Sedat Alibek MD, Presenter: Nothing to Disclose

Alexander Cavallaro MD, Abstract Co-Author: Nothing to Disclose

Werner A. Bautz MD, Abstract Co-Author: Nothing to Disclose

Gundula Staatz MD, Abstract Co-Author: Nothing to Disclose

To evaluate the value of diffusion weighted imaging (DWI) for detection and delineation of malignant thoracic and abdominal tumors in children using a fusion technique in routine MR scans.

10 pediatric patients with suspected malignant tumors were scanned in a 1,5 T MR scanner (Espree, Siemens Medical Solutions) with a routine contrast enhanced scan protocol. Additionally DWI was performed with standard scan parameters (B= 0, 500, 1000; slice thickness: 4 mm, transverse plane). Routine MR scans and DWI were read separately and combined by two experienced radiologists. Diagnosis was established in consensus. DWI images were evaluated regarding tumor detection, delineation, anatomical correctness and compared with routine T2- and T1-weighted pre and postcontrast images. DWI and anatomical T1 weighted pre contrast images were fusioned and presented in daily clinical conferences.

1. DWI showed significantly high signal intensities in all patients for high B-values, matching with areas of contrast-uptake in lesions allowing correct detection of malignant processes. 2. Conventional T2- and T1-weighted images are superior to DWI for anatomical correctness. 3. Fusion of DWI images with T1-weighted non-enhanced images allows for a correct anatomical delineation of the tumor extent. 4. DWI images add value to routine MR scans enabling a combined visualization of anatomy and functional MRI.

1. DWI is a stable functional imaging method 2. Areas of high-signal intensity in DWI with high B-values (1000) correlate accurately with contrast-enhancing malignant processes 3. Deficiency of demonstrating exact anatomy of malignant tumors can be compensated by fusion of DWI and T1-weighted images 4. Colleagues of clinical departments reckon fusioned images (DWI+T1-weighted images) for visualization of malignant tumors 5. MR scans without any Gd-administration seems to be possible for tumor staging and has to be investigated in further studies.

Adding DWI to routine pediatric oncology protocols with use of a fusion technique provides functional visualization of tumor extent and correlates excellent with Gd-enhancement in malignant tumors.

Alibek, S, Cavallaro, A, Bautz, W, Staatz, G, Value of Diffusion-weighted Imaging in Routine MR Scans Using a Fusion Technique for Visualization of Malignant Tumors in Pediatric Oncology Patients.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5010157.html