Whole Body MRI at 3T with Quantitative Diffusion Weighted Imaging and Contrast-Enhanced Sequences for the Characterization of Peripheral Lesions in Patients with Neurofibromatosis Type 2 and Schwannomatosis
Purpose. WB-MRI is mainly used for tumor detection and surveillance. The purpose of this study is to establish the feasibility of WB-MRI at 3T for lesion characterization, with DWI/ADC-mapping and contrast-enhanced sequences, in patients with neurofibromatosis type 2 (NF-2) and schwannomatosis. Materials and Methods. At 3T, WB-MRI was performed in 11 subjects (10 NF-2 and 1 schwannomatosis) with STIR, T1, contrast-enhanced T1, and DWI/ADC mapping ( , 400, 800？s/mm2). Two readers reviewed imaging for the presence and character of peripheral lesions. Lesion size and features (signal intensity, heterogeneity, enhancement characteristics, and ADC values) were recorded. Descriptive statistics were reported. Results. Twenty-three lesions were identified, with average size of ？cm. Lesions were characterized as tumors (21/23) or cysts (2/23) by contrast-enhancement properties (enhancement in tumors, no enhancement in cysts). On T1, tumors were homogeneously isointense (5/21) or hypointense (16/21); on STIR, tumors were hyperintense and homogeneous (10/21) or heterogeneous (11/21); on postcontrast T1, tumors enhanced homogeneously (14/21) or heterogeneously (7/21); on DWI, tumor ADC values were variable (range 0.8–2.7), suggesting variability in intrinsic tumor properties. Conclusion. WB-MRI with quantitative DWI and contrast-enhanced sequences at 3T is feasible and advances the utility of WB-MRI not only to include detection, but also to provide additional metrics for lesion characterization. 1. Introduction Whole body magnetic resonance imaging (WB-MRI) has been used for tumor detection in several clinical settings, primarily for cancer staging and the detection of metastatic disease (both visceral and bone metastases) [1–8]. A recent application for WB-MRI includes the detection of peripheral nerve sheath tumors (PNSTs) and the assessment of tumor burden in syndromes with a predominance of multifocal PNSTs, such as the NF syndromes, including NF-1, NF-2, and schwannomatosis (SWN) [9–13]. For such applications, a typical WB-MRI protocol includes noncontrast T1 and short tau inversion recovery (STIR), and has thus far been performed utilizing 1.5 Telsa (T) systems with good diagnostic capability. However, with the development of new therapeutics there is an increasing demand to measure not only size, but also the biologic properties of these tumors. In particular, functional MRI parameters that include molecular, vascular, and metabolic-based measures are available with diffusion weighted imaging (DWI)/apparent diffusion coefficient (ADC) mapping and dynamic
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