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Master Thesis

Apport de la phase hépatobiliaire en IRM pour la détection des métastases hépatiques du mélanome uvéal

Abstract : Aim: to evaluate the sensitivity of the hepatobiliary phase (HBP) in liver MRI for the detection of hepatic metastases of uveal melanoma (HMUM) and re-evaluate the contribution of diffusion-weighted imaging (DWI) with b 800 and b 1000 s/mm2. Materials and methods: seventeen patients with surgical resection of HMUM (n=55) were included. Preoperative MRI sequences included T1, T2, DWI (b=800/1000 s/mm2), T1 post dynamic injection of Multihance®, and HBP. Two radiologists independently reviewed 5 sets of images (T1/T2/dynamics, T1/T2/b800, T1/T2/b1000, T1/T2/HBP, combined). The gold standard was histopathological analysis of surgical specimens. Results: 47% of pigmented lesions showed intrinsic T1 hyperintensity, compared to 8% of achromic lesions (p=0.024). The latter were hypointense on HBP in 62% of cases, compared to 23% of pigmented lesions (p=0.036). The sensitivity of the imaging sets including DWI with b 800, b 1000, and PHB was 65%, 76%, and 55% for reader 1 (R1), and 67%, 80%, and 55% for reader 2 (R2). The sensitivity of the combined set was higher (R1: 84%; R2: 87%) than the other sets (p≤0.002) except for the set including DWI with b 1000 (p=0.125). The latter had a higher sensitivity than the set including the HBP (p≤0.002). Conclusion: HBP does not significantly improve the detection of HMUM mainly because of the pigmentation of most lesions. However, it shows the potential added value of DWI sequences with a high b value of 1000 s/mm2.
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Master Thesis
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Fanny Bonvalet. Apport de la phase hépatobiliaire en IRM pour la détection des métastases hépatiques du mélanome uvéal. Médecine humaine et pathologie. 2019. ⟨dumas-02498261⟩



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