Footnote:
Hinweis: Link zur Erstveröffentlichung URL: https://doi.org/10.3390/ curroncol29070364
Description:
Over the last few years, diffusion-weighted imaging (DWI) has become increasingly
relevant in the diagnostic assessment of peritoneal carcinomatosis. The aim of this study was
to investigate the benefits of high-b DWI (c-DWI) compared to standard DWI in patients with
peritoneal carcinomatosis. A cohort of 40 patients with peritoneal carcinomatosis were included in
this retrospective study. DWI was performed with b-values of 50, 400, and 800 or 1000 s/mm2 on a
1.5-T magnetic resonance imaging (MRI) scanner. C-DWI was calculated using a mono-exponential
model with high b-values of 1000, 2000, 3000, 4000, and 5000 s/mm2. All c-DWI images with high
b-values were compared in terms of volume, detectability of peritoneal lesions, and image quality
with the DWI sequence acquired with a b-value of 800 or 1000 s/mm2 by two readers. In the group
with a b-value of 800 s/mm2, there was no statistically significant difference in terms of lesion volume.
In the second group with a b-value of 1000 s/mm2, peritoneal carcinomatosis lesions were statistically
significantly larger than in the c-DWI with a- high b-value of 2000 s/mm2 (median 7 cm3, range
1–26 cm3vs. median 6 cm3, range 1–83 cm3, p < 0.05). In both groups, there was a marked decrease
in the detectability of peritoneal lesions starting at b = 2000 s/mm2. In addition, image quality
decreased noticeably from c-DWI at b = 3000 s/mm2. In both groups, all images with high b-values
at b = 4000 s/mm2 and 5000 s/mm2 were not diagnostically valuable due to poor image quality.
The c-DWI technique offers good diagnostic performance without additional scanning time. High
c-DWI b-values up to b = 1000 s/mm2 provide comparable detectability of peritoneal carcinomatosis
compared to standard DWI. Higher b-values over 1500 s/mm2 result in lower image quality, which
might lead to misdiagnosis.