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Lambert L, Burgetova A, Trneny M, Bircakova B, Molinsky J, Benesova K, Zogala D, Michalek P. The diagnostic performance of whole-body MRI in the staging of lymphomas in adult patients compared to PET/CT and enhanced reference standard-systematic review and meta-analysis. Quant Imaging Med Surg 2022; 12:1558-1570. [PMID: 35111648 DOI: 10.21037/qims-21-649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Accepted: 09/26/2021] [Indexed: 11/06/2022]
Abstract
BACKGROUND Morphology highlighted by diffusion weighted imaging (DWI) is the basis of whole-body MRI (wbMRI). The aim of this study was to analyze current knowledge on the diagnostic performance of wbMRI in the pretreatment staging of patients with lymphoma. METHODS A search for original articles reporting the diagnostic performance (sensitivity, specificity) of pretreatment (first staging or staging in relapsed patients after complete remission) wbMRI in nodal and extranodal involvement by extracranial lymphoma and the agreement of stage by the Cotswolds-modified Ann Arbor classification in adult patients compared to the reference standard (PET/CT or enhanced reference standard) was conducted in PubMed, EMBASE, Cochrane Library, ClinicalTrials.gov. RESULTS Altogether 15 studies with 519 patients were included in the meta-analysis. The pooled sensitivity and specificity for nodal involvement were 0.93 (95% CI: 0.90 to 0.96) and 0.99 (95% CI: 0.98 to 1.00). For nodal staging, most studies used the size criterion of 10 mm in the short diameter (n=10) and the absence of prominent fatty hilum (n=4). Restricted diffusion on diffusion-weighted imaging as a sign of nodal involvement was either not used (n=5), used for detection (n=4), semi-quantitatively (n=4), or quantitatively (n=1). Only one study (7) relied solely on restricted diffusion as the main criterion for nodal involvement. The pooled sensitivity and specificity for extranodal involvement were 0.89 (95% CI: 0.79 to 0.98) and 0.99 (95% CI: 0.99 to 1.00). Seven studies considered diffuse splenic involvement when its long or vertical axis was greater than 13 cm regardless of the patient's physiognomy. The pooled agreement in staging (Cohen's kappa) was almost perfect (0.90, 95% CI: 0.84 to 0.95). DISCUSSION The sensitivity and specificity of wbMRI in the assessment of the nodal and extranodal involvement by lymphoma is high. The agreement of wbMRI with the reference standard is almost perfect.
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Affiliation(s)
- Lukas Lambert
- Department of Radiology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Andrea Burgetova
- Department of Radiology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Marek Trneny
- Department of Hematology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Bianka Bircakova
- Department of Radiology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Jan Molinsky
- Department of Hematology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Katerina Benesova
- Department of Hematology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - David Zogala
- Institute of Nuclear Medicine, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Pavel Michalek
- Department of Anaesthesiology, Resuscitation and Intensive Medicine, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
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Petralia G, Koh DM, Attariwala R, Busch JJ, Eeles R, Karow D, Lo GG, Messiou C, Sala E, Vargas HA, Zugni F, Padhani AR. Oncologically Relevant Findings Reporting and Data System (ONCO-RADS): Guidelines for the Acquisition, Interpretation, and Reporting of Whole-Body MRI for Cancer Screening. Radiology 2021; 299:494-507. [PMID: 33904776 DOI: 10.1148/radiol.2021201740] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Acknowledging the increasing number of studies describing the use of whole-body MRI for cancer screening, and the increasing number of examinations being performed in patients with known cancers, an international multidisciplinary expert panel of radiologists and a geneticist with subject-specific expertise formulated technical acquisition standards, interpretation criteria, and limitations of whole-body MRI for cancer screening in individuals at higher risk, including those with cancer predisposition syndromes. The Oncologically Relevant Findings Reporting and Data System (ONCO-RADS) proposes a standard protocol for individuals at higher risk, including those with cancer predisposition syndromes. ONCO-RADS emphasizes structured reporting and five assessment categories for the classification of whole-body MRI findings. The ONCO-RADS guidelines are designed to promote standardization and limit variations in the acquisition, interpretation, and reporting of whole-body MRI scans for cancer screening. Published under a CC BY 4.0 license Online supplemental material is available for this article.
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Affiliation(s)
- Giuseppe Petralia
- From the Precision Imaging and Research Unit, Department of Medical Imaging and Radiation Sciences (G.P.), and Department of Radiology (F.Z.), IEO European Institute of Oncology IRCCS, Via Giuseppe Ripamonti 435, 20141 Milan, Italy; Department of Oncology and Hemato-Oncology, University of Milan, Italy (G.P.); Department of Radiology, Royal Marsden Hospital and Institute of Cancer Research, Sutton, England (D.M.K., C.M.); AIM Medical Imaging, Vancouver, Canada (R.A.); Busch Center, Alpharetta, Ga (J.J.B.); The Institute of Cancer Research and Royal Marsden NHS Foundation Trust, London, England (R.E.); Human Longevity, San Diego, Calif (D.K.); Department of Diagnostic & Interventional Radiology, Hong Kong Sanatorium & Hospital, Hong Kong (G.G.L.); Department of Radiology and Cancer Research, UK Cambridge Center, Cambridge, England (E.S.); Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY (H.A.V.); and Paul Strickland Scanner Centre, Northwood, England (A.R.P.)
| | - Dow-Mu Koh
- From the Precision Imaging and Research Unit, Department of Medical Imaging and Radiation Sciences (G.P.), and Department of Radiology (F.Z.), IEO European Institute of Oncology IRCCS, Via Giuseppe Ripamonti 435, 20141 Milan, Italy; Department of Oncology and Hemato-Oncology, University of Milan, Italy (G.P.); Department of Radiology, Royal Marsden Hospital and Institute of Cancer Research, Sutton, England (D.M.K., C.M.); AIM Medical Imaging, Vancouver, Canada (R.A.); Busch Center, Alpharetta, Ga (J.J.B.); The Institute of Cancer Research and Royal Marsden NHS Foundation Trust, London, England (R.E.); Human Longevity, San Diego, Calif (D.K.); Department of Diagnostic & Interventional Radiology, Hong Kong Sanatorium & Hospital, Hong Kong (G.G.L.); Department of Radiology and Cancer Research, UK Cambridge Center, Cambridge, England (E.S.); Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY (H.A.V.); and Paul Strickland Scanner Centre, Northwood, England (A.R.P.)
| | - Raj Attariwala
- From the Precision Imaging and Research Unit, Department of Medical Imaging and Radiation Sciences (G.P.), and Department of Radiology (F.Z.), IEO European Institute of Oncology IRCCS, Via Giuseppe Ripamonti 435, 20141 Milan, Italy; Department of Oncology and Hemato-Oncology, University of Milan, Italy (G.P.); Department of Radiology, Royal Marsden Hospital and Institute of Cancer Research, Sutton, England (D.M.K., C.M.); AIM Medical Imaging, Vancouver, Canada (R.A.); Busch Center, Alpharetta, Ga (J.J.B.); The Institute of Cancer Research and Royal Marsden NHS Foundation Trust, London, England (R.E.); Human Longevity, San Diego, Calif (D.K.); Department of Diagnostic & Interventional Radiology, Hong Kong Sanatorium & Hospital, Hong Kong (G.G.L.); Department of Radiology and Cancer Research, UK Cambridge Center, Cambridge, England (E.S.); Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY (H.A.V.); and Paul Strickland Scanner Centre, Northwood, England (A.R.P.)
| | - Joseph J Busch
- From the Precision Imaging and Research Unit, Department of Medical Imaging and Radiation Sciences (G.P.), and Department of Radiology (F.Z.), IEO European Institute of Oncology IRCCS, Via Giuseppe Ripamonti 435, 20141 Milan, Italy; Department of Oncology and Hemato-Oncology, University of Milan, Italy (G.P.); Department of Radiology, Royal Marsden Hospital and Institute of Cancer Research, Sutton, England (D.M.K., C.M.); AIM Medical Imaging, Vancouver, Canada (R.A.); Busch Center, Alpharetta, Ga (J.J.B.); The Institute of Cancer Research and Royal Marsden NHS Foundation Trust, London, England (R.E.); Human Longevity, San Diego, Calif (D.K.); Department of Diagnostic & Interventional Radiology, Hong Kong Sanatorium & Hospital, Hong Kong (G.G.L.); Department of Radiology and Cancer Research, UK Cambridge Center, Cambridge, England (E.S.); Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY (H.A.V.); and Paul Strickland Scanner Centre, Northwood, England (A.R.P.)
| | - Ros Eeles
- From the Precision Imaging and Research Unit, Department of Medical Imaging and Radiation Sciences (G.P.), and Department of Radiology (F.Z.), IEO European Institute of Oncology IRCCS, Via Giuseppe Ripamonti 435, 20141 Milan, Italy; Department of Oncology and Hemato-Oncology, University of Milan, Italy (G.P.); Department of Radiology, Royal Marsden Hospital and Institute of Cancer Research, Sutton, England (D.M.K., C.M.); AIM Medical Imaging, Vancouver, Canada (R.A.); Busch Center, Alpharetta, Ga (J.J.B.); The Institute of Cancer Research and Royal Marsden NHS Foundation Trust, London, England (R.E.); Human Longevity, San Diego, Calif (D.K.); Department of Diagnostic & Interventional Radiology, Hong Kong Sanatorium & Hospital, Hong Kong (G.G.L.); Department of Radiology and Cancer Research, UK Cambridge Center, Cambridge, England (E.S.); Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY (H.A.V.); and Paul Strickland Scanner Centre, Northwood, England (A.R.P.)
| | - David Karow
- From the Precision Imaging and Research Unit, Department of Medical Imaging and Radiation Sciences (G.P.), and Department of Radiology (F.Z.), IEO European Institute of Oncology IRCCS, Via Giuseppe Ripamonti 435, 20141 Milan, Italy; Department of Oncology and Hemato-Oncology, University of Milan, Italy (G.P.); Department of Radiology, Royal Marsden Hospital and Institute of Cancer Research, Sutton, England (D.M.K., C.M.); AIM Medical Imaging, Vancouver, Canada (R.A.); Busch Center, Alpharetta, Ga (J.J.B.); The Institute of Cancer Research and Royal Marsden NHS Foundation Trust, London, England (R.E.); Human Longevity, San Diego, Calif (D.K.); Department of Diagnostic & Interventional Radiology, Hong Kong Sanatorium & Hospital, Hong Kong (G.G.L.); Department of Radiology and Cancer Research, UK Cambridge Center, Cambridge, England (E.S.); Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY (H.A.V.); and Paul Strickland Scanner Centre, Northwood, England (A.R.P.)
| | - Gladys G Lo
- From the Precision Imaging and Research Unit, Department of Medical Imaging and Radiation Sciences (G.P.), and Department of Radiology (F.Z.), IEO European Institute of Oncology IRCCS, Via Giuseppe Ripamonti 435, 20141 Milan, Italy; Department of Oncology and Hemato-Oncology, University of Milan, Italy (G.P.); Department of Radiology, Royal Marsden Hospital and Institute of Cancer Research, Sutton, England (D.M.K., C.M.); AIM Medical Imaging, Vancouver, Canada (R.A.); Busch Center, Alpharetta, Ga (J.J.B.); The Institute of Cancer Research and Royal Marsden NHS Foundation Trust, London, England (R.E.); Human Longevity, San Diego, Calif (D.K.); Department of Diagnostic & Interventional Radiology, Hong Kong Sanatorium & Hospital, Hong Kong (G.G.L.); Department of Radiology and Cancer Research, UK Cambridge Center, Cambridge, England (E.S.); Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY (H.A.V.); and Paul Strickland Scanner Centre, Northwood, England (A.R.P.)
| | - Christina Messiou
- From the Precision Imaging and Research Unit, Department of Medical Imaging and Radiation Sciences (G.P.), and Department of Radiology (F.Z.), IEO European Institute of Oncology IRCCS, Via Giuseppe Ripamonti 435, 20141 Milan, Italy; Department of Oncology and Hemato-Oncology, University of Milan, Italy (G.P.); Department of Radiology, Royal Marsden Hospital and Institute of Cancer Research, Sutton, England (D.M.K., C.M.); AIM Medical Imaging, Vancouver, Canada (R.A.); Busch Center, Alpharetta, Ga (J.J.B.); The Institute of Cancer Research and Royal Marsden NHS Foundation Trust, London, England (R.E.); Human Longevity, San Diego, Calif (D.K.); Department of Diagnostic & Interventional Radiology, Hong Kong Sanatorium & Hospital, Hong Kong (G.G.L.); Department of Radiology and Cancer Research, UK Cambridge Center, Cambridge, England (E.S.); Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY (H.A.V.); and Paul Strickland Scanner Centre, Northwood, England (A.R.P.)
