10のキーポイントでDWIBSの歴史を振り返る

Whole body DWI revisited

DWIBS（diffusion-weighted whole body imaging with background suppression）法による，体幹部全体の拡散強調像を初めて学会発表したのは，2004年4月の日本医学放射線学会である。3日間の会期を通して画像を見ていただきたかったため，口演発表ではなくあえてposter展示とした。

14 years has passed since initial report of DWIBS. In this presentation, we will revisit 10 key points in development history, and think future clinical application of DWIBS. The concept of DWIBS has been established in 2004 under technical support of Dr. Marc Van Cauteren（Philips）and direction of Prof. Yutaka Imai. In the primary phase, we could not conduct whole body scan accurately. This inconvenience was solved by the effort of Mr. Tetsuro Sakamoto（Philips）about table sliding method. Also, Total Imaging Matrix（TIM）concept（Siemens）and Mobiview（Philips）contributed easy whole body acquisition and easy merge of images throughout of the different stations. This kind of（mainly）domestic effort and technique has been widely spread internationally with considerable amount of English papers by great support of Dr. Thomas Kwee（Utrecht University）. Then “Body DWI meeting” has been established and standard protocol was proposed and improved by enthusiastic technicians every half year. Diagnostic clue such as differentiation of red bone marrow and metastasis has been established by Dr. Kazuhiro Katahira（Kumamoto City Hospital）and Dr. Katsuyuki Nakanishi. Fusion technique（between DWI and anatomical images）was developed and spreading. Image quality at 3T was not satisfactory in the initial phase, but recently it is going to solve by water excitation（GE）and SSGR. Last year, automatic window setting throughout the stations（Ziosoft）, and quantitative analysis software（PixSpace, AZE）was developd. European guideline put WB-DWI method as the first choice of evaluation of therapeutic response, and the concept of MET-RADS-P（imaging interpretation guideline）has been proposed. Official request of increase of reimbursement for WB-DWI scan has been proposed from JRS to the government.