Tumor staging, imaging techniques, and management rectal cancer is prone to local recurrence and systemic metastasis. Differentiation of clinically benign and malignant breast. Whole body wb magnetic resonance imaging mri with diffusionweighted imaging. Reaction on ocular ultrasound versus mri in the detection of.
Wholebody wb magnetic resonance imaging mri with diffusionweighted imaging. Presurgery liver mr imaging included t2weighted, t1weighted, dw and dynamicgadoliniumenhanced mr sequences. Wholebody mri including diffusionweighted imaging compared to. Diffusion and perfusion magnetic resonance imaging mri can provide functional information about brain tumors, and they are able to detect tumor volume and physiological changes beyond the lesions shown on conventional mri. There is evidence from other solid organ cancers and metastases that dwi may be used as a biomarker of prognosis and treatment response. This noninvasive technique continues to grow in popularity as a way to study brain pathways that could never. To compare adc values of hypervascular and hypovascular metastases and the added value of dwmri to. Diffusion and perfusion weighted magnetic resonance. We hypothesized that ocular melanoma has a marked diffusion restriction as.
Diffusionweighted imaging of metastatic brain tumors. Diffusion measurements reflect the effective displacement of water molecules allowed to migrate for a given time. Any information contained in this pdf file is automatically generated from digital material. Magnetic resonance imaging identifies early effects of. Primary uveal malignant melanoma radiology reference. Skeletal scintigraphy is the standard procedure for visualizing bone metastases, 5070% of distant metstases. Evaluation of diffusionweighted mri and fdgpetct to assess. In all patients with melanoma and prostate cancer lymph node and soft tissue metastasis with increased 18fdg11choline uptake could also be characterized by restriction of water diffusion and visualized by high bvalue mrimaging compare figure. Healthy cells are impermeable to fumarate, so conversion of. There are few case reports of mri findings in vaginal melanoma,,, and the diffusion weighted imaging dwi and dynamic contrastenhanced mri findings in vaginal melanoma have not yet been documented. Wholebody mri including diffusionweighted imaging compared to ct for staging of malignant melanoma. Imaging of ocular melanoma metastasis the british journal. Principles and applications of diffusionweighted imaging in. Chemoembolization of hepatic metastases from ocular.
Our results indicate that diffusion weighted and contrastenhanced mri can be used to. Improved detection of metastatic melanoma by t2weighted imaging. Pdf diffusion restriction of posterior uveal melanoma on mr. Metastatic lesions are isointense to mildly hypointense on t1weighted images and are hyperintense on t2weighted images or with fluid attenuation inversion recovery. Sixteen patients with uveal melanoma were imaged with mpmri. A regionofinterest analysis of diffusionweighted images with b values of 0 and smm2 was performed to calculate the apparent diffusion coefficient adc of. Diffusionweighted mri for imaging cell death after. Diffusionweighted mri for uveal melanoma liver metastasis.
Figure 3 demonstrates the scatterplots of the observed adcs. Although no investigators have reported diffusion findings in a series of cases of choroidal melanoma, roshdy et al 10 reported two cases of choroidal melanoma, both. On mri, melanomas are classically hyperintense on t1weighted images. Jan 25, 2016 studies have shown that in cutaneous melanoma, wholebody diffusion weighted imaging is as sensitive as conventional mri sequences in the detection of extracranial metastases. Research paper freebreathing 3d diffusion mri for highresolution hepatic metastasis characterization in small animals emeline j. A regionofinterest analysis of diffusionweighted images with b values of 0 and smm was performed to calculate the apparent diffusion coefficient adc of the ocular melanoma and the. The objective of our study was to use the criteria of iodized oil deposition, tumor size, and tumor enhancement to assess the utility of diffusion weighted and conventional mri in the evaluation of tumor response after tace for metastatic ocular melanoma. Diffusion mri remains the most comprehensive reference for understanding this rapidly evolving and powerful technology and is an essential handbook for designing, analyzing, and interpreting diffusion mr experiments diffusion imaging provides a unique window on human brain anatomy. Diffusion mr imaging of the brain in patients with cancer. Pdf diffusion restriction of posterior uveal melanoma on. Advantages of multicontrast mri examination including a diffusionweighted sequence in comparison with petct.