| | - Evis Sala
- From the Precision Imaging and Research Unit, Department of Medical Imaging and Radiation Sciences (G.P.), and Department of Radiology (F.Z.), IEO European Institute of Oncology IRCCS, Via Giuseppe Ripamonti 435, 20141 Milan, Italy; Department of Oncology and Hemato-Oncology, University of Milan, Italy (G.P.); Department of Radiology, Royal Marsden Hospital and Institute of Cancer Research, Sutton, England (D.M.K., C.M.); AIM Medical Imaging, Vancouver, Canada (R.A.); Busch Center, Alpharetta, Ga (J.J.B.); The Institute of Cancer Research and Royal Marsden NHS Foundation Trust, London, England (R.E.); Human Longevity, San Diego, Calif (D.K.); Department of Diagnostic & Interventional Radiology, Hong Kong Sanatorium & Hospital, Hong Kong (G.G.L.); Department of Radiology and Cancer Research, UK Cambridge Center, Cambridge, England (E.S.); Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY (H.A.V.); and Paul Strickland Scanner Centre, Northwood, England (A.R.P.)
| | - Hebert A Vargas
- From the Precision Imaging and Research Unit, Department of Medical Imaging and Radiation Sciences (G.P.), and Department of Radiology (F.Z.), IEO European Institute of Oncology IRCCS, Via Giuseppe Ripamonti 435, 20141 Milan, Italy; Department of Oncology and Hemato-Oncology, University of Milan, Italy (G.P.); Department of Radiology, Royal Marsden Hospital and Institute of Cancer Research, Sutton, England (D.M.K., C.M.); AIM Medical Imaging, Vancouver, Canada (R.A.); Busch Center, Alpharetta, Ga (J.J.B.); The Institute of Cancer Research and Royal Marsden NHS Foundation Trust, London, England (R.E.); Human Longevity, San Diego, Calif (D.K.); Department of Diagnostic & Interventional Radiology, Hong Kong Sanatorium & Hospital, Hong Kong (G.G.L.); Department of Radiology and Cancer Research, UK Cambridge Center, Cambridge, England (E.S.); Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY (H.A.V.); and Paul Strickland Scanner Centre, Northwood, England (A.R.P.)
| | - Fabio Zugni
- From the Precision Imaging and Research Unit, Department of Medical Imaging and Radiation Sciences (G.P.), and Department of Radiology (F.Z.), IEO European Institute of Oncology IRCCS, Via Giuseppe Ripamonti 435, 20141 Milan, Italy; Department of Oncology and Hemato-Oncology, University of Milan, Italy (G.P.); Department of Radiology, Royal Marsden Hospital and Institute of Cancer Research, Sutton, England (D.M.K., C.M.); AIM Medical Imaging, Vancouver, Canada (R.A.); Busch Center, Alpharetta, Ga (J.J.B.); The Institute of Cancer Research and Royal Marsden NHS Foundation Trust, London, England (R.E.); Human Longevity, San Diego, Calif (D.K.); Department of Diagnostic & Interventional Radiology, Hong Kong Sanatorium & Hospital, Hong Kong (G.G.L.); Department of Radiology and Cancer Research, UK Cambridge Center, Cambridge, England (E.S.); Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY (H.A.V.); and Paul Strickland Scanner Centre, Northwood, England (A.R.P.)
| | - Anwar R Padhani
- From the Precision Imaging and Research Unit, Department of Medical Imaging and Radiation Sciences (G.P.), and Department of Radiology (F.Z.), IEO European Institute of Oncology IRCCS, Via Giuseppe Ripamonti 435, 20141 Milan, Italy; Department of Oncology and Hemato-Oncology, University of Milan, Italy (G.P.); Department of Radiology, Royal Marsden Hospital and Institute of Cancer Research, Sutton, England (D.M.K., C.M.); AIM Medical Imaging, Vancouver, Canada (R.A.); Busch Center, Alpharetta, Ga (J.J.B.); The Institute of Cancer Research and Royal Marsden NHS Foundation Trust, London, England (R.E.); Human Longevity, San Diego, Calif (D.K.); Department of Diagnostic & Interventional Radiology, Hong Kong Sanatorium & Hospital, Hong Kong (G.G.L.); Department of Radiology and Cancer Research, UK Cambridge Center, Cambridge, England (E.S.); Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY (H.A.V.); and Paul Strickland Scanner Centre, Northwood, England (A.R.P.)
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Direct comparison of diagnostic accuracies of F-18 FDG PET and MRI for detection of bone marrow involvement in lymphoma patients; A meta-analysis. Leuk Res 2020; 99:106475. [PMID: 33189988 DOI: 10.1016/j.leukres.2020.106475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 10/26/2020] [Accepted: 11/01/2020] [Indexed: 11/23/2022]
Abstract
BACKGROUND The purpose of the current study was to compare the diagnostic accuracies of F-18 FDG PET or PET/CT and MRI for detection of bone marrow involvement (BMI) in lymphoma patients through a systematic review and meta-analysis. METHODS AND MATERIALS The PubMed, Cochrane database, and EMBASE database, from the earliest available date of indexing through July 31, 2020, were searched for studies evaluating direct comparison of diagnostic performance of F-18 FDG PET or PET/CT and MRI for BMI in lymphoma patients. We determined the sensitivities and specificities across studies, calculated positive and negative likelihood ratios (LR + and LR-), and constructed summary receiver operating characteristic curves. RESULTS Across 5 studies (212 patients), the pooled sensitivity of F-18 FDG PET or PET/CT was 0.65 (95 % CI; 0.42-0.82) a pooled specificity of 0.90 (95 % CI; 0.85-0.94). Likelihood ratio (LR) syntheses gave an overall positive likelihood ratio (LR+) of 6.4 (95 % CI; 3.3-12.4) and negative likelihood ratio (LR-) of 0.39 (95 % CI; 0.21-0.73). The pooled DOR was 16 (95 % CI; 5-56). The pooled sensitivity of MRI was 0.78 (95 % CI; 0.55-0.91) and a pooled specificity of 0.86 (95 % CI; 0.67-0.95). Likelihood ratio (LR) syntheses gave an overall positive likelihood ratio (LR+) of 5.6 (95 % CI; 1.8-17.0) and negative likelihood ratio (LR-) of 0.26 (95 % CI; 0.1-0.65). The pooled DOR was 22 (95 % CI; 3-149). In meta-regression analysis, no variable was the source of the study heterogeneity. CONCLUSION F-18 FDG PET or PET/CT and MRI showed similar diagnostic performances for the detection of BMI in lymphoma patients. Further large multicenter studies would be necessary to substantiate the diagnostic accuracy of F-18 FDG PET or PET/CT and MRI for the diagnosis of BMI in lymphoma patients.
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Yoon JH, Yu MH, Hur BY, Park CM, Lee JM. Detection of distant metastases in rectal cancer: contrast-enhanced CT vs whole body MRI. Eur Radiol 2020; 31:104-111. [PMID: 32789755 DOI: 10.1007/s00330-020-07149-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 06/16/2020] [Accepted: 08/05/2020] [Indexed: 12/13/2022]
Abstract
OBJECTIVES To evaluate the diagnostic performance of whole-body MRI (WB-MRI) including contrast-enhanced T1-weighted imaging (T1WI) and WB-DWI in rectal cancer initial staging. METHODS This retrospective study was approved by the IRB and the requirement of informed consent was waived. From September 2013 to Feb 2015, patients who underwent rectal MRI including WB-MRI, as well as chest and abdominopelvic CT for initial staging, were included. WB-MRI consisted of contrast-enhanced T1-weighted imaging and DWI covering neck to the pelvis. Three radiologists reviewed WB-MRI and CECT independently for the M-classification. The diagnostic performance of CECT and WB-MRI was compared using a reference standard incorporating histology, FDG-PET results, and clinical follow-up. RESULTS A total of 139 patients (male:female = 89:50, mean age 63.2 ± 12.4 years) were included and metastasis was observed in 15.2% (21/139). WB-MRI showed significantly higher specificity (96.7% [114/118] vs. 85.6% [101/118], p = 0.001) and positive predictive value (PPV) (80% [16/20] vs. 48.5% [16/33], p < 0.001) than CECT. However, there were no significant differences in sensitivity (76.2% [16/21] for both, p > 0.99) and negative predictive value (95.3% [101/106] at CECT vs. 95.8% [114/119] at WB-MRI, p = 0.77) between CECT and WB-MRI. CONCLUSIONS WB-MRI showed higher specificity and PPV than CECT in newly diagnosed rectal cancer. Adding WB-MRI to standard rectal MRI is a feasible option for initial staging workup of rectal cancer. KEY POINTS • WB-MRI showed a higher specificity and PPV than those of CECT for identifying metastasis at initial staging workup of rectal cancer. • WB-MRI and CECT did not show a significant difference in sensitivity and NPV for the M-classification. • WB-MRI can be used as an alternative to CECT for the initial M-classification modality in newly diagnosed rectal cancer.
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Affiliation(s)
- Jeong Hee Yoon
- Radiology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.,College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.,Institute of Radiation Medicine, Seoul National University Medical Research Center, 103 Daehak-ro, Jongno-gu, Seoul, 03087, Republic of Korea
| | - Mi Hye Yu
- Radiology, Radiology Department, Konkuk University School of Medicine, Seoul, 05030, Republic of Korea
| | - Bo Yun Hur
- Radiology, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, 06236, Republic of Korea
| | - Chang Min Park
- Radiology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.,College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.,Institute of Radiation Medicine, Seoul National University Medical Research Center, 103 Daehak-ro, Jongno-gu, Seoul, 03087, Republic of Korea
| | - Jeong Min Lee
- Radiology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea. .,College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea. .,Department of Radiology and Institute of Radiation Medicine, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
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Use of Magnetic Resonance Imaging in the Evaluation of Mediastinal and Systemic Disease in Lymphoma. A Systematic Review. OPEN RESPIRATORY ARCHIVES 2020. [DOI: 10.1016/j.opresp.2020.03.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Diffusion-Weighted Imaging in Oncology: An Update. Cancers (Basel) 2020; 12:cancers12061493. [PMID: 32521645 PMCID: PMC7352852 DOI: 10.3390/cancers12061493] [Citation(s) in RCA: 91] [Impact Index Per Article: 22.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 05/28/2020] [Accepted: 06/01/2020] [Indexed: 02/06/2023] Open
Abstract
To date, diffusion weighted imaging (DWI) is included in routine magnetic resonance imaging (MRI) protocols for several cancers. The real additive role of DWI lies in the "functional" information obtained by probing the free diffusivity of water molecules into intra and inter-cellular spaces that in tumors mainly depend on cellularity. Although DWI has not gained much space in some oncologic scenarios, this non-invasive tool is routinely used in clinical practice and still remains a hot research topic: it has been tested in almost all cancers to differentiate malignant from benign lesions, to distinguish different malignant histotypes or tumor grades, to predict and/or assess treatment responses, and to identify residual or recurrent tumors in follow-up examinations. In this review, we provide an up-to-date overview on the application of DWI in oncology.
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Sivesgaard K, Larsen LP, Sørensen M, Kramer S, Schlander S, Amanavicius N, Mortensen FV, Pedersen EM. Whole-body MRI added to gadoxetic acid-enhanced liver MRI for detection of extrahepatic disease in patients considered eligible for hepatic resection and/or local ablation of colorectal cancer liver metastases. Acta Radiol 2020; 61:156-167. [PMID: 31189329 DOI: 10.1177/0284185119855184] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Background Fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) can detect extrahepatic disease before local treatment of colorectal liver metastases. Purpose To investigate if whole-body magnetic resonance imaging (MRI) added to gadoxetic acid liver MRI could replace FDG-PET/CT for detection of extrahepatic disease in patients with colorectal liver metastases eligible for hepatic local treatment. Material and Methods This health-research-ethics-committee-approved prospective consecutive diagnostic accuracy study with written informed consent analyzed 79 cases included between 29 June 2015 and 7 February 2017. Whole-body MRI covering the thorax, abdomen, and pelvis and FDG-PET/CT including contrast-enhanced CT was performed 0–3 days before local treatment of liver metastases. Whole-body MR images were read independently by two readers. FDG-PET/CT images were read independently by two pairs of readers. Histopathology and follow-up imaging were used as reference standard. Sensitivities and specificities were calculated and compared including noninferiority analysis. Results Seventy-five malignant lesions and 419 benign lesions were confirmed. Sensitivities of both PET/CT reader pairs 1 and 2 (56.7 and 67.9%) and MRI reader 2 (63.0%) were significantly higher than that of MRI reader 1 (42.7) (P<0.04). Specificities of both PET/CT reader pairs 1 and 2 (92.5 and 92.4%) and MRI reader 1 (91.1%) were significantly higher than that of MRI reader 2 (86.3%) ( P < 0.02). Sensitivity of MRI reader 2 was non-inferior compared to PET/CT reader pair 1. Specificities of both MRI readers were non-inferior to both PET/CT reader pairs. Conclusion For detection of extrahepatic disease in patients with colorectal liver metastases, whole-body MRI was non-inferior to FDG-PET/CT for some reader combinations. However, reader-independent non-inferiority could not be demonstrated.
