Comparison Between Whole Body Diffusion MRI and FDG PET/CT in Detection of Metastatic Disease | ||||
| International Journal of Medical Arts | ||||
| Articles in Press, Accepted Manuscript, Available Online from 18 June 2025 | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/ijma.2025.383258.2182 | ||||
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| Authors | ||||
Mohamed Shawky Alwarraky; Mohamed Mohamed Houseni; Hazem Omer; Heba ElDesouky Fath Allah 
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| Department of Interventional and Diagnostic Radiology, National Liver Institute, Menoufia University, Shebin-elkom, Menoufia, Egypt. | ||||
| Abstract | ||||
| Background: Technological advancements and continual enhancements in imaging modalities have significantly increased the sensitivity of cancer detection and diagnosis. Among these, 18F-fluorodeoxyglucose positron emission tomography/computed tomography (¹⁸F-FDG PET/CT) is widely regarded as the reference standard for staging the majority of malignancies and evaluating disease distribution, as it provides both functional and anatomical data within a single whole-body examination. In clinical settings where PET/CT is unavailable, conventional cross-sectional imaging techniques such as CT and MRI are typically employed for staging purposes. Aim of the research: to evaluate and compare the diagnostic performance of whole-body diffusion-weighted MRI (WB-DWI) and ¹⁸F-FDG PET/CT in detecting metastatic disease in cases with various primary malignancies. Patients and Methods: a prospective research with 30 cases (aged 18–74 years) with confirmed metastatic lesions originating from different primary tumors underwent WB-DWI within one week of undergoing ¹⁸F-FDG PET/CT, to ensure temporal consistency of imaging data. A consultant radiologist interpreted the MRI findings. For both PET/CT and WB-DWI, diagnostic performance metrics; including overall agreement, sensitivity, specificity, and positive and negative predictive values (NPV) were calculated. Results: The findings demonstrated strong concordance between WB-DWI and ¹⁸F-FDG PET/CT in the detection of hepatic, osseous, peritoneal, and adrenal metastases. Moderate agreement was observed in the identification of pulmonary, lymph nodal, and cerebral metastases. Across all metastatic sites, the mean ADC values were significantly lower than those of corresponding healthy tissues. Conclusion: WB-DWI presents as a viable imaging alternative for the detection of visceral and skeletal metastases in cases with solid tumors, demonstrating diagnostic accuracy similar to that of ¹⁸F-FDG PET/CT. Metastatic lesions consistently exhibit reduced ADC values relative to normal tissues. While WB-DWI shows moderate to good agreement with PET/CT for metastasis detection, the combined application of both modalities enhances diagnostic accuracy and increases the likelihood of identifying additional metastatic sites. | ||||
| Keywords | ||||
| ¹⁸F-FDG PET/CT; Hepatocellular carcinoma; WB-DWMRI; Subtraction MRI-DWI; HCC response | ||||
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