The incidence of these tumors increases with age, with only 2% of tumors found in patients younger than 20 years of age 6. Studies have shown that in cutaneous melanoma, wholebody diffusionweighted imaging is as sensitive as conventional mri sequences in the detection of extracranial metastases. Melanoma is a malignant disease that arises from melanocytes and has a steadily increased incidence over the last decades. Airp best cases in radiologicpathologic correlation. Aug 03, 2014 diffusion weighted mri dwi has been used in neurosurgical practice mainly to distinguish cerebral metastases from abscess and glioma. Article the basics of diffusion and perfusion imaging in. Reaction on ocular ultrasound versus mri in the detection. It usually occurs in older women, with an average age at diagnosis of 68 years age range. In bone metastases of thyroid tumors and melanoma, the wbmridwi shows a higher sensitivity when compared to 18ffdg petct. Diffusion related mri parameters for assessing early treatment response of liver metastases to cytotoxic therapy in colorectal cancer jung hoon kim1,2 ijin joo1 taeyong kim3 saewon han3 yong jae kim4 jeong min lee1,2 joon koo han1,2 kim jh, joo i, kim ty, et al. Whole body magnetic resonance imaging mri with diffusionweighted imaging wbmridwi is currently emerging as a diagnostic technique in the evaluation of bone metastases from breast, prostate, lung, thyroid, and melanoma tumors. This article is from upsala journal of medical sciences, volume 118. Intracranial metastatic melanoma is the third most common brain metastasis. For these reasons, we assessed sorafenib responses using hyperpolarized cfumarate, diffusion weighted mri dw mri in a xenograft model of human breast cancer in which daily administration of.
To compare adc values of hypervascular and hypovascular metastases and the added value of dwmri to t2weighted t2w images in their detection. Diffusionweighted magnetic resonance imaging dwmri is routinely included in mri examination protocols for tumor diagnosis, to differ benign from malignant lesions, to detect recurrent. Melanoma metastases were either hypointense on t2weighted images, hyperintense on t1weighted images, or both in 71% 85120 of melanoma lesions, compared with 19% of lung lesions p melanoma lesions but in only 2% of lung. Twenty patients who underwent complete surgical resection of their umlm n 83 were included. Malignant tumors usually show restricted diffusion, with a low apparent diffusion coefficient. Diffusionweighted magnetic resonance imaging dwmri is. Our purpose was to show the feasibility and potential value of a multiparametric mp mri protocol employing state of the art diffusion and perfusionweighted imaging techniques. Mri appearance metastatic lesions are isointense to mildly hypointense on t1weighted images and are hyperintense on t2weighted images or with fluid attenuation inversion recovery. However, owing to improvements in tnm staging and treatment, including a more widespread use of rectal mri and increased radiologist awareness of the key rectal cancer tnm staging features. We assessed the ability of dynamic contrast enhanced t1 mri dcemri perfusion to identify pseudoprogression in melanoma brain metastases. Also diffuse muscle infiltration in the case of nonhodgkin lymphoma was visualized by mr.
Our results indicate that diffusionweighted and contrastenhanced mri can be used to. Compared with skin melanoma, the prognosis of vaginal melanoma is worse, and the 5year overall survival rate is 5. Pdf wholebody mri including diffusionweighted imaging. The rather sobering performance of wholebody mri for nstaging in malignant melanoma has to be seen in the context of major advantages that. Purpose to assess the value of wb mri including dwi compared to computed tomography ct for staging of malignant melanoma. Comparative study of two wholebody imaging techniques in the. Comparison of adcs in benign and malignant breast lesions. Clinical and imaging features of noncutaneous melanoma. Diffusion mri petct oncology wholebody melanoma abstract the aim of our study was to compare wholebody mri magnetic resonance imaging with a multicontrast protocol including a dw diffusion weighted sequence to petct positron emission tomography using 18 fdg 18f. Indeed, diffusion mri has been shown to be an earlier biomarker compared to tumor volume 7, 8. Wholebody mri with diffusionweighted sequences compared with 18 fdg petct, ct and superficial lymph node ultrasonography in the staging of advanced cutaneous melanoma. Principles and applications of diffusionweighted imaging.
Wholebody mri with diffusionweighted sequences for the. In the recently published article entitled ocular ultrasound versus mri in the detection of extrascleral extension in a patient with choroidal melanoma jacobsen et al. It has enormous potential, but at this stage, it is more of a research option than a clinical reality. With the development of new magnetic resonance mr imaging technologies and stronger diffusion gradients, recent applications of diffusionweighted imaging in wholebody imaging have attracted considerable attention, especially in the field of oncology. Targeted chemotherapeutic agents often do not result in tumor shrinkage, so new biomarkers that correlate with clinical efficacy are needed. Whereas temperature modulates molecular mobility in pure water by approximately 2.