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Affiliation(s)
- Kim Sivesgaard
- Department of Radiology, Aarhus University Hospital, Aarhus, Denmark
| | - Lars P Larsen
- Department of Radiology, Aarhus University Hospital, Aarhus, Denmark
| | - Michael Sørensen
- Department of Hepatology & Gastroenterology, Aarhus University Hospital, Aarhus, Denmark
- Department of Nuclear Medicine & PET Center, Aarhus University Hospital, Aarhus, Denmark
| | - Stine Kramer
- Department of Nuclear Medicine & PET Center, Aarhus University Hospital, Aarhus, Denmark
| | - Sven Schlander
- Department of Radiology, Aarhus University Hospital, Aarhus, Denmark
| | | | - Frank V Mortensen
- Department of Surgery, Section for Upper Gastrointestinal and Hepato-pancreato-biliary Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - Erik M Pedersen
- Department of Radiology, Aarhus University Hospital, Aarhus, Denmark
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Winzer R, Hoberück S, Zöphel K, Kotzerke J, Brauer T, Hoffmann RT, Platzek I. Diffusion-weighted MRI for initial staging in Hodgkin`s lymphoma: comparison with FDG PET. Eur J Radiol 2019; 123:108775. [PMID: 31864143 DOI: 10.1016/j.ejrad.2019.108775] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 10/27/2019] [Accepted: 12/02/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE To evaluate the use of diffusion-weighted MRI (DWI) for initial staging of Hodgkin`s lymphoma and compare it to FDG PET. METHODS Forty-one patients with Hodgkin`s lymphoma (14 f, 27 m, median age 39 y) were included in this retrospective study. All patients underwent FDG PET/MR for initial staging, including DWI. The Lugano classification was used to describe disease extent. A combination of follow-up imaging and histopathology served as the reference standard. Method agreement was assessed using weighted kappa (κ). The accuracy of the imaging methods was evaluated using ROC curve analysis. RESULTS Regarding the Lugano stage, DWI and FDG PET had identical results in 34/41 cases (κ = 0.77). Sensitivity and specificity for nodal involvement was 89.9% and 93.8% for DWI, and 93.8% and 86.9% for FDG PET, respectively. In regard to extranodal involvement, sensitivity and specificity were 88.5% and 99.3% for DWI and 92.3% and 92.7% for FDG PET. The accuracy of both methods for nodal (p = 0.06) and extranodal involvement (p = 0.66) did not differ significantly. CONCLUSION Despite high sensitivity and specificity, DWI in free breathing cannot be currently recommended as an alternative to FDG PET in initial staging of Hodgkin`s lymphoma due to substantial differences in regard to therapy-determining Lugano Stage.
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Affiliation(s)
- Robert Winzer
- Dresden University Hospital, Department of Radiology, Fetscherstr. 74, 01307 Dresden, Germany.
| | - Sebastian Hoberück
- Dresden University Hospital, Department of Nuclear Medicine, Fetscherstr. 74, 01307 Dresden, Germany
| | - Klaus Zöphel
- Dresden University Hospital, Department of Nuclear Medicine, Fetscherstr. 74, 01307 Dresden, Germany
| | - Jörg Kotzerke
- Dresden University Hospital, Department of Nuclear Medicine, Fetscherstr. 74, 01307 Dresden, Germany
| | - Thomas Brauer
- Dresden University Hospital, Department of Radiology, Fetscherstr. 74, 01307 Dresden, Germany
| | - Ralf-Thorsten Hoffmann
- Dresden University Hospital, Department of Radiology, Fetscherstr. 74, 01307 Dresden, Germany
| | - Ivan Platzek
- Dresden University Hospital, Department of Radiology, Fetscherstr. 74, 01307 Dresden, Germany
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9
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Baranska D, Matera K, Podgorski M, Gorska-Chrzastek M, Krajewska K, Trelinska J, Grzelak P. Feasibility of diffusion-weighted imaging with DWIBS in staging Hodgkin lymphoma in pediatric patients: comparison with PET/CT. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2018; 32:381-390. [PMID: 30498885 PMCID: PMC6525117 DOI: 10.1007/s10334-018-0726-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 11/20/2018] [Accepted: 11/22/2018] [Indexed: 12/17/2022]
Abstract
Objective The aim of the study was to evaluate feasibility of diffusion-weighted whole-body imaging with background body signal suppression (DWIBS) method in diagnosing Hodgkin lymphoma in pediatric patients and to compare it with 18F-FDG PET/CT as a gold standard. Materials and methods Eleven patients (median age 14) with newly diagnosed Hodgkin lymphoma were examined with 18F-FDG PET/CT and MRI including whole-body DWIBS sequence (b = 0, 800 s/mm2), before the oncologic treatment. About 26 locations of lymphatic tissues were evaluated visually and quantitatively using ADCmean (DWIBS) and SUVmax (18F-FDG PET/CT), respectively. Results All affected lymph node regions (n = 134) diagnosed in 18F-FDG PET/CT were found with DWIBS, presenting decreased diffusion. Significant correlation was found between ADC and SUV values (R2 = − 0.37; p = 0.0001). Nevertheless, additional 33 regions were recognized only by DWIBS. They were significantly smaller than regions diagnosed by both methods. Discussion Agreement between DWIBS and 18F-FDG PET/CT for detection and staging of malignant lymphoma is high. DWIBS can be used for the evaluation of pediatric Hodgkin lymphoma.
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Affiliation(s)
- Dobromila Baranska
- Department of Diagnostic Imaging, Polish Mother's Memorial Hospital-Research Institute in Lodz, Rzgowska 281/289, 93-338, Lodz, Poland
| | - Katarzyna Matera
- Department of Diagnostic Imaging, Polish Mother's Memorial Hospital-Research Institute in Lodz, Rzgowska 281/289, 93-338, Lodz, Poland.
| | - Michal Podgorski
- Department of Diagnostic Imaging, Polish Mother's Memorial Hospital-Research Institute in Lodz, Rzgowska 281/289, 93-338, Lodz, Poland
| | | | - Karolina Krajewska
- Department of Pediatrics, Oncology, Hematology and Diabetology Medical, University of Lodz, Pankiewicza 16, 91-738, Lodz, Poland
| | - Joanna Trelinska
- Department of Pediatrics, Oncology, Hematology and Diabetology Medical, University of Lodz, Pankiewicza 16, 91-738, Lodz, Poland
| | - Piotr Grzelak
- Department of Diagnostic Imaging, Polish Mother's Memorial Hospital-Research Institute in Lodz, Rzgowska 281/289, 93-338, Lodz, Poland
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10
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Petralia G, Padhani AR, Pricolo P, Zugni F, Martinetti M, Summers PE, Grazioli L, Colagrande S, Giovagnoni A, Bellomi M. Whole-body magnetic resonance imaging (WB-MRI) in oncology: recommendations and key uses. Radiol Med 2018; 124:218-233. [PMID: 30430385 DOI: 10.1007/s11547-018-0955-7] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Accepted: 10/23/2018] [Indexed: 12/16/2022]
Abstract
The past decade has witnessed a growing role and increasing use of whole-body magnetic resonance imaging (WB-MRI). Driving these successes are developments in both hardware and software that have reduced overall examination times and significantly improved MR imaging quality. In addition, radiologists and clinicians have continued to find promising new applications of this innovative imaging technique that brings together morphologic and functional characterization of tissues. In oncology, the role of WB-MRI has expanded to the point of being recommended in international guidelines for the assessment of several cancer histotypes (multiple myeloma, melanoma, prostate cancer) and cancer-prone syndromes (Li-Fraumeni and hereditary paraganglioma-pheochromocytoma syndromes). The literature shows growing use of WB-MRI for the staging and follow-up of other cancer histotypes and cancer-related syndromes (including breast cancer, lymphoma, neurofibromatosis, and von Hippel-Lindau syndromes). The main aim of this review is to examine the current scientific evidence for the use of WB-MRI in oncology.
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Affiliation(s)
- Giuseppe Petralia
- Department of Radiology, IEO, European Institute of Oncology IRCCS, Milan, Italy.,Department of Oncology and Hematology, University of Milan, Milan, Italy.,Advanced Screening Centers - ASC Italia, Castelli Calepio, Bergamo, Italy
| | - Anwar R Padhani
- Paul Strickland Scanner Centre, Mount Vernon Hospital, Northwood, UK
| | - Paola Pricolo
- Department of Radiology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Fabio Zugni
- Postgraduate School in Radiodiagnostics, University of Milan, Milan, Italy
| | - Marco Martinetti
- Advanced Screening Centers - ASC Italia, Castelli Calepio, Bergamo, Italy
| | - Paul E Summers
- Department of Radiology, IEO, European Institute of Oncology IRCCS, Milan, Italy.
| | - Luigi Grazioli
- First Department of Radiology, Civic and University Hospital of Brescia, Brescia, Italy
| | - Stefano Colagrande
- Department of Experimental and Clinical Biomedical Sciences, Radiodiagnostic Unit n. 2, University of Florence - Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Andrea Giovagnoni
- Department of Radiology, Ospedali Riuniti, Università Politecnica delle Marche, Ancona, Italy
| | - Massimo Bellomi
- Department of Radiology, IEO, European Institute of Oncology IRCCS, Milan, Italy.,Department of Oncology and Hematology, University of Milan, Milan, Italy.,Advanced Screening Centers - ASC Italia, Castelli Calepio, Bergamo, Italy
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11
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Wang D, Huo Y, Chen S, Wang H, Ding Y, Zhu X, Ma C. Whole-body MRI versus 18F-FDG PET/CT for pretherapeutic assessment and staging of lymphoma: a meta-analysis. Onco Targets Ther 2018; 11:3597-3608. [PMID: 29950864 PMCID: PMC6016278 DOI: 10.2147/ott.s148189] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Purpose 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) is the reference standard in staging of 18F-FDG-avid lymphomas; however, there is no recommended functional imaging modality for indolent lymphomas. Therefore, we aimed to compare the performance of whole-body magnetic resonance imaging (WB-MRI) with that of 18F-FDG PET/CT for lesion detection and initial staging in patients with aggressive or indolent lymphoma. Materials and methods We searched the MEDLINE, EMBASE, and CENTRAL databases for studies that compared WB-MRI with 18F-FDG PET/CT for lymphoma staging or lesion detection. The methodological quality of the studies was assessed using version 2 of the “Quality Assessment of Diagnostic Accuracy Studies” tool. The pooled staging accuracy (μ) of WB-MRI and 18F-FDG PET/CT for initial staging and for assessing possible heterogeneity (χ2) across studies were calculated using commercially available software. Results Eight studies comprising 338 patients were included. In terms of staging, the meta-analytic staging accuracies of WB-MRI and 18F-FDG PET/CT for Hodgkin lymphoma and aggressive non-Hodgkin lymphoma (NHL) were 98% (95% CI, 94%–100%) and 98% (95% CI, 94%–100%), respectively. The pooled staging accuracy of 18F-FDG PET/CT dropped to 87% (95% CI, 72%–97%) for staging in patients with indolent lymphoma, whereas that of WB-MRI remained 96% (95% CI, 91%–100%). Subgroup analysis indicated an even lower staging accuracy of 18F-FDG PET/CT for staging of less FDG-avid indolent NHLs (60%; 95% CI, 23%–92%), in contrast to the superior performance of WB-MRI (98%; 95% CI, 88%–100%). Conclusion WB-MRI is a promising radiation-free imaging technique that may serve as a viable alternative to 18F-FDG PET/CT for staging of 18FDG-avid lymphomas, where 18F-FDG PET/CT remains the standard of care. Additionally, WB-MRI seems a less histology-dependent functional imaging test than 18F-FDG PET/CT and may be the imaging test of choice for staging of indolent NHLs with low 18F-FDG avidity.
