Clinical Utility of Diffusion-weighted Whole-body Magnetic Resonance Imaging with Background Body Signal Suppression for Assessing and Monitoring IgG4-related Disease

Overview

Journal Intern Med

Specialty General Medicine

Date 2019 Dec 3

PMID 31787698

Authors

Akira Oshita

Yusuke Kono

Toru Miyoshi

Moeko Suzuki

Takuro Kazatani

Hiroshi Matsuoka

Hideo Kawakami

Affiliations

Soon will be listed here.

Abstract

A 77-year-old man with symptoms of chest pain was diagnosed with immunoglobulin G4 (IgG4)-related disease. Fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) revealed an intense uptake in the submandibular gland, lymph nodes and abdominal aortic wall. Diffusion-weighted imaging with background body signal suppression (DWIBS) revealed signal enhancements at the same location as those of the FDG-PET/CT findings. The DWIBS signal intensity decreased after steroid treatment, so we decreased the steroid dosage. Relapse did not occur. DWIBS makes it possible to adjust the medicine dosage while confirming the therapeutic effects and will likely be a useful method for monitoring IgG4-related disease.

References

Sakamoto A, Tanaka T, Hirano K, Koike K, Komuro I . Immunoglobulin G4-related Coronary Periarteritis and Luminal Stenosis in a Patient with a History of Autoimmune Pancreatitis. Intern Med. 2017; 56(18):2445-2450. PMC: 5643172. DOI: 10.2169/internalmedicine.8259-16. View

Bito Y, Sasaki Y, Hirai H, Hosono M, Nakahira A, Suehiro Y . A surgical case of expanding bilateral coronary aneurysms regarded as immunoglobulin G4-related disease. Circulation. 2014; 129(16):e453-6. DOI: 10.1161/CIRCULATIONAHA.114.008706. View

Tajima M, Hiroi Y, Takazawa Y, Muraoka H, Iwata H, Yamashita H . Immunoglobulin G4-related multiple systemic aneurysms and splenic aneurysm rupture during steroid therapy. Hum Pathol. 2013; 45(1):175-9. DOI: 10.1016/j.humpath.2013.07.035. View

Kusumoto S, Kawano H, Takeno M, Kawahara F, Abe K, Hayashi H . Mass lesions surrounding coronary artery associated with immunoglobulin G4-related disease. J Cardiol Cases. 2018; 5(3):e150-e154. PMC: 6265394. DOI: 10.1016/j.jccase.2012.02.006. View

Masaki Y, Sugai S, Umehara H . IgG4-related diseases including Mikulicz's disease and sclerosing pancreatitis: diagnostic insights. J Rheumatol. 2010; 37(7):1380-5. DOI: 10.3899/jrheum.091153. View

Urabe Y, Fujii T, Kurushima S, Tsujiyama S, Kihara Y . Pigs-in-a-blanket coronary arteries: a case of immunoglobulin G4-related coronary periarteritis assessed by computed tomography coronary angiography, intravascular ultrasound, and positron emission tomography. Circ Cardiovasc Imaging. 2012; 5(5):685-7. DOI: 10.1161/CIRCIMAGING.112.975946. View

Nakanishi K, Kobayashi M, Nakaguchi K, Kyakuno M, Hashimoto N, Onishi H . Whole-body MRI for detecting metastatic bone tumor: diagnostic value of diffusion-weighted images. Magn Reson Med Sci. 2007; 6(3):147-55. DOI: 10.2463/mrms.6.147. View

Mavrogeni S, Markousis-Mavrogenis G, Kolovou G . IgG4-related cardiovascular disease. The emerging role of cardiovascular imaging. Eur J Radiol. 2016; 86:169-175. DOI: 10.1016/j.ejrad.2016.11.012. View

Komiya Y, Soejima M, Tezuka D, Kohsaka H . Early Detection and Intervention of Coronary Artery Involvement in Immunoglobulin G4-related Disease. Intern Med. 2017; 57(4):617-622. PMC: 5849564. DOI: 10.2169/internalmedicine.7816-16. View

10.

Tanigawa J, Daimon M, Murai M, Katsumata T, Tsuji M, Ishizaka N . Immunoglobulin G4-related coronary periarteritis in a patient presenting with myocardial ischemia. Hum Pathol. 2012; 43(7):1131-4. DOI: 10.1016/j.humpath.2011.09.019. View

11.

Takahara T, Imai Y, Yamashita T, Yasuda S, Nasu S, Van Cauteren M . Diffusion weighted whole body imaging with background body signal suppression (DWIBS): technical improvement using free breathing, STIR and high resolution 3D display. Radiat Med. 2004; 22(4):275-82. View

12.

Ito S, Hasuo T, Nimura Y . iMAP™ imaging of tumorous lesions surrounding the coronary arteries in a patient with an elevated serum level of immunoglobulin G4. Heart Vessels. 2016; 31(12):2061-2067. DOI: 10.1007/s00380-016-0852-8. View

13.

Ironi G, Tombetti E, Napolitano A, Campolongo M, Fallanca F, Incerti E . Diffusion-Weighted Magnetic Resonance Imaging Detects Vessel Wall Inflammation in Patients With Giant Cell Arteritis. JACC Cardiovasc Imaging. 2018; 11(12):1879-1882. DOI: 10.1016/j.jcmg.2018.06.015. View

14.

Matsubayashi H, Furukawa H, Maeda A, Matsunaga K, Kanemoto H, Uesaka K . Usefulness of positron emission tomography in the evaluation of distribution and activity of systemic lesions associated with autoimmune pancreatitis. Pancreatology. 2009; 9(5):694-9. DOI: 10.1159/000199439. View

15.

Higashi H, Inaba S, Azuma T, Sumimoto T . Effects of Steroid Therapy for IgG4-related Coronary Periarteritis. Intern Med. 2016; 55(14):1935-6. DOI: 10.2169/internalmedicine.55.6484. View

16.

Matsuda K, Oshita A, Kono Y, Miyoshi T, Kawakami H, Matsuoka H . Intravascular ultrasound findings of immunoglobulin G4-related periarteritis. Cardiovasc Interv Ther. 2019; 34(4):388-389. DOI: 10.1007/s12928-019-00569-x. View

17.

Ikutomi M, Matsumura T, Iwata H, Nishimura G, Ishizaka N, Hirata Y . Giant tumorous lesions (correction of legions) surrounding the right coronary artery associated with immunoglobulin-G4-related systemic disease. Cardiology. 2011; 120(1):22-6. DOI: 10.1159/000332996. View

18.

Stecco A, Romano G, Negru M, Volpe D, Saponaro A, Costantino S . Whole-body diffusion-weighted magnetic resonance imaging in the staging of oncological patients: comparison with positron emission tomography computed tomography (PET-CT) in a pilot study. Radiol Med. 2008; 114(1):1-17. DOI: 10.1007/s11547-008-0348-4. View

19.

Kan-O M, Kado Y, Sadanaga A, Tamiya S, Toyoshima S, Sakamoto M . Immunoglobulin G4-related multiple cardiovascular lesions successfully treated with a combination of open surgery and corticosteroid therapy. J Vasc Surg. 2013; 61(6):1599-603. DOI: 10.1016/j.jvs.2013.10.106. View

20.

Nishimura S, Amano M, Izumi C, Kuroda M, Yoshikawa Y, Takahashi Y . Multiple Coronary Artery Aneurysms and Thoracic Aortitis Associated with IgG4-related Disease. Intern Med. 2016; 55(12):1605-9. DOI: 10.2169/internalmedicine.55.6314. View