Whole body magnetic resonance imaging mri with diffusion weighted imaging wbmridwi is currently emerging as a diagnostic technique in the evaluation of bone metastases from breast, prostate, lung, thyroid, and melanoma tumors. Sep 21, 2016 accurate target volume delineation is crucial for the radiotherapy of tumors. Human brafv600mutant melanoma a375 xenograftbearing balbc nude mice n21 were imaged by 18ffdgpetct and dwmri before day 0 and after day 7 a 1week braf and cdk 46 inhibitor combination. Dwmri in assessment of the hypoxic fraction, interstitial. Ct, positron emission tomography pet, magnetic resonance imaging mri, are the cornerstone for. In this paper, we report the clinical features and mri findings of four cases of primary vaginal melanoma, including the dwi and dynamic. Diffusion weighted imaging relies on the detection of the random microscopic motion of free water molecules known as brownian movement. Diffusionweighted magnetic resonance imaging dwmri, which measures water mobility within tissues and indirectly relates to extracellular space, has. Based upon this the authors conclude the superiority of ocular ultrasound in the. The aim of our study was to compare wholebody mri magnetic resonance imaging with a multicontrast protocol including a dw diffusion weighted sequence to petct positron emission tomography using 18 fdg 18ffluorodeoxyglucose for staging advanced melanoma.
Diffusion mri allows obtaining functional information on tumors, including the physiological states cell proliferationdensity 1, 2, apoptosis 3, necrosis 4, the stagesgrades 5, 6 and responses to treatments. We therefore investigated dwi characteristics of cerebral metastases and their peritumoral region. A07 and r18 melanoma xenografts were used as general models of human cancer. The potential of diffusionweighted magnetic resonance imaging dwmri in assessing the hypoxic fraction, ifp, and metastatic propensity of tumors was investigated in this study. The smaller lesion also demonstrates clear diffusion restriction due to its. Diffusion weighted imaging dwi allows characterization of masses on the basis of their cellular density. Diffusionweighted imaging dwi allows characterization of masses on the basis of their cellular density.
Wholebody wb magnetic resonance imaging mri, including diffusion weighted imaging dwi, has been increasingly used for the detection of metastatic disease. Freebreathing 3d diffusion mri for highresolution hepatic. Another comparative study on the same topic found wholebody mri to be at least as accurate as 18 ffdg petct for nstaging, using a combination of conventional mri sequences and diffusionweighted mri. Purpose to assess the value of wb mri including dwi compared to computed tomography ct. Dwmri revealed malignant lymph nodes due to malignant melanoma metastases correlation with pathological findings. Malignant melanoma of the uvea is the most common primary intraocular malignancy and is predominantly seen in caucasians 5. Role of wholebody diffusion mr in detection of metastatic.
Diffusionweighted imaging of ocular melanoma request pdf. Comparative study of two wholebody imaging techniques in. On mri, sinonasal melanoma that contains melanin is usually isointense to hyperintense to gray matter on t1weighted images, although amelanotic melanoma may also appear t1 hyperintense. Purpose of this study was to evaluate the feasibility and diagnostic potential of wholebody magnetic resonance imaging wbmri with diffusion. Antiangiogenic treatment may change the tumor microenvironment and hence influence the effect of conventional therapies. Methods medical records of all melanoma patients referred to our center. Intracranial metastatic melanoma radiology reference. Aug 27, 2019 in the recently published article entitled ocular ultrasound versus mri in the detection of extrascleral extension in a patient with choroidal melanoma jacobsen et al.
Utility of diffusionweighted imaging in the diagnosis of inguinal. Diffusionweighted mri dwi has been used in neurosurgical practice mainly to distinguish cerebral metastases from abscess and glioma. Wb mri with dwi and ct chest, abdomen, and pelvis were performed in 23 patients with histologically confirmed malignant melanoma. The mean adc obtained from malignant breast lesions was statistically different from that observed with solid benign lesions t 9. There is evidence from other solid organ cancers and metastases that dwi may be used as a biomarker of prognosis and. Mri findings in primary vaginal melanomaa report of four. Diffusion weighted mr imaging is routinely used at brain mr imaging examination. Measurement of cell density and necrotic fraction in human melanoma xenografts by diffusion weighted magnetic resonance imaging. Diffusion and perfusion weighted magnetic resonance imaging. Diffusionweighted mri characteristics of the cerebral. In a first part, we compared the respective overall accuracy of each modality. Diffusionrelated mri parameters for assessing early. Quantitative multiparametric mri in uveal melanoma. In this study, we investigated noninvasive imaging protocols to monitor responses to sorafenib, a multikinase inhibitor approved for treatment of renal cell and hepatocellular carcinoma.
Monitoring chemotherapeutic response by hyperpolarized c. We aimed to assess the sensitivity of diffusion weighted dw magnetic resonance mr imaging for the detection of pathologically confirmed uveal melanoma liver metastases umlm. Neuroradiology brain, mr, mrdiffusionperfusion, diagnostic procedure. Research article open access dwmri in assessment of. While nuclear medicine technology, including petct, has been at the foreground of exploration, new mr imaging techniques, specifically diffusionweighted and diffusion tensor imaging, have shown interesting applications towards. We aimed to assess the sensitivity of diffusionweighted dw magnetic resonance mr imaging for the detection of pathologically confirmed uveal melanoma liver metastases umlm.