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Affiliation(s)
- Danyang Wang
- Department of Nuclear Medicine, Affiliated XinHua Hospital of Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yanlei Huo
- Department of Nuclear Medicine, Affiliated XinHua Hospital of Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Suyun Chen
- Department of Nuclear Medicine, Affiliated XinHua Hospital of Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Hui Wang
- Department of Nuclear Medicine, Affiliated XinHua Hospital of Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yingli Ding
- Department of Nuclear Medicine, Affiliated Third People's Hospital of Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Xiaochun Zhu
- Department of Nuclear Medicine, Affiliated Ninth People's Hospital of Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Chao Ma
- Department of Nuclear Medicine, Affiliated XinHua Hospital of Shanghai Jiaotong University School of Medicine, Shanghai, China.,Department of Nuclear Medicine, Tenth People's Hospital of Tongji University, Shanghai, China
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12
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Application of the apparent diffusion coefficient in magnetic resonance imaging in an assessment of the early response to treatment in Hodgkin's and non-Hodgkin's lymphoma - pilot study. Pol J Radiol 2018; 83:e210-e214. [PMID: 30627237 PMCID: PMC6323582 DOI: 10.5114/pjr.2018.76007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 02/23/2018] [Indexed: 12/11/2022] Open
Abstract
Purpose Lymphoproliferative neoplasms are the largest and most frequently diagnosed entities in the group of haematological malignancies. The aim of the study was to assess whether apparent diffusion coefficient (ADC) measured on the first day of the second cycle of chemotherapy could be a predictor of prognosis and of the final treatment’s outcome. Material and methods The study included 27 patients with diagnosed Hodgkin’s and non-Hodgkin’s lymphoma, who had magnetic resonance (MR) performed with diffusion weighted imaging/apparent diffusion coefficient (DWI/ADC) before and on the first day of the second cycle of chemotherapy. Imaging was performed using a 1.5 T MR scanner. ADC was measured in lymphoma infiltration in the area of the lowest signal in the ADC map and the highest signal on β 800 images in post-treatment study. After that, the corresponding area was determined in a pre-treatment study and an ADC value was measured. Results The difference between ADC values in pre-treatment (ADC = 720 mm2/s) and post-treatment (ADC = 1059 mm2/s) studies was statistically significant (p < 0.001). Cutoff values for estimating response to treatment were established at the level of ADC 1080 mm2/s, and ADC to muscle ratio at 0.82 in post-treatment study. Patients with ADC > 752 mm2/s before treatment manifested lower probability of progression than patients with ADC < 752 mm2/s. Conclusions ADC measurement’s before treatment and on the first day of the second cycle of chemotherapy can be used as a prognostic marker in lymphoma therapy. ADC values lower than 1080 mm2/s and an increase of the ratio after the treatment can be considered as a marker of disease progression.
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13
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Can diffusion-weighted whole-body MRI replace contrast-enhanced CT for initial staging of Hodgkin lymphoma in children and adolescents? Pediatr Radiol 2018; 48:638-647. [PMID: 29362839 DOI: 10.1007/s00247-018-4071-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Revised: 10/30/2017] [Accepted: 01/03/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND Although positron emission tomography with 18F-fluoro-2-deoxyglucose (FDG-PET/CT) has been recommended as the method of choice for lymphoma staging, it has limited availability in several countries, therefore, studies comparing whole-body magnetic resonance imaging (MRI) to conventional staging methods or to FDG-PET/CT are an important tool to establish whole-body MRI as an alternative to these methods. OBJECTIVE To compare whole-body MRI versus conventional imaging methods for staging of Hodgkin lymphoma in children and adolescents. MATERIALS AND METHODS The study included 22 patients ages 5 to 21 years. Staging was performed using conventional imaging methods and whole-body MRI. Conventional imaging methods were defined as computed tomography (CT) of the neck, chest, abdomen and pelvis and ultrasonography of the neck and/or abdomen. We calculated the sensitivity of these methods for Hodgkin lymphoma staging and their sensitivity and specificity for detecting sites of nodal and extranodal involvement. RESULTS The sensitivity of whole-body MRI for Hodgkin lymphoma staging was superior to that of conventional imaging methods (95.5% vs. 86.4%, respectively), but both methods had similar sensitivity and specificity for detecting involvement of nodal sites (99.1% and 100% vs. 97.3% and 100%, respectively) and extranodal sites (90.5% and 98.7% vs. 90.5% and 99.4%, respectively). CONCLUSION Whole-body MRI has excellent sensitivity for staging of Hodgkin lymphoma in children and adolescents. It can thus be considered an alternative for this purpose, particularly because it does not expose patients to ionizing radiation.
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14
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Albano D, Patti C, Matranga D, Lagalla R, Midiri M, Galia M. Whole-body diffusion-weighted MR and FDG-PET/CT in Hodgkin Lymphoma: Predictive role before treatment and early assessment after two courses of ABVD. Eur J Radiol 2018; 103:90-98. [PMID: 29803392 DOI: 10.1016/j.ejrad.2018.04.014] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 03/03/2018] [Accepted: 04/10/2018] [Indexed: 02/06/2023]
Abstract
PURPOSE To evaluate whether imaging features of pathologic lymph nodes on whole-body diffusion-weighted MR have a predictive role before treatment and may assess the response after two courses of chemotherapy in comparison to FDG-PET/CT in Hodgkin Lymphoma. MATERIALS AND METHODS We reviewed the whole-body MR and FDG-PET/CT performed on 41 patients with Hodgkin Lymphoma before and after two Doxorubicin-Bleomycin-Vinblastine-Dacarbazine (ABVD). Responder and non-responder lesions were identified on interim-FDG-PET/CT performed after two ABVD. We used Multivariate Generalized Estimating Equations model to assess statistical association between being-responder and baseline-Maximum Standard Uptake Value (SUVmax), baseline and interim-Apparent Diffusion Coefficient (ADC) and size, ADC and size changes during chemotherapy, site of disease, bulky, and stage. RESULTS 10/41 (24%) patients were positive on interim-FDG-PET/CT. The interim-FDG-PET/CT positivity was associated with worse cumulative survival rate at 24 months in comparison to interim-FDG-PET/CT negativity (P < .05); 3/10 patients with positive interim-FDG-PET/CT and 1/31 with negative interim-FDG-PET/CT experienced disease progression. Baseline-SUVmax was 11.18 ± 5.58 (3.1-28.0) and baseline-ADC was 0.70 ± 0.14 × 10-3 mm2/s (0.39-0.98). There was a significant difference between responder and non-responder lesions based on interim-ADC (1.83 ± 0.34 × 10-3 mm2/s vs. 1.01 ± 0.27 × 10-3 mm2/s;p <.001), interim-size (3.1 cm2 vs. 9.4 cm2;p = .009), and bulky (8.2% vs. 66.7%;p = .002). There was no significant difference between responder and non-responder lesions based on baseline-SUVmax (p = .713), baseline-ADC (p = .253), ADC changes (p = .058), size changes (p = .085), site (p = .209), stage (p = .290), baseline-size (p = .064). CONCLUSIONS Interim-ADC is helpful for identifying non-responder lesions, while size changes are not useful. Baseline-SUVmax and ADC have no predictive role. Bulky is the most useful imaging parameter to predict suboptimal response to chemotherapy.
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Affiliation(s)
- Domenico Albano
- Department of Radiology, Di.Bi.Med, University of Palermo, Via del Vespro 127, 90127 Palermo, Italy.
| | - Caterina Patti
- Department of Hematology I, Azienda Ospedali Riuniti Villa Sofia-Cervello, Viale Trabucco 180, 90146 Palermo, Italy.
| | - Domenica Matranga
- Department of Sciences for Health Promotion and Mother and Child Care "G. D'Alessandro", University of Palermo, Via del Vespro 133, 90127 Palermo, Italy.
| | - Roberto Lagalla
- Department of Radiology, Di.Bi.Med, University of Palermo, Via del Vespro 127, 90127 Palermo, Italy.
| | - Massimo Midiri
- Department of Radiology, Di.Bi.Med, University of Palermo, Via del Vespro 127, 90127 Palermo, Italy.
| | - Massimo Galia
- Department of Radiology, Di.Bi.Med, University of Palermo, Via del Vespro 127, 90127 Palermo, Italy.
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De Paepe KN, De Keyzer F, Wolter P, Bechter O, Dierickx D, Janssens A, Verhoef G, Oyen R, Vandecaveye V. Improving lymph node characterization in staging malignant lymphoma using first-order ADC texture analysis from whole-body diffusion-weighted MRI. J Magn Reson Imaging 2018; 48:897-906. [DOI: 10.1002/jmri.26034] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Accepted: 03/17/2018] [Indexed: 12/13/2022] Open
Affiliation(s)
| | | | - Pascal Wolter
- Department of Medical Oncology; University Hospitals Leuven; Belgium
| | - Oliver Bechter
- Department of Medical Oncology; University Hospitals Leuven; Belgium
| | - Daan Dierickx
- Department of Hematology; University Hospitals Leuven; Belgium
| | - Ann Janssens
- Department of Hematology; University Hospitals Leuven; Belgium
| | - Gregor Verhoef
- Department of Hematology; University Hospitals Leuven; Belgium
| | - Raymond Oyen
- Deparment of Radiology; University Hospitals Leuven; Belgium
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Morone M, Bali MA, Tunariu N, Messiou C, Blackledge M, Grazioli L, Koh DM. Whole-Body MRI: Current Applications in Oncology. AJR Am J Roentgenol 2017; 209:W336-W349. [PMID: 28981354 DOI: 10.2214/ajr.17.17984] [Citation(s) in RCA: 79] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE The purpose of this article is to review current image acquisition and interpretation for whole-body MRI, clinical applications, and the emerging roles in oncologic imaging, especially in the assessment of bone marrow diseases. CONCLUSION Whole-body MRI is an emerging technique used for early diagnosis, staging, and assessment of therapeutic response in oncology. The improved accessibility and advances in technology, including widely available sequences (Dixon and DWI), have accelerated its deployment and acceptance in clinical practice.
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Affiliation(s)
- Mario Morone
- 1 Prima Radiologia Azienda Socio Sanitaria Territoriale Spedali Civili di Brescia, Piazzale Spedali Civili, 1, Brescia, BS 25123, Italy
| | | | - Nina Tunariu
- 2 Radiology Department, Royal Marsden NHS Foundation Trust, Sutton, UK
| | - Christina Messiou
- 2 Radiology Department, Royal Marsden NHS Foundation Trust, Sutton, UK
| | | | - Luigi Grazioli
- 1 Prima Radiologia Azienda Socio Sanitaria Territoriale Spedali Civili di Brescia, Piazzale Spedali Civili, 1, Brescia, BS 25123, Italy
| | - Dow-Mu Koh
- 2 Radiology Department, Royal Marsden NHS Foundation Trust, Sutton, UK
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17
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Sando M, Terasaki M, Okamoto Y, Suzumura K, Tsuchiya T. The Utility of Diagnostic Laparoscopic Biopsy for Mesenteric and Retroperitoneal Lymph Nodes. AMERICAN JOURNAL OF CASE REPORTS 2017; 18:878-882. [PMID: 28794405 PMCID: PMC5560472 DOI: 10.12659/ajcr.904444] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
BACKGROUND Ultrasound (US) or computed tomography (CT)-guided biopsy of intra-abdominal lymph nodes is minimally invasive; however, percutaneous procedures are often difficult to perform because of the location and size of the lymph nodes. In many cases, this approach may result in insufficient specimens necessary to evaluate histopathology. In such cases, laparoscopic biopsy is useful to obtain adequate specimens, regardless of the location and size of the lymph nodes. Additionally, laparoscopic biopsy is an approach that can avoid the possible complications associated with a laparotomy. CASE REPORT Between 2013 and 2016, a series of 11 patients underwent laparoscopic biopsy of mesenteric and retroperitoneal lymph nodes. All patients received a definitive histopathological diagnosis via laparoscopic biopsy. The median postoperative hospital stay was four days (range 3-13 days), and all patients were able to resume oral intake on postoperative day 1. No case was converted to laparotomy, and no major perioperative complication occurred, except for wound infection in one patient. CONCLUSIONS Diagnostic laparoscopic biopsy for mesenteric and retroperitoneal lymph nodes is safe and reliable.
