Evaluation of Diffusion-Weighted MRI for Pretherapeutic Assessment and Staging of Lymphoma: Results of a Prospective Study in 140 Patients

To determine the value of diffusion-weighted MRI (DWI-MRI) for pretherapeutic imaging of fluorodeoxyglucose (FDG)-avid lymphoma and lymphoma with variable FDG avidity. Treatment-naïve patients with lymphoma who were referred for whole-body staging were included in this prospective study. Group A inc...

Full description

Saved in:

Bibliographic Details
Published in:	Clinical cancer research 2014-06, Vol.20 (11), p.2984-2993
Main Authors:	MAYERHOEFER, Marius E, KARANIKAS, Georgios, HOFFMANN, Martha, SILLABER, Christian, JAEGER, Ulrich, MÜLLAUER, Leonhard, SIMONITSCH-KLUPP, Ingrid, DOLAK, Werner, GAIGER, Alexander, UBL, Philipp, LUKAS, Julius, RADERER, Markus, KLETTER, Kurt, PROSCH, Helmut, KIESEWETTER, Barbara, SKRABS, Cathrin, PORPACZY, Edit, WEBER, Michael, PINKER-DOMENIG, Katja, BERZACZY, Dominik
Format:	Article
Language:	eng
Subjects:	Adolescent Adult Aged Aged, 80 and over Antineoplastic agents Biological and medical sciences Diffusion Magnetic Resonance Imaging Female Fluorodeoxyglucose F18 Hematologic and hematopoietic diseases Humans Image Interpretation, Computer-Assisted Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis Lymphoma - pathology Male Medical sciences Middle Aged Multimodal Imaging - methods Neoplasm Staging - methods Pharmacology. Drug treatments Positron-Emission Tomography Prospective Studies Radiopharmaceuticals Sensitivity and Specificity Tomography, X-Ray Computed Young Adult
Online Access:	Get full text
Tags:	Add Tag No Tags, Be the first to tag this record!

Description
Summary:	To determine the value of diffusion-weighted MRI (DWI-MRI) for pretherapeutic imaging of fluorodeoxyglucose (FDG)-avid lymphoma and lymphoma with variable FDG avidity. Treatment-naïve patients with lymphoma who were referred for whole-body staging were included in this prospective study. Group A included patients with FDG-avid lymphoma (e.g., Hodgkin, diffuse large B-cell, and follicular lymphoma), whereas Group B included patients with lymphoma of variable FDG avidity [e.g., extranodal marginal zone B-cell lymphoma of the mucosa-associated lymphoid tissue (MALT)]. All patients underwent DWI-MRI and 18F-FDG- positron emission tomography/computed tomography (PET/CT). Region-based sensitivity and agreement with Ann Arbor staging, relative to the reference standard, were calculated for DWI-MRI, and, in Group B, also 18F-FDG-PET/CT and contrast-enhanced (CE-) CT. In Group A (100 patients), DWI-MRI had a region-based sensitivity of 97%, and with regard to staging, agreed with the reference standard in 94 of 100 patients (κ, 0.92). In Group B (40 patients; 38 MALT lymphomas and 2 small lymphocytic lymphomas/chronic lymphocytic leukemias), DWI-MRI, 18F-FDG-PET/CT, and CE-CT had region-based sensitivities of 94.4%, 60.9%, and 70.7%, respectively. With regard to staging in Group B, DWI-MRI, 18F-FDG-PET/CT, and CE-CT agreed with the reference standard in 37 of 40, 26 of 40, and 24 of 40 patients, with κ values of 0.89, 0.52, and 0.43, respectively. In patients with FDG-avid lymphoma, DWI-MRI seems to be only slightly inferior to 18F-FDG-PET/CT with regard to pretherapeutic regional assessment and staging. In patients with lymphoma subtypes that show a variable FDG avidity (e.g., MALT lymphoma), DWI-MRI seems to be superior to both 18F-FDG-PET/CT and CE-CT.
ISSN:	1078-0432 1557-3265