet cell cancer of the rectum was diagnosed as multiple peritoneal metastases on preoperative WB-DWI, while preoperative positron emission tomography-CT (PET-CT) was negative. PM was confirmed in the followed cytoreductive surgery along with the resection for primary lesion. The PCI of preoperative WB-DWI and surgery were 13 and 18 respectively, with a same PCI Type.

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    3

    Comparison of PCI on preoperative WB-DWI and surgical PCI score.

Tables

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    1

    Peritoneal tumor detection on WB-DWI at 13 anatomic sites compared with surgical and histopathologic findings

    RegionTrue positiveFalse negativeTrue negativeFalse positiveSensitivity (%)Specificity (%)Accuracy (%)
    012410175.090.981.5
    113110392.976.985.2
    21429287.581.885.2
    311211384.678.681.5
    411411173.391.781.5
    51428387.572.781.5
    62213195.775.092.6
    713211186.791.788.9
    812311180.091.785.2
    99314175.093.385.2
    1011213184.692.988.9
    111078258.880.066.7
    121176361.166.763.0
    Total163401252380.384.582.1
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    2

    Sensitivity of WB-DWI for the detection of peritoneal metastases of different size

    Lesion size (cm)< 0.50.5–5.0> 5.0
    WB-DWI757315
    Surgery1088015
    Sensitivity (%)69.491.3100
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    3

    PCI type of WB-DWI vs. surgery

    Surgery
    Small-volume tumorModerate-volume tumorLarge-volume tumor
    WB-DWI
    Small-volume tumor1000
    Moderate-volume tumor0121
    Large-volume tumor022
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Cancer Biology and Medicine: 15 (2)
Cancer Biology & Medicine
Vol. 15, Issue 2
1 May 2018
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Diagnostic value of whole-body MRI with diffusion-weighted sequence for detection of peritoneal metastases in colorectal malignancy
Huan Zhang, Weixing Dai, Caixia Fu, Xu Yan, Alto Stemmer, Tong Tong, Guoxiang Cai
Cancer Biology & Medicine May 2018, 15 (2) 165-170; DOI: 10.20892/j.issn.2095-3941.2017.0162

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Diagnostic value of whole-body MRI with diffusion-weighted sequence for detection of peritoneal metastases in colorectal malignancy
Huan Zhang, Weixing Dai, Caixia Fu, Xu Yan, Alto Stemmer, Tong Tong, Guoxiang Cai
Cancer Biology & Medicine May 2018, 15 (2) 165-170; DOI: 10.20892/j.issn.2095-3941.2017.0162
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Keywords

  • MRI
  • diffusion-weighted imaging
  • peritoneal cancer index
  • peritoneal metastases
  • colorectal malignancy

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