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Affiliation(s)
- Masanori Sando
- Department of Surgery, Shizuoka Saiseikai General Hospital, Shizuoka City, Shizuoka, Japan
| | - Masaki Terasaki
- Department of Surgery, Shizuoka Saiseikai General Hospital, Shizuoka City, Shizuoka, Japan
| | - Yoshichika Okamoto
- Department of Surgery, Shizuoka Saiseikai General Hospital, Shizuoka City, Shizuoka, Japan
| | - Kiyoshi Suzumura
- Department of Surgery, Shizuoka Saiseikai General Hospital, Shizuoka City, Shizuoka, Japan
| | - Tomonori Tsuchiya
- Department of Surgery, Shizuoka Saiseikai General Hospital, Shizuoka City, Shizuoka, Japan
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18
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Whole body MRI with qualitative and quantitative analysis of DWI for assessment of bone marrow involvement in lymphoma. Radiol Med 2017; 122:623-632. [PMID: 28421406 DOI: 10.1007/s11547-017-0762-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Accepted: 03/30/2017] [Indexed: 01/21/2023]
Abstract
AIM Our study aimed to investigate the role of qualitative and quantitative whole body MRI with DWI for assessment of bone marrow involvement (BMI) in newly diagnosed lymphoma using FDG PET-CT and bone marrow biopsy (BMB) as reference standard. MATERIALS AND METHODS We retrospectively evaluated 56 patients with newly diagnosed lymphoma (21 Hodgkin's lymphoma and 35 non-Hodgkin's lymphoma) who underwent random unilateral BMB, FDG PET-CT and Wb-MRI-DWI for initial staging. In a patient-based analysis, results of Wb-MRI-DWI were compared with FDG PET-CT and BMB. For quantitative analysis, mean ADC values of posterior iliac crest were correlated with BMI and bone marrow cellularity. RESULTS WB-MR-DWI obtained excellent concordance with FDG PET-CT both in HL (k = 1.000; 95% CI 1.000-1.000) and in DLBCL (k = 1.000; 95% CI 1.000-1.000). In other NHL, WB-MRI-DWI obtained a good correlation with BMB (k = 0.611; 95% CI 0.295-0.927) while FDG PET-CT had poor concordance (k = 0.067; 95% CI 0.372-0.505). WB-MR-DWI has no false negative errors but 4 false positive results consisting in focal lesions consensually reported by FDG PET-CT and resolved after therapy. No significant correlation between ADC mean value and BMI was found (p = 0.0586). CONCLUSION Our data suggest that Wb-MRI-DWI is a valid technique for BMI assessment in lymphoma patients, thanks to its excellent concordance with FDG PET-CT and good concordance with BMB (superior than FDG PET-CT). If further investigations will confirm our results on larger patient groups, it could become a useful tool in the clinical workup.
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Sivesgaard K, Jöhnk ML, Larsen LP, Sørensen M, Kramer S, Løgager VB, Hansen F, Pedersen EM. Comparison of four MRI protocols for detection of extrahepatic colorectal cancer metastases. J Magn Reson Imaging 2017; 46:1619-1630. [PMID: 28301099 DOI: 10.1002/jmri.25704] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Accepted: 02/27/2017] [Indexed: 11/06/2022] Open
Abstract
PURPOSE To compare three magnetic resonance imaging (MRI) protocols containing diffusion-weighted imaging with background suppression (DWIBS) and one traditional protocol for detecting extrahepatic colorectal cancer metastases. MATERIALS AND METHODS Thirty patients with extrahepatic colorectal cancer metastases were scanned in three stations from the skull base to the upper thighs using a 1.5T MRI system with six different MRI sequences; transverse and coronal T2 -weighted (T2 W) turbo spin-echo (TSE), coronal short tau inversion recovery (STIR), 3D T1 W TSE, DWIBS, and a contrast-enhanced T1 W 3D gradient echo (GRE) sequence. The six sequences were used to build four hypothetical MRI interpretive sets which were read by two readers in consensus, blinded to prior imaging. Lesions were categorized into 13 anatomic regions. Fluorodeoxyglucose / positron emission tomography / computed tomography (FDG-PET/CT) read with full access to prior imaging and clinical records was used as the reference standard. Sensitivity, specificity, and false discovery rate (FDR) were calculated as appropriate and receiver operating characteristic (ROC) curves were constructed. RESULTS In all, 177 malignant lesions were detected by FDG-PET/CT and distributed in 92 out of 390 scanned anatomic regions. The sensitivity was statistically higher in two out of three sets incorporating DWIBS on a per-lesion basis (66.7%, 63.3%, and 66.7% vs. 57.6%) (P = 0.01, P = 0.11, and P = 0.01, respectively) and in all sets incorporating DWIBS on a per-region basis (75.0%, 75.0%, and 77.2 vs. 66.3%) (P = 0.04, P = 0.04, and P = 0.01, respectively). There was no difference in specificity, FDR, or AUCROC . There was no difference between sets containing DWIBS irrespective of the use of a contrast-enhanced sequence. CONCLUSION MRI sets containing DWIBS had superior sensitivity. This sensitivity was retained when omitting a contrast-enhanced sequence. LEVEL OF EVIDENCE 1 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2017;46:1619-1630.
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Affiliation(s)
- Kim Sivesgaard
- Department of Radiology, Aarhus University Hospital, Aarhus, Denmark
| | | | - Lars P Larsen
- Department of Radiology, Aarhus University Hospital, Aarhus, Denmark
| | - Michael Sørensen
- Department of Hepatology & Gastroenterology, Aarhus University Hospital, Aarhus, Denmark
| | - Stine Kramer
- Department of Nuclear Medicine & PET-Center, Aarhus University Hospital, Aarhus, Denmark
| | - Vibeke Berg Løgager
- Department of Radiology, Herlev Hospital, University of Copenhagen, Herlev, Denmark
| | - Flemming Hansen
- Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
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Can Interim 18F-FDG PET or Diffusion-Weighted MRI Predict End-of-Treatment Outcome in FDG-Avid MALT Lymphoma After Rituximab-Based Therapy?: A Preliminary Study in 15 Patients. Clin Nucl Med 2017; 41:837-843. [PMID: 27648705 DOI: 10.1097/rlu.0000000000001395] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PURPOSE To determine whether interim F-FDG PET or interim diffusion-weighted magnetic resonance imaging (DWI) can predict the end-of-treatment (EOT) outcome after immunotherapy in patients with FDG-avid extranodal marginal zone B-cell lymphoma of the mucosa-associated lymphoid tissue (MALT). MATERIALS AND METHODS Patients with untreated MALT lymphoma prospectively underwent whole-body F-FDG PET/CT and DWI before treatment (baseline), and after three cycles (interim) of rituximab-based immunotherapy. Maximum and mean standardized uptake values (SUVmax, SUVmean), and minimum and mean apparent diffusion coefficients (ADCmin, ADCmean), were measured for up to three target lesions per patient. Rates of change between baseline and interim examinations (ΔSUVmax, ΔSUVmean, ΔADCmin, and ΔADCmean) were compared, using ANOVAs, between the four end-of-treatment (EOT, after six cycles of immunotherapy) outcomes: complete remission (CR), partial remission (PR), stable disease (SD), or progressive disease (PD). RESULTS Fifteen patients with 25 lesions were included. Lesion-based post hoc tests showed significant differences between CR and PR for ΔSUVmax (P < 0.001), ΔSUVmean (P < 0.001), and ΔADCmin (P = 0.044), and between CR and SD for ΔSUVmax (P < 0.001), ΔSUVmean (P < 0.001), ΔADCmin (P = 0.021), and ΔADCmean (P = 0.022). No lesion showed PD at EOT. CONCLUSIONS Both quantitative interim F-FDG PET and interim DWI may possibly be useful to predict complete remission at end-of-treatment in MALT lymphoma patients after immunotherapy.
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Manias KA, Gill SK, MacPherson L, Foster K, Oates A, Peet AC. Magnetic resonance imaging based functional imaging in paediatric oncology. Eur J Cancer 2016; 72:251-265. [PMID: 28011138 DOI: 10.1016/j.ejca.2016.10.037] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Revised: 09/26/2016] [Accepted: 10/30/2016] [Indexed: 12/16/2022]
Abstract
Imaging is central to management of solid tumours in children. Conventional magnetic resonance imaging (MRI) is the standard imaging modality for tumours of the central nervous system (CNS) and limbs and is increasingly used in the abdomen. It provides excellent structural detail, but imparts limited information about tumour type, aggressiveness, metastatic potential or early treatment response. MRI based functional imaging techniques, such as magnetic resonance spectroscopy, diffusion and perfusion weighted imaging, probe tissue properties to provide clinically important information about metabolites, structure and blood flow. This review describes the role of and evidence behind these functional imaging techniques in paediatric oncology and implications for integrating them into routine clinical practice.
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Affiliation(s)
- Karen A Manias
- Institute of Cancer and Genomic Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK; Department of Paediatric Oncology, Birmingham Children's Hospital, Steelhouse Lane, Birmingham, B4 6NH, UK.
| | - Simrandip K Gill
- Institute of Cancer and Genomic Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK; Department of Paediatric Oncology, Birmingham Children's Hospital, Steelhouse Lane, Birmingham, B4 6NH, UK.
| | - Lesley MacPherson
- Department of Radiology, Birmingham Children's Hospital, Steelhouse Lane, Birmingham, B4 6NH, UK.
| | - Katharine Foster
- Department of Radiology, Birmingham Children's Hospital, Steelhouse Lane, Birmingham, B4 6NH, UK.
| | - Adam Oates
- Department of Radiology, Birmingham Children's Hospital, Steelhouse Lane, Birmingham, B4 6NH, UK.
| | - Andrew C Peet
- Institute of Cancer and Genomic Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK; Department of Paediatric Oncology, Birmingham Children's Hospital, Steelhouse Lane, Birmingham, B4 6NH, UK.
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22
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England CG, Rui L, Cai W. Lymphoma: current status of clinical and preclinical imaging with radiolabeled antibodies. Eur J Nucl Med Mol Imaging 2016; 44:517-532. [PMID: 27844106 DOI: 10.1007/s00259-016-3560-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Accepted: 10/25/2016] [Indexed: 12/22/2022]
Abstract
Lymphoma is a complex disease that arises from cells of the immune system with an intricate pathology. While lymphoma may be classified as Hodgkin or non-Hodgkin, each type of tumor is genetically and phenotypically different and highly invasive tissue biopsies are the only method to investigate these differences. Noninvasive imaging strategies, such as immunoPET, can provide a vital insight into disease staging, monitoring treatment response in patients, and dose planning in radioimmunotherapy. ImmunoPET imaging with radiolabeled antibody-based tracers may also assist physicians in optimizing treatment strategies and enhancing patient stratification. Currently, there are two common biomarkers for molecular imaging of lymphoma, CD20 and CD30, both of which have been considered for investigation in preclinical imaging studies. In this review, we examine the current status of both preclinical and clinical imaging of lymphoma using radiolabeled antibodies. Additionally, we briefly investigate the role of radiolabeled antibodies in lymphoma therapy. As radiolabeled antibodies play critical roles in both imaging and therapy of lymphoma, the development of novel antibodies and the discovery of new biomarkers may greatly affect lymphoma imaging and therapy in the future.
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Affiliation(s)
- Christopher G England
- Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, 1111 Highland Ave, Madison, WI, 53705-2275, USA.
| | - Lixin Rui
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
- Carbone Cancer Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Weibo Cai
- Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, 1111 Highland Ave, Madison, WI, 53705-2275, USA.
- Carbone Cancer Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Room 7137, 1111 Highland Ave, Madison, WI, 53705-2275, USA.
