Imaging assessment of malignancy screening using computed tomography and diffusion-weighted whole-body imaging with background body signal suppression in rheumatoid arthritis.

OBJECTIVES

To investigate differences in information obtained from plain computed tomography (CT) and diffusion-weighted whole-body imaging with background body signal suppression (DWIBS) during malignancy screening in patients with rheumatoid arthritis.

METHODS

We enrolled 524 patients with RA who underwent plain CT from the chest to the pelvis and DWIBS. CT and DWIBS were performed within 3 months of each other. Rheumatologists, radiologists, and pulmonologists interpreted the plain CT and DWIBS images.

RESULTS

The prevalence of malignancy was 3.1%. Prostate, lung, breast, uterine, ovarian, and fallopian tube cancers were detected in 7, 4, 2, 1, 1, and 1 patient, respectively. The sensitivities of CT and DWIBS were 75.0% and 93.8%, respectively (P = .333). The specificities of CT and DWIBS were 76.0% and 85.8%, respectively (P < .001). The prevalence rates of interstitial lung disease, colonic diverticula, and kidney stones on CT were 17.6%, 27.1%, and 19.1%, respectively. The prevalence of lymphadenopathy in patients who underwent DWIBS was 3.6%.

CONCLUSION

This study suggests that DWIBS is superior to or equivalent to CT for malignancy screening. Our findings have important implications for imaging-based screening and can help address cancer-related issues in rheumatoid arthritis treatment.