Comparison Study Between PET/CT and Whole-Body Diffusion Weighted MRI in the Detection of Distant Malignancies

N/AUnknownNCT06205901

Sohag University50 enrolled

Overview

The purpose of the study is to compare the efficacy of 18F-FDG PET/CT and DWI WB-MRI in detection of distant metastasis of various cancers.

Metastasis is the leading cause of morbidity and mortality in patients with cancer, accounting for \~90% of cancer-associated deaths. Distant metastasis (DM) is a crucial point in the management of malignant tumors. DM is always associated with poor survival. Conclusive diagnosis of DM is crucial for improving the prognosis, reduction of the recurrence rate and hence, elevation of the 5-year survival rate. Positron emission tomography/computed tomography (PET/CT) allows the analysis of active tumor tissue in the whole body. So, it obtains improved sensitivity and specificity when compared to conventional imaging modalities. 18F-FDG PET/CT is a diagnostic imaging modality with good quantitative properties. It has proven its interest in diagnosing, staging, and evaluating tumor response. Whole-body MRI (WB-MRI) has been proposed as another effective whole-body approach for assessing both local invasiveness and distant metastases in patients with newly diagnosed cancers providing several advantages. WB-MRI primarily provides structural information (revealing a detailed image of the pathology or lesion) on tumor spread; however, the absence of functional datasets has been resolved by incorporating Whole-body Diffusion Weighted Imaging (WB-DWI) into medical practice. WB-DWI shortens examination interpretation times by directing the radiologist's attention to abnormalities, which may then be investigated on anatomic sequences. It enables early detection of skeletal metastases as well as spread to other sites (liver and brain). DW-MRI measures the Brownian motion of water molecules within intra- and extracellular spaces. This occurs in highly cellular lesions or in environments in which tissue architecture is disrupted and can be quantified by calculating the apparent diffusion coefficient (ADC).

Study Type

OBSERVATIONAL

Enrollment

Conditions

Distant Metastasis

Interventions

PET-CT, MRIDEVICE

whole body MRI and PET-CT for cancer patients with distant metastasis

Eligibility

Sex: ALLMin age: 18 YearsMax age: 100 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Only patients with malignancies proven by histology and patients with metastatic lesions proven by histopathology or cytology were included. Exclusion Criteria: * • As regard the PET/CT study, patients who have the general CT contraindications such as pregnancy, breast feeding, history of allergic reaction to the contrast medium, renal disease, etc. * As regard the MRI study, general contraindications including claustrophobia, MR-incompatible pacemakers and MR-incompatible heart valves. * Patients whose MRI sequences were incomplete, low-quality and/or had no histopathological evidence of metastatic lesions were eliminated from the study. * Low-quality or incomplete MRI included MRI exams with incomplete sequence(s), which is particularly common in elderly patients who are unable to tolerate the scan, or uncooperative patients who do not obey breathing instructions and motion artifacts that may impair images and lead to lower accuracy. * Declined consent.

Outcomes

Primary Outcomes

comparison between the efficacy of 18F-FDG PET/CT and DWI WB-MRI in detection of distant metastasis of various cancers

comparing the value of both PET-CT and whole body MRI mainly the DWI sequence in detection of bony and soft tissue metastasis in different types of malignancy. Which? will be better in early detection. PET-CT: differentiation of benign from malignant lesions can be determined using (Standardized uptake value) (SUV) as malignant lesions show higher SUV than benign lesions. Typically, a standardized uptake value (SUV) is a descriptive name of the quantity that incorporates the patient's size and the injected dose; \> 2.0: considered malignancy, less than this value: considered to be benign. DWI WB-MRI: differentiation of benign from malignant lesions can be determined using ADC value as malignant lesions show low ADC value compared to the benign lesions. Apparent diffusion coefficient (ADC) is a descriptive name of the measure of the magnitude of diffusion (of water molecules) within tissue.

Time frame: 1 Year

Secondary Outcomes

DWI-MRI in detection of metastatic lesions in cancer patients

detection of malignancy with applying ADC cut-off level for differentiating the malignant metastatic deposits. qualitative interpretation: differentiation of benign from malignant lesions can be determined through presence Vs absence diffusion restriction at diffusion weighted images (DWI), as only the malignant lesions that show diffusion restriction . quantitative interpretation: differentiation of benign from malignant lesions can be determined using ADC value as malignant lesions show low ADC value compared to the benign lesions. Apparent diffusion coefficient (ADC) is a descriptive name of the measure of the magnitude of diffusion (of water molecules) within tissue.

Time frame: 1 Year

MRI in detection of metastatic lesions in cancer patients

comparing each sequence of MRI in different organs including T2WI, T1WI and DWI sequences. ? Which is the best for detection and characterization of the Metastatic lesions in different bony and soft tissue in different parts of the body. T2WI \& T1WI are descriptive names of sequences in the MRI study that can be evaluated qualitatively. DWI is a descriptive name of sequences in the MRI study that can be evaluated qualitatively and quantitively through using the ADC value which is a descriptive name of the measure of the magnitude of diffusion (of water molecules) within tissue.

Data from ClinicalTrials.gov

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