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18F-Fluorodeoxyglucose Positron Emission Tomography/Magnetic Resonance in Lymphoma: Comparison With 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography and With the Addition of Magnetic Resonance Diffusion-Weighted Imaging. Invest Radiol 2016; 51:163-9. [PMID: 26784400 PMCID: PMC4747979 DOI: 10.1097/rli.0000000000000218] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Objectives The aim of this study was to compare 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/magnetic resonance (MR) (with and without diffusion-weighted imaging [DWI]) to 18F-FDG PET/computed tomography (CT), with regard to the assessment of nodal and extranodal involvement, in patients with Hodgkin lymphoma and non-Hodgkin lymphoma, without restriction to FDG-avid subytpes. Materials and Methods Patients with histologically proven lymphoma were enrolled in this prospective, institutional review board–approved study. After a single 18F-FDG injection, patients consecutively underwent 18F-FDG PET⁄CT and 18F-FDG PET/MR on the same day for staging or restaging. Three sets of images were analyzed separately: 18F-FDG PET/CT, 18F-FDG PET/MR without DWI, and 18F-FDG PET/MR with DWI. Region-based agreement and examination-based sensitivity and specificity were calculated for 18F-FDG PET/CT, 18F-FDG PET/MR without DWI, and 18F-FDG PET/MR DWI. Maximum and mean standardized uptake values (SUVmax, SUVmean) on 18F-FDG PET/CT and 18F-FDG PET/MR were compared and correlated with minimum and mean apparent diffusion coefficients (ADCmin, ADCmean). Results Thirty-four patients with a total of 40 examinations were included. Examination-based sensitivities for 18F-FDG PET/CT, 18F-FDG PET/MR, and 18F-FDG PET/MR DWI were 82.1%, 85.7%, and 100%, respectively; specificities were 100% for all 3 techniques; and accuracies were 87.5%, 90%, and 100%, respectively. 18F-FDG PET/CT was false negative in 5 of 40 examinations (all with mucosa-associated lymphoid tissue lymphoma), and 18F-FDG PET/MR (without DWI) was false negative in 4 of 40 examinations. Region-based percentages of agreement were 99% (κ, 0.95) between 18F-FDG PET/MR DWI and 18F-FDG PET/CT, 99.2% (κ, 0.96) between 18F-FDG PET/MR and 18F-FDG PET/CT, and 99.4% (κ, 0.97) between 18F-FDG PET/MR DWI and 18F-FDG PET/MR. There was a strong correlation between 18F-FDG PET/CT and 18F-FDG PET/MR for SUVmax (r = 0.83) and SUVmean (r = 0.81) but no significant correlation between ADCmin and SUVmax (18F-FDG PET/CT: r = 0.46, P = 0.65; 18F-FDG PET/MR: r = 0.64, P = 0.53) or between ADCmean and SUVmean (respectively, r = −0.14, P = 0.17 for the correlation with PET/CT and r = −0.14, P = 0.14 for the correlation with PET/MR). Conclusions 18F-FDG PET/MR and 18F-FDG PET/CT show a similar diagnostic performance in lymphoma patients. However, if DWI is included in the 18F-FDG PET/MR protocol, results surpass those of 18F-FDG PET/CT because of the higher sensitivity of DWI for mucosa-associated lymphoid tissue lymphomas.
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Osteonecrosis detected by whole body magnetic resonance in patients with Hodgkin Lymphoma treated by BEACOPP. Eur Radiol 2016; 27:2129-2136. [PMID: 27519911 DOI: 10.1007/s00330-016-4535-8] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Revised: 07/09/2016] [Accepted: 07/27/2016] [Indexed: 12/20/2022]
Abstract
OBJECTIVES The purpose of our retrospective review of prospectively acquired Whole Body Magnetic Resonance (WB-MRI) scans was to assess the incidence of osteonecrosis in patients who received different chemotherapies. METHODS We evaluated the WB-MRI scans performed on 42 patients with Hodgkin Lymphoma treated by three chemotherapy regimens (6ABVD, 2ABVD + 4BEACOPP, 2ABVD + 8BEACOPP), excluding patients with the main risk factors for osteonecrosis. RESULTS Six out of seven patients (86 %) who received eight BEACOPP and one out of five patients (20 %) treated by four BEACOPP presented osteonecrosis, with a statistically significant difference of frequency between the two groups of patients (p < 0.05); no injury has been reported in patients treated by only ABVD. Among a total of 48 osteonecrotic lesions observed, 48 % were detected in the knee; multifocal osteonecrosis were detected in six out of seven patients (86 %). CONCLUSIONS The development of osteonecrosis is strictly related to the chemotherapy protocol adopted and the number of cycles received, with a strong correlation between the dose of corticosteroids included in the BEACOPP scheme and this complication. WB-MRI can be considered as a helpful tool that allows detecting earlier osteonecrotic lesions in patients treated with corticosteroids. KEY POINTS • Osteonecrosis is a possible complication of patients with Lymphoma treated by chemotherapy. • Osteonecrosis is related to the corticosteroids included within the BEACOPP protocol. • WB-MRI allows detecting osteonecrotic lesions in patients treated with corticosteroids.
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Atkinson W, Catana C, Abramson JS, Arabasz G, McDermott S, Catalano O, Muse V, Blake MA, Barnes J, Shelly M, Hochberg E, Rosen BR, Guimaraes AR. Hybrid FDG-PET/MR compared to FDG-PET/CT in adult lymphoma patients. Abdom Radiol (NY) 2016; 41:1338-48. [PMID: 27315095 DOI: 10.1007/s00261-016-0638-6] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
PURPOSE The goal of this study is to evaluate the diagnostic performance of simultaneous FDG-PET/MR including diffusion compared to FDG-PET/CT in patients with lymphoma. METHODS Eighteen patients with a confirmed diagnosis of non-Hodgkin's (NHL) or Hodgkin's lymphoma (HL) underwent an IRB-approved, single-injection/dual-imaging protocol consisting of a clinical FDG-PET/CT and subsequent FDG-PET/MR scan. PET images from both modalities were reconstructed iteratively. Attenuation correction was performed using low-dose CT data for PET/CT and Dixon-MR sequences for PET/MR. Diffusion-weighted imaging was performed. SUVmax was measured and compared between modalities and the apparent diffusion coefficient (ADC) using ROI analysis by an experienced radiologist using OsiriX. Strength of correlation between variables was measured using the Pearson correlation coefficient (r p). RESULTS Of the 18 patients included in this study, 5 had HL and 13 had NHL. The median age was 51 ± 14.8 years. Sixty-five FDG-avid lesions were identified. All FDG-avid lesions were visible with comparable contrast, and therefore initial and follow-up staging was identical between both examinations. SUVmax from FDG-PET/MR [(mean ± sem) (21.3 ± 2.07)] vs. FDG-PET/CT (mean 23.2 ± 2.8) demonstrated a strongly positive correlation [r s = 0.95 (0.94, 0.99); p < 0.0001]. There was no correlation found between ADCmin and SUVmax from FDG-PET/MR [r = 0.17(-0.07, 0.66); p = 0.09]. CONCLUSION FDG-PET/MR offers an equivalent whole-body staging examination as compared with PET/CT with an improved radiation safety profile in lymphoma patients. Correlation of ADC to SUVmax was weak, understating their lack of equivalence, but not undermining their potential synergy and differing importance.
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Affiliation(s)
- Wendy Atkinson
- Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA, 02129, USA
| | - Ciprian Catana
- Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA, 02129, USA
| | - Jeremy S Abramson
- Division of Hematology and Oncology, Department of Medicine, Massachusetts General Hospital, Boston, MA, 02114, USA
| | - Grae Arabasz
- Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA, 02129, USA
| | - Shanaugh McDermott
- Division of Abdominal Imaging, Department of Radiology, Massachusetts General Hospital, Boston, MA, 02114, USA
| | - Onofrio Catalano
- Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA, 02129, USA
| | - Victorine Muse
- Division of Thoracic Radiology, Department of Radiology, Massachusetts General Hospital, Boston, MA, 02114, USA
| | - Michael A Blake
- Division of Abdominal Imaging, Department of Radiology, Massachusetts General Hospital, Boston, MA, 02114, USA
| | - Jeffrey Barnes
- Division of Hematology and Oncology, Department of Medicine, Massachusetts General Hospital, Boston, MA, 02114, USA
| | - Martin Shelly
- Division of Abdominal Imaging, Department of Radiology, Massachusetts General Hospital, Boston, MA, 02114, USA
| | - Ephraim Hochberg
- Division of Hematology and Oncology, Department of Medicine, Massachusetts General Hospital, Boston, MA, 02114, USA
| | - Bruce R Rosen
- Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA, 02129, USA
| | - Alexander R Guimaraes
- Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA, 02129, USA.
- Division of Abdominal Imaging, Department of Radiology, Massachusetts General Hospital, Boston, MA, 02114, USA.
- Division of Body Imaging, Department of Diagnostic Radiology, Oregon Health Sciences University, 3181 SW Sam Jackson Park Rd., Mail Code L340, Portland, OR, 97239, USA.
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Keraliya AR, Krajewski KM, Jagannathan JP, Shinagare AB, Braschi-Amirfarzan M, Tirumani SH, Ramaiya NH. Multimodality imaging of osseous involvement In haematological malignancies. Br J Radiol 2016; 89:20150980. [PMID: 26781757 DOI: 10.1259/bjr.20150980] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
The purpose of this article is to provide a comprehensive review of the imaging features of osseous involvement in haematological malignancies. Osseous involvement can be seen in various haematological malignancies including lymphomas, plasma cell neoplasms, leukaemias and myeloproliferative neoplasms. Imaging plays a crucial role in initial diagnosis, staging and in the assessment of treatment response in these patients.
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Affiliation(s)
- Abhishek R Keraliya
- 1 Department of Imaging, Dana Farber Cancer Institute, Harvard Medical School, Boston, MA.,2 Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Katherine M Krajewski
- 1 Department of Imaging, Dana Farber Cancer Institute, Harvard Medical School, Boston, MA.,2 Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Jyothi P Jagannathan
- 1 Department of Imaging, Dana Farber Cancer Institute, Harvard Medical School, Boston, MA.,2 Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Atul B Shinagare
- 1 Department of Imaging, Dana Farber Cancer Institute, Harvard Medical School, Boston, MA.,2 Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Marta Braschi-Amirfarzan
- 1 Department of Imaging, Dana Farber Cancer Institute, Harvard Medical School, Boston, MA.,2 Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Sree H Tirumani
- 1 Department of Imaging, Dana Farber Cancer Institute, Harvard Medical School, Boston, MA.,2 Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Nikhil H Ramaiya
- 1 Department of Imaging, Dana Farber Cancer Institute, Harvard Medical School, Boston, MA.,2 Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
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Albano D, Patti C, La Grutta L, Agnello F, Grassedonio E, Mulè A, Cannizzaro G, Ficola U, Lagalla R, Midiri M, Galia M. Comparison between whole-body MRI with diffusion-weighted imaging and PET/CT in staging newly diagnosed FDG-avid lymphomas. Eur J Radiol 2015; 85:313-8. [PMID: 26781135 DOI: 10.1016/j.ejrad.2015.12.006] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Revised: 10/12/2015] [Accepted: 12/10/2015] [Indexed: 12/31/2022]
Abstract
OBJECTIVES To compare whole body-MRI (WB-MRI) with diffusion-weighted imaging and FDG-PET/CT in staging newly diagnosed FDG-avid lymphomas. METHODS 68 patients (37 males, 31 females; median age 42 years; range 15-86 years) with histologically confirmed lymphoma (37 Classical Hodgkin, 16 Diffuse large B-cell, 10 Follicular, 5 Mantle cell) underwent both MRI and FDG-PET/CT before treatment. Ann Arbor stages obtained with WB-MRI and FDG-PET/CT were compared using Cohen's k statistics. Moreover WB-MRI and FDG-PET/CT stages were compared with the pathological stages obtained after the diagnostic iter using also bone marrow and available biopsies if clinically indicated. RESULTS The agreement between WB-MRI and FDG-PET/CT was excellent. WB-MRI stage was equal to those of FDG-PET/CT in 62/68 patients (91.2%). There was an excellent agreement between WB-MRI stage and pathological stage (63/68 patients; 92.6%), and between FDG-PET/CT and pathological stage (64/68 patients; 94.1%). The differences between the stages were more frequent in the patients with Mantle cell lymphoma. CONCLUSIONS WB-MRI can be considered as a promising technique for FDG-avid lymphoma staging.
