Comparison between whole-body MRI with diffusion-weighted imaging and PET/CT in staging newly diagnosed FDG-avid lymphomas.

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.

[1]  Bruce D Cheson,et al.  Recommendations for initial evaluation, staging, and response assessment of Hodgkin and non-Hodgkin lymphoma: the Lugano classification. , 2014, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[2]  P. Mclaughlin,et al.  Frequency of gastrointestinal involvement and its clinical significance in mantle cell lymphoma , 2003, Cancer.

[3]  J. Armitage,et al.  Staging Non‐Hodgkin Lymphoma , 2005, CA: a cancer journal for clinicians.

[4]  A. Qayyum Diffusion-weighted imaging in the abdomen and pelvis: concepts and applications. , 2009, Radiographics : a review publication of the Radiological Society of North America, Inc.

[5]  M. Federico,et al.  Long-term survival, prevalence, and cure of cancer: a population-based estimation for 818 902 Italian patients and 26 cancer types , 2014, Annals of oncology : official journal of the European Society for Medical Oncology.

[6]  Thomas C Kwee,et al.  Imaging in staging of malignant lymphoma: a systematic review. , 2008, Blood.

[7]  R. Reznek,et al.  Computerised tomography in the staging of Hodgkin's disease and non-Hodgkin's lymphoma , 2003, European Journal of Nuclear Medicine and Molecular Imaging.

[8]  A. Salar,et al.  Gastrointestinal Involvement in Mantle Cell Lymphoma: A Prospective Clinic, Endoscopic, and Pathologic Study , 2006, The American journal of surgical pathology.

[9]  A. Luciani,et al.  Whole-Body Diffusion-weighted Imaging in Hodgkin Lymphoma and Diffuse Large B-Cell Lymphoma. , 2015, Radiographics : a review publication of the Radiological Society of North America, Inc.

[10]  M Tubiana,et al.  Report of a committee convened to discuss the evaluation and staging of patients with Hodgkin's disease: Cotswolds meeting. , 1989, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[11]  C. Claussen,et al.  Kostenüberlegungen zur Ganzkörper-MRT und PET-CT im Rahmen des onkologischen Stagings , 2008, Der Radiologe.

[12]  T. Takahara,et al.  Whole-Body MRI, Including Diffusion-Weighted Imaging, for the Initial Staging of Malignant Lymphoma: Comparison to Computed Tomography , 2009, Investigative radiology.

[13]  A. Jemal,et al.  Cancer statistics, 2012 , 2012, CA: a cancer journal for clinicians.

[14]  J. Vose Mantle cell lymphoma: 2013 Update on diagnosis, risk‐stratification, and clinical management , 2012, American journal of hematology.

[15]  P. Choyke,et al.  Diffusion-weighted magnetic resonance imaging as a cancer biomarker: consensus and recommendations. , 2009, Neoplasia.

[16]  Pek-Lan Khong,et al.  Whole-body PET/CT scanning: estimation of radiation dose and cancer risk. , 2009, Radiology.

[17]  Peter R Luijten,et al.  ADC measurements of lymph nodes: inter- and intra-observer reproducibility study and an overview of the literature. , 2010, European journal of radiology.

[18]  R. Fisher,et al.  Role of imaging in the staging and response assessment of lymphoma: consensus of the International Conference on Malignant Lymphomas Imaging Working Group. , 2014, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[19]  D. Collins,et al.  Whole-body diffusion-weighted MRI: tips, tricks, and pitfalls. , 2012, AJR. American journal of roentgenology.

[20]  D. Vincent,et al.  Comparison of PET-CT and magnetic resonance diffusion weighted imaging with body suppression (DWIBS) for initial staging of malignant lymphomas. , 2013, European journal of radiology.

[21]  T. Takahara,et al.  Diffusion weighted whole body imaging with background body signal suppression (DWIBS): technical improvement using free breathing, STIR and high resolution 3D display. , 2004, Radiation medicine.

[22]  T. Kwee,et al.  Whole-body MRI vs. CT for staging lymphoma: patient experience. , 2014, European journal of radiology.

[23]  F. De Keyzer,et al.  Whole-body diffusion-weighted magnetic resonance imaging at 3 Tesla for early assessment of treatment response in non-Hodgkin lymphoma: a pilot study , 2013, Cancer imaging : the official publication of the International Cancer Imaging Society.

[24]  T. Kwee,et al.  Magnetic resonance imaging for the detection of bone marrow involvement in malignant lymphoma , 2008, British journal of haematology.

[25]  A. Rossi,et al.  Risk factors for the development of secondary malignancy after high-dose chemotherapy and autograft, with or without rituximab: a 20-year retrospective follow-up study in patients with lymphoma. , 2011, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[26]  D. Collins,et al.  Whole-body diffusion-weighted MR imaging in cancer: current status and research directions. , 2011, Radiology.

[27]  Ash A. Alizadeh,et al.  Utility of positron emission tomography scans in mantle cell lymphoma , 2011, American journal of hematology.

[28]  C. Gundy,et al.  FDG PET in lymphoma: The need for standardization of interpretation. An observer variation study , 2007, Nuclear medicine communications.

[29]  Jaap Stoker,et al.  Whole‐body MRI, including diffusion‐weighted imaging, for staging lymphoma: Comparison with CT in a prospective multicenter study , 2014, Journal of magnetic resonance imaging : JMRI.

[30]  Alexandra G. Smith,et al.  Epidemiology of lymphomas , 2011, Histopathology.

[31]  M. Sumi,et al.  Diagnostic ability of apparent diffusion coefficients for lymphomas and carcinomas in the pharynx , 2007, European Radiology.

[32]  Pek-Lan Khong,et al.  Whole-body diffusion-weighted imaging: the added value to whole-body MRI at initial diagnosis of lymphoma. , 2011, AJR. American journal of roentgenology.

[33]  Thomas C. Kwee,et al.  ADC measurements in the evaluation of lymph nodes in patients with non-Hodgkin lymphoma: feasibility study , 2011, Magnetic Resonance Materials in Physics, Biology and Medicine.