Diagnostic accuracy and agreement between whole-body diffusion MRI and bone scintigraphy in detecting bone metastases |
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Authors: | A. Stecco M. Lombardi L. Leva M. Brambilla E. Negru S. Delli Passeri A. Carriero |
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Affiliation: | 1870. SCDU Radiologia, AOU Maggiore della Carità, Università del Piemonte Orientale A. Avogadro, C.so Mazzini 18, 28100, Novara, Italy 2870. SCDU Medicina Nucleare, AOU Maggiore della Carità, Università del Piemonte Orientale A. Avogadro, Novara, Italy 3870. SDO Fisica Sanitaria, AOU Maggiore della Carità, Novara, Italy 4870. SCDU Oncologia, AOU Maggiore della Carità, Università del Piemonte Orientale A. Avogadro, Novara, Italy
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Abstract: | Purpose This study was done to determine the diagnostic value of whole-body magnetic resonance using diffusion-weighted imaging with background suppression (WB-DWIBS) for detecting bone metastases compared with whole-body bone scintigraphy (WB-BS). Materials and methods Twenty-three patients with solid tumours underwent both WB-DWIBS imaging and WBBS. A nuclear medicine specialist interpreted WB-BS images and two blinded radiologists, first independently and then jointly, interpreted the WB-DWIBS images by completing a reading grid categorising the skeletal segments. Cohen’s k statistic was used to determine interobserver agreement in reading the WB-DWIBS images and the agreement between WB-BS and WB-DWIBS. Sensitivity and specificity were calculated per patient and per lesion. Results Interobserver agreement in reading the WBDWIBS images was substantial or good, with κ=0.68. Analysis of agreement between the nuclear physician’s and the radiologists’ readings provided κ=0.87 [95% confidence interval (CI)=0.76–0.98)] Per-lesion analysis gave a sensitivity of 80% (95% CI=75–85) and a specificity of 98.2% (95% CI=96.5–99.8). Conclusions We found a good level of interobserver agreement for the WB-DWIBS images and an excellent level of agreement in the subjective judgement of presence or absence of disease between WB-BS and WB-DWIBS after consensual double reading. WB-DWIBS has the same specificity as WB-BS in detecting bone metastases. The anatomical sites exhibiting the highest level of disagreement between WB-DWIBS and WB-BS are the pelvis, the coccyx, and the sternum, all sites at which detection with WB-BS has the greatest limitations. |
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