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Affiliation(s)
- Domenico Albano
- Department of Radiology, University of Palermo, Via del Vespro 127, Palermo 90127, Italy.
| | - Caterina Patti
- Department of Hematology I, Azienda Ospedali Riuniti Villa Sofia-Cervello, Viale Strasburgo 233, Palermo 90146, Italy
| | - Ludovico La Grutta
- Department of Radiology, University of Palermo, Via del Vespro 127, Palermo 90127, Italy
| | - Francesco Agnello
- Department of Radiology, University of Palermo, Via del Vespro 127, Palermo 90127, Italy
| | - Emanuele Grassedonio
- Department of Radiology, University of Palermo, Via del Vespro 127, Palermo 90127, Italy
| | - Antonino Mulè
- Department of Hematology I, Azienda Ospedali Riuniti Villa Sofia-Cervello, Viale Strasburgo 233, Palermo 90146, Italy
| | - Giorgio Cannizzaro
- Department of Nuclear Medicine, Azienda Ospedali Riuniti Villa Sofia-Cervello, Viale Strasburgo 233, Palermo 90146, Italy
| | - Umberto Ficola
- Department of Nuclear Medicine, La Maddalena Hospital, Via San Lorenzo Colli 312/d, Palermo 90146, Italy
| | - Roberto Lagalla
- Department of Radiology, University of Palermo, Via del Vespro 127, Palermo 90127, Italy
| | - Massimo Midiri
- Department of Radiology, University of Palermo, Via del Vespro 127, Palermo 90127, Italy
| | - Massimo Galia
- Department of Radiology, University of Palermo, Via del Vespro 127, Palermo 90127, Italy
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Maggialetti N, Ferrari C, Minoia C, Asabella AN, Ficco M, Loseto G, De Tullio G, de Fazio V, Calabrese A, Guarini A, Rubini G, Brunese L. Role of WB-MR/DWIBS compared to (18)F-FDG PET/CT in the therapy response assessment of lymphoma. Radiol Med 2015; 121:132-43. [PMID: 26349573 DOI: 10.1007/s11547-015-0581-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2015] [Accepted: 08/25/2015] [Indexed: 12/18/2022]
Abstract
INTRODUCTION This study prospectively evaluated whole-body magnetic resonance/diffusion-weighted imaging with body signal suppression (WB-MR/DWIBS) reliability compared to (18)F-FDG PET/CT in the treatment response assessment of classic Hodgkin lymphomas (HL) and aggressive non-Hodgkin lymphomas (aNHL). MATERIALS AND METHODS Twenty-seven consecutive patients were prospectively enrolled at the time of diagnosis. Eighteen (11 HL and seven aNHL) were considered for the analysis. They received chemo/radiotherapy as induction and completed post-treatment evaluation performing both (18)F-FDG PET/CT and WB-MR/DWIBS. The revised response criteria for malignant lymphomas were used to assess the response to treatment. We evaluated the agreement between the two methods by Cohen's K test. Post-therapy WB-MR/DWIBS sensitivity, specificity, PPV, NPV and accuracy were then calculated, considering the 12 months of follow-up period as the gold standard. RESULTS By using an evaluation on a lesion-by-lesion basis, WB-MR/DWIBS and (18)F-FDG PET/CT showed an overall good agreement (K = 0.796, 95% IC = 0.651-0.941), especially in the evaluation of the nodal basins in aNHL (K = 0.937, 95% IC = 0.814-1). In reference to the revised response criteria for malignant lymphomas, the two methods showed a good agreement (K = 0.824, 95% IC = 0.493-1). Post-therapy sensitivity, specificity, PPV, NPV and accuracy of WB-MR/DWIBS were 43, 91, 75, 71 and 72%, respectively. CONCLUSION WB-MR/DWIBS seems to be an appropriate method for the post-treatment assessment of patients affected by HL and aNHL. The small discrepancies between the two methods found within HL could be due to the biological and metabolic behavior of this group of diseases. Larger prospective studies are necessary to better define the role of WB-MR/DWIBS in this setting of patients.
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Affiliation(s)
- Nicola Maggialetti
- Department of Medicine and Health Science, University of Molise, Campobasso, Italy.
| | - Cristina Ferrari
- D.I.M.- Diagnostic Imaging - Nuclear Medicine, University of Bari "Aldo Moro", Bari, Italy
| | - Carla Minoia
- Department of Medical and Experimental Oncology, IRCCS National Cancer Research Centre "Giovanni Paolo II", Bari, Italy
| | - Artor Niccoli Asabella
- D.I.M.- Diagnostic Imaging - Nuclear Medicine, University of Bari "Aldo Moro", Bari, Italy
| | - Michele Ficco
- Department of Radiodiagnostic, IRCCS National Cancer Research Centre "Giovanni Paolo II", Bari, Italy
| | - Giacomo Loseto
- Department of Medical and Experimental Oncology, IRCCS National Cancer Research Centre "Giovanni Paolo II", Bari, Italy
| | - Giacomina De Tullio
- Department of Medical and Experimental Oncology, IRCCS National Cancer Research Centre "Giovanni Paolo II", Bari, Italy
| | - Vincenza de Fazio
- Department of Medical and Experimental Oncology, IRCCS National Cancer Research Centre "Giovanni Paolo II", Bari, Italy
| | - Angela Calabrese
- Department of Radiodiagnostic, IRCCS National Cancer Research Centre "Giovanni Paolo II", Bari, Italy
| | - Attilio Guarini
- Department of Medical and Experimental Oncology, IRCCS National Cancer Research Centre "Giovanni Paolo II", Bari, Italy
| | - Giuseppe Rubini
- D.I.M.- Diagnostic Imaging - Nuclear Medicine, University of Bari "Aldo Moro", Bari, Italy
| | - Luca Brunese
- Department of Medicine and Health Science, University of Molise, Campobasso, Italy
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Grisold W, Grisold A, Marosi C, Meng S, Briani C. Neuropathies associated with lymphoma †. Neurooncol Pract 2015; 2:167-178. [PMID: 31386037 DOI: 10.1093/nop/npv025] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Indexed: 12/12/2022] Open
Abstract
Neuropathy occurs with various manifestations as a consequence of lymphoma, and an understanding of the etiology is necessary for proper treatment. Advances in medical imaging have improved the detection of peripheral nerve involvement in lymphoma, yet tissue diagnosis is often equally important. The neoplastic involvement of the peripheral nervous system (PNS) in lymphoma can occur within the cerebrospinal fluid (CSF), inside the dura, or outside of the CSF space, affecting nerve root plexuses and peripheral nerves. The infiltration of either cranial or peripheral nerves in lymphoma is termed neurolymphomatosis (NL). These infiltrations can occur as mononeuropathy, multifocal neuropathy, symmetric neuropathies, or plexopathies. In rare cases, intravascular lymphoma (IL) can affect the PNS and an even rarer condition is the combination of NL and IL. Immune-mediated and paraneoplastic neuropathies are important considerations when treating patients with lymphoma. Demyelinating neuropathies, such as Guillain-Barré syndrome and chronic inflammatory demyelinating polyradiculoneuropathy, occur more frequently in non-Hodgkin's lymphoma than in Hodgkin's disease. Paraproteinemic neuropathies can be associated with lymphoma and paraneoplastic neuropathies are rare. While the treatment of lymphomas has improved, a knowledge of neurotoxic, radiotherapy, neoplastic, immune-mediated and paraneoplastic effects are important for patient care.
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Affiliation(s)
- Wolfgang Grisold
- Department of Neurology, Kaiser Franz Josef Hospital, Kundratstraße 3, Vienna 1100, Austria (W.G.); Department of Neurology, Medical University of Vienna, Waehringer Gürtel 18-20, Vienna 1090, Austria (A.G.); Department of Oncology, Medical University of Vienna, Waehringer Gürtel 18-20, Vienna 1090, Austria (C.M.); Department of Radiology, Kaiser Franz Josef Hospital, Kundratstraße 3, Vienna 1100, Austria (S.M.); Department of Neurosciences, University of Padova, Via Giustiniani, 5, Padova 35128, Italy (C.B.)
| | - Anna Grisold
- Department of Neurology, Kaiser Franz Josef Hospital, Kundratstraße 3, Vienna 1100, Austria (W.G.); Department of Neurology, Medical University of Vienna, Waehringer Gürtel 18-20, Vienna 1090, Austria (A.G.); Department of Oncology, Medical University of Vienna, Waehringer Gürtel 18-20, Vienna 1090, Austria (C.M.); Department of Radiology, Kaiser Franz Josef Hospital, Kundratstraße 3, Vienna 1100, Austria (S.M.); Department of Neurosciences, University of Padova, Via Giustiniani, 5, Padova 35128, Italy (C.B.)
| | - Christine Marosi
- Department of Neurology, Kaiser Franz Josef Hospital, Kundratstraße 3, Vienna 1100, Austria (W.G.); Department of Neurology, Medical University of Vienna, Waehringer Gürtel 18-20, Vienna 1090, Austria (A.G.); Department of Oncology, Medical University of Vienna, Waehringer Gürtel 18-20, Vienna 1090, Austria (C.M.); Department of Radiology, Kaiser Franz Josef Hospital, Kundratstraße 3, Vienna 1100, Austria (S.M.); Department of Neurosciences, University of Padova, Via Giustiniani, 5, Padova 35128, Italy (C.B.)
| | - Stefan Meng
- Department of Neurology, Kaiser Franz Josef Hospital, Kundratstraße 3, Vienna 1100, Austria (W.G.); Department of Neurology, Medical University of Vienna, Waehringer Gürtel 18-20, Vienna 1090, Austria (A.G.); Department of Oncology, Medical University of Vienna, Waehringer Gürtel 18-20, Vienna 1090, Austria (C.M.); Department of Radiology, Kaiser Franz Josef Hospital, Kundratstraße 3, Vienna 1100, Austria (S.M.); Department of Neurosciences, University of Padova, Via Giustiniani, 5, Padova 35128, Italy (C.B.)
| | - Chiara Briani
- Department of Neurology, Kaiser Franz Josef Hospital, Kundratstraße 3, Vienna 1100, Austria (W.G.); Department of Neurology, Medical University of Vienna, Waehringer Gürtel 18-20, Vienna 1090, Austria (A.G.); Department of Oncology, Medical University of Vienna, Waehringer Gürtel 18-20, Vienna 1090, Austria (C.M.); Department of Radiology, Kaiser Franz Josef Hospital, Kundratstraße 3, Vienna 1100, Austria (S.M.); Department of Neurosciences, University of Padova, Via Giustiniani, 5, Padova 35128, Italy (C.B.)
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Whole-body diffusion kurtosis imaging: initial experience on non-Gaussian diffusion in various organs. Invest Radiol 2015; 49:773-8. [PMID: 24979203 DOI: 10.1097/rli.0000000000000082] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
INTRODUCTION Diffusion kurtosis imaging (DKI) is based on a non-Gaussian diffusion model that should inherently better account for restricted water diffusion within the complex microstructure of most tissues than the conventional diffusion-weighted imaging (DWI), which presumes Gaussian distributed water molecule displacement probability. The aim of this investigation was to test the technical feasibility of in vivo whole-body DKI, probe for organ-specific differences, and compare whole-body DKI and DWI results. MATERIALS AND METHODS Eight healthy subjects underwent whole-body DWI on a clinical 3.0 T magnetic resonance imaging system. Echo-planar images in the axial orientation were acquired at b-values of 0, 150, 300, 500, and 800 mm²/s. Parametrical whole-body maps of the diffusion coefficient (D), the kurtosis (K), and the traditional apparent diffusion coefficient (ADC) were generated. Goodness of fit was compared between DKI and DWI fits using the sums of squared residuals. Data groups were tested for significant differences of the mean by paired Student t tests. RESULTS Good-quality parametrical whole-body maps of D, K, and ADC could be computed. Compared with ADC values, D values were significantly higher in the cerebral gray matter (by 30%) and white matter (27%), renal cortex (23%) and medulla (21%), spleen (101%), as well as erector spinae muscle (34%) (each P value <0.001). No significant differences between D and ADC were found in the cerebrospinal fluid (P = 0.08) and in the liver (P = 0.13). Curves of DKI fitted the measurement points significantly better than DWI curves did in most organs. CONCLUSIONS Whole-body DKI is technically feasible and may reflect tissue microstructure more meaningfully than whole-body DWI.
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Beyond PET/CT in Hodgkin lymphoma: a comprehensive review of the role of imaging at initial presentation, during follow-up and for assessment of treatment-related complications. Insights Imaging 2015; 6:381-92. [PMID: 25917934 PMCID: PMC4444788 DOI: 10.1007/s13244-015-0407-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Revised: 03/26/2015] [Accepted: 03/31/2015] [Indexed: 12/17/2022] Open
Abstract
Objective The purpose of this article is to provide a comprehensive review of the role of imaging modalities other than PET/CT in the management of Hodgkin lymphoma (HL). PET/CT is the imaging modality of choice in the management of Hodgkin’s lymphoma (HL). However, imaging modalities other than PET/CT such as plain radiographs, ultrasound, CT, MRI and nuclear imaging can help in various stages of clinical management of HL, including the initial workup and post-treatment surveillance. Both CT and MRI help in detecting recurrences, treatment-related pulmonary, cardiovascular and abdominal complications as well as second malignancies. Familiarity with expected post-treatment changes and complications on surveillance images can help radiologists guide patient management. The purpose of this article is to provide a comprehensive review of the role of imaging modalities other than PET/CT in the management of Hodgkin lymphoma (HL). Main Messages • Surveillance of HL patients is usually performed with plain radiographs and CT. • Follow-up imaging can depict normal post-treatment changes or treatment-related complications. • Imaging is important for the timely detection of second malignancies in HL patients.
