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Diffusion-weighted MRI findings of treated and untreated retroperitoneal fibrosis
Lars Kamper1, Alexander Sascha Brandt, Hendrik Ekamp
1Department of Diagnostic and Interventional Radiology, HELIOS Medical Center Wuppertal, University Hospital Witten/Herdecke, Wuppertal, Germany; Center for Clinical Medicine Witten/Herdecke University Faculty of Health, Wuppertal, Germany. lars.kamper@helios-kliniken.de.
Purpose:
We aimed to evaluate diffusion-weighted imaging (DWI) findings in patients with treated and untreated retroperitoneal fibrosis (RPF).
Methods:
We analyzed magnetic resonance imaging examinations of 44 RPF patients (36 male, 8 female), of which 15 were untreated and 29 were under therapy. Qualitative DWI and T1 postcontrast signal intensities and the largest perivascular extent of RPF were compared between treated and untreated groups and correlated to erythrocyte sedimentation rate and C-reactive protein values. Quantitative DWI signal intensities and apparent-diffusion-coefficients were calculated in regions-of-interest, together with a relative index between signal intensities of RPF and psoas muscle in 15 untreated patients and 14 patients under treatment with remaining perivascular fibrosis of more than 5 mm.
Results:
The extent of RPF in untreated patients was significantly larger compared with the extent of RPF in treated patients (P <0.0001). DWI signal intensities were significantly higher in untreated patients than in patients under therapy (mean, 27 s/mm2 vs. 20 s/mm2; P = 0.009). The calculated DWI-index was significantly higher in untreated patients than in patients under therapy (P = 0.003).
Conclusion:
Our data show significant differences in the DWI findings (b800 signal intensities and relative DWI-index) of patients with treated and untreated RPF. DWI is a promising technique in the assessment of disease activity and the selection of patients suitable for medical therapy.
Insights
Diffusion-weighted imaging (DWI) reveals significant differences in treated versus untreated retroperitoneal fibrosis (RPF). DWI can assess disease activity and guide therapy selection in RPF patients.
Area of Science:
- Radiology
- Medical Imaging
- Oncology
Background:
- Retroperitoneal fibrosis (RPF) is a rare condition characterized by inflammatory infiltration and fibrosis in the retroperitoneum.
- Accurate assessment of RPF activity is crucial for guiding treatment decisions and monitoring therapeutic response.
Purpose of the Study:
- To evaluate the utility of diffusion-weighted imaging (DWI) in differentiating between treated and untreated retroperitoneal fibrosis (RPF).
- To assess the correlation between DWI findings and disease activity in RPF patients.
Main Methods:
- Retrospective analysis of MRI examinations in 44 RPF patients (15 untreated, 29 treated).
- Qualitative and quantitative DWI analysis, including signal intensities and apparent diffusion coefficients (ADCs).
- Comparison of DWI findings between treated and untreated groups, correlated with inflammatory markers.
Main Results:
- Untreated RPF showed significantly larger extent and higher DWI signal intensities compared to treated RPF.
- A significantly higher DWI index was observed in untreated patients.
- DWI findings correlated with disease activity and inflammatory markers.
Conclusions:
- DWI effectively distinguishes between treated and untreated RPF, indicating its potential for assessing disease activity.
- DWI may aid in selecting patients who would benefit from medical therapy for RPF.
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