C. Brussaard , L. Faggioni , F.E. Ramirez-Barbosa , M. Vervoort , Y. Jansen , B. Neyns , J. de Mey , I. Willekens , D. Cioni , E. Neri
{"title":"区分皮肤黑色素瘤患者的正常淋巴结和转移淋巴结：基于 DIXON 全身磁共振成像方法的初步研究结果","authors":"C. Brussaard , L. Faggioni , F.E. Ramirez-Barbosa , M. Vervoort , Y. Jansen , B. Neyns , J. de Mey , I. Willekens , D. Cioni , E. Neri","doi":"10.1016/j.ejro.2024.100560","DOIUrl":null,"url":null,"abstract":"<div><h3>Purpose</h3><p>Metastatic melanoma lymph nodes (MMLns) might be challenging to detect on MR-WBI, as both MMLns and normal lymph nodes (NLns) can show restricted water diffusion. Our purpose is to assess the potential contribution of the DIXON sequence in differentiating MMLns from NLns.</p></div><div><h3>Material and methods</h3><p>We followed a cohort of 107 patients with stage IIIb/c and IV skin melanoma for 32 months using MR-WBI with DIXON, STIR, and DWI/ADC sequences. We compared signal intensity (SI) values of MMLns and NLns in the four series of the DIXON sequence (in/out-of-phase, fat_only, and water_only series). The fat fraction (SI<sub>fat_only</sub>/SI<sub>in</sub>) and the long:short axis ratio of MMLns were calculated. The fat fraction was also calculated in the fatty hila of NLns.</p></div><div><h3>Results</h3><p>All MMLns (8 from 7 patients) showed SI<sub>out</sub>>SI<sub>in</sub> with a mean fat fraction of 10%. In 40 normal fatty hila (25 patients), the proportion of SI<sub>out</sub>>SI<sub>in</sub> was 100% and mean fat fraction was 89% (p<0.001 for fat fraction, Mann-Whitney U-test). In the cortex of NLns, a SI<sub>out</sub>>SI<sub>in</sub> pattern was identified in 41/113 cases from 19/40 patients. The median long:short axis ratio in MMLns was 1.13 (range 1.03–1.25).</p></div><div><h3>Conclusion</h3><p>The combination of three features of MMLns (SI<sub>out</sub>>SI<sub>in</sub>, low-fat fraction and rounded shape) might hold promise in differentiating NLns from MMLns in patients with skin melanoma. Further research is warranted due to the small number of MMLns in our cohort.</p></div>","PeriodicalId":38076,"journal":{"name":"European Journal of Radiology Open","volume":null,"pages":null},"PeriodicalIF":1.8000,"publicationDate":"2024-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352047724000157/pdfft?md5=34ff329133c0102b886e5261844da659&pid=1-s2.0-S2352047724000157-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Differentiation between normal and metastatic lymph nodes in patients with skin melanoma: Preliminary findings using a DIXON-based whole-body MRI approach\",\"authors\":\"C. Brussaard , L. Faggioni , F.E. Ramirez-Barbosa , M. Vervoort , Y. Jansen , B. Neyns , J. de Mey , I. Willekens , D. Cioni , E. Neri\",\"doi\":\"10.1016/j.ejro.2024.100560\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Purpose</h3><p>Metastatic melanoma lymph nodes (MMLns) might be challenging to detect on MR-WBI, as both MMLns and normal lymph nodes (NLns) can show restricted water diffusion. Our purpose is to assess the potential contribution of the DIXON sequence in differentiating MMLns from NLns.</p></div><div><h3>Material and methods</h3><p>We followed a cohort of 107 patients with stage IIIb/c and IV skin melanoma for 32 months using MR-WBI with DIXON, STIR, and DWI/ADC sequences. We compared signal intensity (SI) values of MMLns and NLns in the four series of the DIXON sequence (in/out-of-phase, fat_only, and water_only series). The fat fraction (SI<sub>fat_only</sub>/SI<sub>in</sub>) and the long:short axis ratio of MMLns were calculated. The fat fraction was also calculated in the fatty hila of NLns.</p></div><div><h3>Results</h3><p>All MMLns (8 from 7 patients) showed SI<sub>out</sub>>SI<sub>in</sub> with a mean fat fraction of 10%. In 40 normal fatty hila (25 patients), the proportion of SI<sub>out</sub>>SI<sub>in</sub> was 100% and mean fat fraction was 89% (p<0.001 for fat fraction, Mann-Whitney U-test). In the cortex of NLns, a SI<sub>out</sub>>SI<sub>in</sub> pattern was identified in 41/113 cases from 19/40 patients. The median long:short axis ratio in MMLns was 1.13 (range 1.03–1.25).</p></div><div><h3>Conclusion</h3><p>The combination of three features of MMLns (SI<sub>out</sub>>SI<sub>in</sub>, low-fat fraction and rounded shape) might hold promise in differentiating NLns from MMLns in patients with skin melanoma. Further research is warranted due to the small number of MMLns in our cohort.</p></div>\",\"PeriodicalId\":38076,\"journal\":{\"name\":\"European Journal of Radiology Open\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.8000,\"publicationDate\":\"2024-03-19\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.sciencedirect.com/science/article/pii/S2352047724000157/pdfft?md5=34ff329133c0102b886e5261844da659&pid=1-s2.0-S2352047724000157-main.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"European Journal of Radiology Open\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2352047724000157\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Journal of Radiology Open","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2352047724000157","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
Differentiation between normal and metastatic lymph nodes in patients with skin melanoma: Preliminary findings using a DIXON-based whole-body MRI approach
Purpose
Metastatic melanoma lymph nodes (MMLns) might be challenging to detect on MR-WBI, as both MMLns and normal lymph nodes (NLns) can show restricted water diffusion. Our purpose is to assess the potential contribution of the DIXON sequence in differentiating MMLns from NLns.
Material and methods
We followed a cohort of 107 patients with stage IIIb/c and IV skin melanoma for 32 months using MR-WBI with DIXON, STIR, and DWI/ADC sequences. We compared signal intensity (SI) values of MMLns and NLns in the four series of the DIXON sequence (in/out-of-phase, fat_only, and water_only series). The fat fraction (SIfat_only/SIin) and the long:short axis ratio of MMLns were calculated. The fat fraction was also calculated in the fatty hila of NLns.
Results
All MMLns (8 from 7 patients) showed SIout>SIin with a mean fat fraction of 10%. In 40 normal fatty hila (25 patients), the proportion of SIout>SIin was 100% and mean fat fraction was 89% (p<0.001 for fat fraction, Mann-Whitney U-test). In the cortex of NLns, a SIout>SIin pattern was identified in 41/113 cases from 19/40 patients. The median long:short axis ratio in MMLns was 1.13 (range 1.03–1.25).
Conclusion
The combination of three features of MMLns (SIout>SIin, low-fat fraction and rounded shape) might hold promise in differentiating NLns from MMLns in patients with skin melanoma. Further research is warranted due to the small number of MMLns in our cohort.
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