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Regacini R, Puchnick A, Shigueoka DC, Iared W, Lederman HM. Whole-body diffusion-weighted magnetic resonance imaging versus FDG-PET/CT for initial lymphoma staging: systematic review on diagnostic test accuracy studies. SAO PAULO MED J 2015; 133:141-50. [PMID: 25789779 PMCID: PMC10496634 DOI: 10.1590/1516-3180.2014.8312810] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2014] [Revised: 01/31/2014] [Accepted: 10/28/2014] [Indexed: 11/22/2022] Open
Abstract
CONTEXT AND OBJECTIVE Positron emission tomography with [18]F-fluoro-2-deoxyglucose (FDG-PET/CT) has been advocated as the method of choice for lymphoma staging, since it enables whole-body analysis with high sensitivity for detection of affected areas and because it combines capacities for anatomical and functional assessment. With technological advances, magnetic resonance imaging (MRI) has emerged as an alternative to FDG-PET/CT. This systematic review with meta-analysis aimed to compare whole-body diffusion-weighted MRI (WB-MRI) with FDG-PET/CT for lymphoma staging. DESIGN AND SETTING Systematic review on diagnostic test accuracy studies conducted at a public university. METHODS The Medline, Scopus, Embase and Lilacs databases were searched for studies published up to September 2013 that compared WB-MRI and FDG-PET/CT for lymphoma staging. The reference lists of included studies were checked for any relevant additional citations. RESULTS Six studies that evaluated the initial lymphoma staging in 116 patients were included. WB-MRI and FDG-PET/CT agreed in 90.5% of the cases (κ = 0.871; P < 0.0001). In most of the studies, when there was disagreement between the methods, WB-MRI overstaged in relation to FDG-PET/CT. The sensitivity of WB-MRI and FDG-PET/CT, in comparison with the clinical-radiological standard, ranged from 59 to 100% and from 63 to 100% respectively. CONCLUSION WB-MRI is a highly sensitive method for initial lymphoma staging. It has excellent agreement with FDG-PET/CT and is a great alternative for managing lymphoma patients, without using ionizing radiation or an intravenous contrast agent.
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Affiliation(s)
- Rodrigo Regacini
- MD, MSc. Radiologist, Discipline of Pediatric Radiology, Department of Diagnostic Imaging, Universidade Federal de São Paulo-Escola Paulista de Medicina (Unifesp-EPM), São Paulo, Brazil.
| | - Andrea Puchnick
- BSc. Professor and Coordinator of Educational and Research Support, Department of Diagnostic Imaging, Universidade Federal de São Paulo-Escola Paulista de Medicina (Unifesp-EPM), São Paulo, Brazil.
| | - David Carlos Shigueoka
- MD, PhD. Adjunct Professor, Department of Diagnostic Imaging, Universidade Federal de São Paulo-Escola Paulista de Medicina (Unifesp-EPM), São Paulo, Brazil.
| | - Wagner Iared
- MD, PhD. Assistant Research Radiologist, Department of Diagnostic Imaging, Universidade Federal de São Paulo-Escola Paulista de Medicina (Unifesp-EPM), São Paulo, Brazil
| | - Henrique Manoel Lederman
- MD, PhD. Full Professor and Head of the Discipline of Pediatric Radiology, Department of Diagnostic Imaging, Universidade Federal de São Paulo-Escola Paulista de Medicina (Unifesp-EPM), São Paulo, Brazil.
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Hagtvedt T, Seierstad T, Lund KV, Løndalen AM, Bogsrud TV, Smith HJ, Geier OM, Holte H, Aaløkken TM. Diffusion-weighted MRI compared to FDG PET/CT for assessment of early treatment response in lymphoma. Acta Radiol 2015; 56:152-8. [PMID: 24585944 DOI: 10.1177/0284185114526087] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BACKGROUND 18F fluoro-deoxyglucose (FDG) positron emission tomography / computed tomography (PET/CT) is a well-recognized diagnostic tool used for staging and monitoring of therapy response for lymphomas. During the past decade diffusion-weighted (DW) magnetic resonance imaging (MRI) is increasingly being included in the assessment of tumor response for various cancers. PURPOSE To compare the change in maximum standardized uptake value (ΔSUVmax) from FDG PET/CT with the change in apparent diffusion coefficient (ΔADC) from DW MRI after initiation of the first cycle of chemotherapy in patients with Hodgkin's lymphoma (HL) and in patients with diffuse large B-cell lymphoma (DLBCL). MATERIAL AND METHODS Twenty-seven consecutive patients with histologically proven lymphoma and lymphomatous lymph nodes (LLN) of the neck (19 with HL, 8 with DLBCL) underwent FDG PET/CT and MRI of the neck before and after initiation of the first cycle of chemotherapy. The mean time interval from initiation of chemotherapy to imaging was 19 days and 2 days for FDG PET/CT and MRI, respectively. For each patient ΔSUVmax, ΔADC, and change in volume of the same LLN were compared. RESULTS There was a significant mean decrease of SUVmax by 70%, but no significant change in ADC. There was no significant reduction in LLN volume. CONCLUSION There was no significant correlation between ΔSUVmax and ΔADC. Thus, our data do not support that FDG PET/CT can be replaced by early DW MRI for response evaluation in lymphoma patients.
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Affiliation(s)
- Trond Hagtvedt
- Department of Radiology and Nuclear Medicine, Oslo University Hospital, Norway
- University of Oslo, Norway
| | - Therese Seierstad
- Department of Radiology and Nuclear Medicine, Oslo University Hospital, Norway
| | - Kjersti V Lund
- Department of Radiology and Nuclear Medicine, Oslo University Hospital, Norway
| | - Ayca M Løndalen
- Department of Radiology and Nuclear Medicine, Oslo University Hospital, Norway
| | - Trond V Bogsrud
- Department of Radiology and Nuclear Medicine, Oslo University Hospital, Norway
- Department of Nuclear Medicine and PET-Centre, Aarhus University Hospital, Aarhus, Denmark
| | - Hans-Jørgen Smith
- Department of Radiology and Nuclear Medicine, Oslo University Hospital, Norway
- University of Oslo, Norway
| | - Oliver M Geier
- The Intervention Centre, Oslo University Hospital, Norway
| | - Harald Holte
- Department of Oncology, Division of Cancer Medicine, Surgery and Transplantation, Oslo University Hospital, Norway
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Tsuji K, Kishi S, Tsuchida T, Yamauchi T, Ikegaya S, Urasaki Y, Fujiwara Y, Ueda T, Okazawa H, Kimura H. Evaluation of staging and early response to chemotherapy with whole-body diffusion-weighted MRI in malignant lymphoma patients: A comparison with FDG-PET/CT. J Magn Reson Imaging 2014; 41:1601-7. [DOI: 10.1002/jmri.24714] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2014] [Revised: 07/13/2014] [Accepted: 07/15/2014] [Indexed: 11/09/2022] Open
Affiliation(s)
- Kazunobu Tsuji
- Department of Radiology; University of Fukui Hospital; Fukui Japan
| | - Shinji Kishi
- Department of Hematology; University of Fukui Hospital; Fukui Japan
| | - Tatsuro Tsuchida
- Department of Radiology; University of Fukui Hospital; Fukui Japan
| | | | - Satoshi Ikegaya
- Department of Hematology; University of Fukui Hospital; Fukui Japan
| | | | | | - Takanori Ueda
- Department of Hematology; University of Fukui Hospital; Fukui Japan
| | - Hidehiko Okazawa
- Biomedical Imaging Research Center; University of Fukui; Fukui Japan
| | - Hirohiko Kimura
- Department of Radiology; University of Fukui Hospital; Fukui Japan
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Tanaka H, Yoshino K, Sakaida E, Hashimoto S, Takeda Y, Kawajiri C, Takagi T, Nakaseko C. Secondary neurolymphomatosis detected by whole-body diffusion-weighted magnetic resonance imaging: a case report. J Clin Exp Hematop 2014; 53:221-6. [PMID: 24369224 DOI: 10.3960/jslrt.53.221] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Neurolymphomatosis (NL) is a rare clinical entity defined as peripheral nervous system infiltration by lymphoma. The diagnosis is difficult and often elusive. Whole-body diffusion-weighted magnetic resonance imaging (DW MRI) was developed to enhance the detection of vaguely delineated tumors. Here, we describe the case of a 71-year-old male with secondary NL of diffuse large B-cell lymphoma (DLBCL) that was successfully detected by whole-body DW MRI. The patient was diagnosed with DLBCL extending from the ethmoidal sinus to the nasal cavity, orbital cavity, and anterior cranial fossa. Although he was administered R-THP-COP chemotherapy and the tumor remarkably decreased in size, he developed painful paresthesia and weakness in the left upper and bilateral lower extremities during treatment. Because lymphoma cells were detected in his spinal fluid, high-dose methotrexate (MTX) and weekly intrathecal MTX and cytarabine injections were administered. Test results for lymphoma cells in the spinal fluid became negative ; however, the neurological disorders progressed. Whole-body DW MRI was performed as whole-body screening and could localize NL at the left cervical and bilateral lumbar nerve roots. Both cervical spine plain MRI and enhanced computed tomography performed around the same time could not detect the cervical lesion. Our case report suggests that whole-body DW MRI is a useful diagnostic imaging procedure, especially as whole-body screening in facilities where PET/CT is not available.
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Mayerhoefer ME, Karanikas G, Kletter K, Prosch H, Kiesewetter B, Skrabs C, Porpaczy E, Weber M, Pinker-Domenig K, Berzaczy D, Hoffmann M, Sillaber C, Jaeger U, Müllauer L, Simonitsch-Klupp I, Dolak W, Gaiger A, Ubl P, Lukas J, Raderer M. Evaluation of Diffusion-Weighted MRI for Pretherapeutic Assessment and Staging of Lymphoma: Results of a Prospective Study in 140 Patients. Clin Cancer Res 2014; 20:2984-93. [DOI: 10.1158/1078-0432.ccr-13-3355] [Citation(s) in RCA: 83] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Li M, Zhang L, Wu N, Huang W, Lv N. Imaging findings of primary splenic lymphoma: a review of 17 cases in which diagnosis was made at splenectomy. PLoS One 2013; 8:e80264. [PMID: 24278265 PMCID: PMC3837000 DOI: 10.1371/journal.pone.0080264] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2013] [Accepted: 10/11/2013] [Indexed: 12/22/2022] Open
Abstract
Purpose This study sought to characterize the imaging features of primary splenic lymphoma (PSL). Materials and Methods Pathological and imaging data from 17 patients with primary splenic lymphoma initially diagnosed at splenectomy were retrospectively analyzed. Pretreatment computed tomography (CT) imaging was available for 16 patients, and magnetic resonance imaging (MRI) data were available for 4 patients. Splenic lymphoma imaging data were categorized based on the gross pathological presentation in the following manner: type 1, homogeneous enlargement; type 2, miliary nodules; type 3, multifocal masses of varying size; and type 4, solitary large mass. Results Of the 17 patients with PSL, 16 cases were non-Hodgkin lymphoma, and of these, 9 cases were diffuse large B cell lymphomas (DLBCL) and 4 cases were splenic marginal zone B-cell lymphoma (SMZL). Imaging showed the following types of PSL presentation: 1 case of type 1, 0 cases of type 2, 4 cases of type 3, and 12 cases of type 4. There was evidence of necrosis in 12 cases (70.6%), and there was evidence of mild enhancement in enhanced CT in 14 cases and in enhanced MRI in 3 cases. Prior to surgery, PSL was considered possible in 8 patients. Conclusion The most frequent histological subtype was DLBCL, followed by SMZL. In both CT and MRI, PSL generally presents as a solitary mass or masses rather than as splenomegaly. In addition, necrosis and mild enhancement are commonly observed, and splenectomy may be required to confirm the diagnosis.
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Affiliation(s)
- Meng Li
- Department of Diagnostic Radiology, Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Li Zhang
- Department of Diagnostic Radiology, Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Ning Wu
- Department of Diagnostic Radiology, Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
- PET-CT Center, Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
- * E-mail:
| | - Wenting Huang
- Department of Pathology, Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Ning Lv
- Department of Pathology, Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
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