Akihiro Nishie MD, Presenter: Nothing to Disclose

Masao Obuchi MD, Abstract Co-Author: Nothing to Disclose

Alan Howard Stolpen, Abstract Co-Author: Nothing to Disclose

David Michael Kuehn MD, Abstract Co-Author: Nothing to Disclose

Aaron Robert Dagit DO, Abstract Co-Author: Nothing to Disclose

Kelli J. Andresen MD, Abstract Co-Author: Nothing to Disclose

To evaluate the performance of T2- and diffusion-weighted magnetic resonance imaging (MRI) with image-fusion for the detection of locally recurrent pelvic malignancy.

The study group consisted of twenty-eight patients (27F, 1M) who underwent pelvic (MRI) at 1.5 Tesla after treatment of pelvic malignancy. Three MR imaging sequences were evaluated: axial T2-weighted fast spin-echo (FSE), axial dynamic contrast-enhanced (DCE) fat-suppressed T1-weighted spoiled gradient echo, and axial T2- and diffusion-weighted echo-planar imaging (DWI) with image-fusion, the latter performed using OsiriX Medical Imaging Software. All images were reviewed independently by three blinded readers. The performance of the three MRI sequences for detecting tumor recurrence was evaluated using receiver operating characteristic (ROC) analysis.

Local tumor recurrence was identified on MRI in 16 patients and confirmed at biopsy. The mean area under the ROC curve (Az) was 0.85 for T2 FSE imaging and 0.95 for both DCE fat-suppressed T1 imaging and T2 DWI with image-fusion. The difference in the Az values for T2 FSE and T2 DWI with image-fusion was statistically significant (p<0.05). The sensitivity, specificity and accuracy for detection of local tumor recurrence was 81.3%, 66.7% and 75.0%, respectively, for T2 FSE imaging and 93.8%, 75.0% and 85.7%, respectively, for DCE fat-saturated T1-weighted imaging and T2 DWI with image-fusion.

T2 DWI with image-fusion is comparable to DCE fat-saturated T1-weighted imaging and modestly outperforms standard T2 FSE for depicting locally recurrent pelvic malignancy.

T2 DWI with image-fusion can contribute to improvement of depicting local tumor recurrence and is recommended as a part of a follow-up MRI study after treatment of pelvic malignancy.

Nishie, A, Obuchi, M, Stolpen, A, Kuehn, D, Dagit, A, Andresen, K, Evaluation of Locally Recurrent Pelvic Malignancy: Performance of T2- and Diffusion-weighted MRI with Image-Fusion.  Radiological Society of North America 2006 Scientific Assembly and Annual Meeting, November 26 - December 1, 2006 ,Chicago IL. http://archive.rsna.org/2006/4435003.html