Note the light circular areas throughout the liver seen mostly on the left side of the screen. Primary vaginal melanoma is a rare malignant tumor, accounting for only 2. While nuclear medicine technology, including petct, has been at the foreground of exploration, new mr imaging techniques, specifically diffusion weighted and diffusion tensor imaging, have shown interesting applications towards. With the development of new magnetic resonance mr imaging technologies and stronger diffusion gradients, recent applications of diffusion weighted imaging in wholebody imaging have attracted considerable attention, especially in the field of oncology. Over the last several years, there has been significant advancement in the molecular characterization of intracranial diseases, particularly cerebral neoplasms. Dec 20, 2012 wholebody wb magnetic resonance imaging mri, including diffusionweighted imaging dwi, has been increasingly used for the detection of metastatic disease.
Evaluation of diffusionweighted mri and fdgpetct to. Brain metastasis is a common and devastating consequence of metastatic malignant melanoma. Dcemri perfusion predicts pseudoprogression in metastatic. Cancer patients with primary tumors showing extensive hypoxia and highly elevated interstitial fluid pressure ifp have poor prognosis. Wholebody wb magnetic resonance imaging mri, including diffusionweighted imaging dwi, has been increasingly used for the detection of metastatic disease. The potential of diffusion weighted magnetic resonance imaging dwmri and dynamic contrast enhanced mri dcemri in assessing microenvironmental effects of sunitinib treatment was investigated in this preclinical study. Diffusion mri also has been suggested as a measure of therapyinduced cytotoxic edema because viable cells act as a diffusion barrier in tissue. Melanoma can produce distinctive mr findings, 2 however, because approximately half of melanoma metastases are. Diffusionweighted magnetic resonance imaging as a cancer.
The estimated annual incidence of central nervous system cns metastasis is approximately 8. Wholebody mri with diffusionweighted imaging in bone. When wb mri is evaluated, both dwi and conventional mri sequences must be scrutinized. Diffusionweighted imaging relies on the detection of the random microscopic motion of free water molecules known as brownian movement. During the 10 years between 2007 and 2016, a total of 46 consecutive patients 19 men with a mean age sd of 59. The purpose of the study was to investigate a novel braf and cdk 46 inhibitor combination therapy in a murine model of brafv600mutant human melanoma monitored by 18 ffdgpetct and diffusionweighted mri dwm. Patients with melanoma brain metastases who underwent immunotherapy and dcemri were identified. Wholebody wb magnetic resonance imaging mri, including. Dec 24, 2019 it can be challenging to differentiate pseudoprogression from progression. A07 and r18 melanoma xenografts were used as general models of. Wholebody mri with diffusion weighted sequences compared with 18 fdg petct, ct and superficial lymph node ultrasonography in the staging of advanced cutaneous melanoma. Any information contained in this pdf file is automatically generated from digital material submitted. For a broad discussion about the primary tumor or brain metastasis in general, please refer to the articles.
Sensitivity of different mri sequences in the early detection. The objective of our study was to use the criteria of iodized oil deposition, tumor size, and tumor enhancement to assess the utility of diffusionweighted and conventional mri in the evaluation of tumor response after tace for metastatic ocular melanoma. Wholebody mri including diffusionweighted imaging compared. Research article open access 18ffdgpetct and diffusionweighted mri for monitoring a braf and cdk 46 inhibitor combination therapy in a murine model of human melanoma ralf s. It can be challenging to differentiate pseudoprogression from progression. This upper abdominal mri scan shows multiple tumors in the liver which have spread metastasized from a malignant melanoma in an arm or leg. On t2weighted images, lesions are typically isointense to hypointense to gray matter. Accurate target volume delineation is crucial for the radiotherapy of tumors. Dwi, malignant melanoma, wholebody mri introduction wholebody wb magnetic resonance imaging mri with diffusion weighted imaging dwi has recently been introduced for the evaluation of multifocal metastases in oncology patients. A regionofinterest analysis of diffusion weighted images with b values of 0 and smm was performed to calculate the apparent diffusion coefficient adc of the ocular melanoma and the. Sensitivity of different mri sequences in the early detection of. Notably those with lung cancer, breast cancer, and melanoma 39%, 17%, and 11%, respectively largely account for patients with brain metastases.
Schneider1,3, georg keinrath1, olga solyanik1, jessica olivier2, wolfgang g. Chemoembolization of hepatic metastases from ocular melanoma. Dwi, malignant melanoma, wholebody mri introduction wholebody wb magnetic resonance imaging mri with diffusionweighted imaging dwi has recently been introduced for the evaluation of multifocal metastases in oncology patients. Heimer1, andrei todica2, heidrun hirnereppeneder1, moritz j. Improved detection of metastatic melanoma by t2weighted. Presurgery liver mr imaging included t2weighted, t1weighted, dw and dynamicgadoliniumenhanced mr.