European Radiology

, Volume 14, Issue 10, pp 1829–1841 | Cite as

Initial experience with FSE STIR whole-body MR imaging for staging lymphoma in children

  • Christian J. Kellenberger
  • Stephen F. Miller
  • Mustafa Khan
  • David L. Gilday
  • Sheila Weitzman
  • Paul S. Babyn
Pediatric

Abstract

Our objective was to compare fast spin-echo (FSE) short inversion time inversion recovery (STIR) whole-body MR imaging with standard procedures in staging children with lymphoma. Eight children (age range, 2–16 years) underwent multi-station FSE STIR whole-body MR at initial staging (n=5) or for restaging following completion of therapy (n=5). Whole-body MR and conventional staging procedures, including CT (n=10), gallium-67 scintigraphy (n=9), bone scintigraphy (n=3) and bone marrow biopsy (n=7) were retrospectively compared for detection of sites involved by lymphoma and for the assigned stage. FSE STIR whole-body MR detected more sites of possible lymphomatous involvement at initial staging (87/88) and at restaging (5/5) than did conventional imaging (74/88, 3/5). MR was more sensitive than conventional imaging in detecting bone marrow involvement at initial staging. Following treatment, however, residual and therapy-induced bone marrow signal abnormalities could not be differentiated from lymphomatous involvement. Detection of nodal and visceral involvement correlated well. Our results suggest that FSE STIR whole-body MR imaging is a sensitive technique for evaluating lymphomatous involvement of bone marrow as well as non-marrow sites. Larger prospective trials are needed to determine if FSE STIR whole-body MR can replace standard radiographic procedures for initial staging and contribute in the follow-up of lymphoma in children.

Keywords

MRI Turbo STIR Whole-body MRI Paediatrics Neoplasm 

References

  1. 1.
    Weinstein HJ, Tarbell NJ (2001) Leukemias and lymphomas of childhood. In: DeVita VT, Hellman S, Rosenberg SA (eds) Cancer: principles and practice of oncology. Lippincott Williams & Wilkins, Philadelphia, pp 2235–2256Google Scholar
  2. 2.
    Carty H, Martin J (1993) Staging of lymphoma in childhood. Clin Radiol 48:151–159Google Scholar
  3. 3.
    Hamrick-Turner JE, Saif MF, Powers CI, Blumenthal BI, Royal SA, Iyer RV (1994) Imaging of childhood non-Hodgkin lymphoma: assessment by histologic subtype. Radiographics 14:11–28PubMedGoogle Scholar
  4. 4.
    Halliday T, Baxter G (2003) Lymphoma: pictorial review. I. Eur Radiol 13:1154–1164PubMedGoogle Scholar
  5. 5.
    Halliday T, Baxter G (2003) Lymphoma: pictorial review. II. Eur Radiol 13:1224–1234PubMedGoogle Scholar
  6. 6.
    Rosenthal H, Kolb R, Gratz KF, Reiter A, Galanski M (2000) Bone manifestations in non-Hodgkin’s lymphoma in childhood and adolescence. Radiologe 40:737–744CrossRefPubMedGoogle Scholar
  7. 7.
    Shields AF, Porter BA, Churchley S, Olson DO, Appelbaum FR, Thomas ED (1987) The detection of bone marrow involvement by lymphoma using magnetic resonance imaging. J Clin Oncol 5:223–230Google Scholar
  8. 8.
    Linden A, Zankovich R, Theissen P, Diehl V, Schicha H (1989) Malignant lymphoma: bone marrow imaging versus biopsy. Radiology 173:335–339PubMedGoogle Scholar
  9. 9.
    Döhner H, Gückel F, Knauf W, Semmler W, van Kaick G, Ho AD, Hunstein W (1989) Magnetic resonance imaging of bone marrow in lymphoproliferative disorders: correlation with bone marrow biopsy. Br J Haematol 73:12–17PubMedGoogle Scholar
  10. 10.
    Hoane BR, Shields AF, Porter BA, Shulman HM (1991) Detection of lymphomatous bone marrow involvement with magnetic resonance imaging. Blood 78:728–738PubMedGoogle Scholar
  11. 11.
    Tardivon AA, Munck JN, Shapero LG, Koscielny S, Bosq J, Dhermain F, Gilles R, Hayat M, Vanel D (1995) Can clinical data help to screen patients with lymphoma for MR imaging of bone marrow. Ann Oncol 6:795–800PubMedGoogle Scholar
  12. 12.
    Varan A, Cila A, Buyukpamukcu M (1999) Prognostic importance of magnetic resonance imaging in bone marrow involvement of Hodgkin’s disease. Med Pediatr Oncol 32:267–271Google Scholar
  13. 13.
    Cohen MD, Klatte EC, Smith JA, Martin-Simmerman P, Carr B, Baehner R, Weetman R, Provisor A, Coates T, Berkow R et al (1985) Magnetic resonance imaging of lymphomas in children. Pediatr Radiol 15:179–183Google Scholar
  14. 14.
    Greco A, Jelliffe AM, Maher EJ, Leung AW (1988) MR imaging of lymphomas: impact on therapy. J Comput Assist Tomogr 12:785–791PubMedGoogle Scholar
  15. 15.
    Tesoro-Tess JD, Balzarini L, Ceglia E, Petrillo R, Santoro A, Musumeci R (1991) Magnetic resonance imaging in the initial staging of Hodgkin’s disease and non-Hodgkin’s lymphoma. Eur J Radiol 12:81–90CrossRefPubMedGoogle Scholar
  16. 16.
    Hanna SL, Fletcher BD, Boulden TF, Hudson MM, Greenwald CA, Kun LE (1993). MR imaging of infradiaphragmatic lymphadenopathy in children and adolescents with Hodgkin’s disease: comparison with lymphography and CT. J Magn Reson Imaging 3:461–470PubMedGoogle Scholar
  17. 17.
    Hoane BR, Shields AF, Porter BA, Borrow JW (1994) Comparison of initial lymphoma staging using computed tomography (CT) and magnetic resonance (MR) imaging. Am J Hematol 47:100–105PubMedGoogle Scholar
  18. 18.
    Jung G, Heindel W, von Bergwelt-Baildon M, Bredenfeld H, Gossmann A, Zahringer M, Tesch H (2000) Abdominal lymphoma staging: is MR imaging with T2-weighted turbo-spin-echo sequence a diagnostic alternative to contrast-enhanced spiral CT? J Comput Assist Tomogr 24:783–787CrossRefPubMedGoogle Scholar
  19. 19.
    Walker RE, Eustace SJ (2001) Whole-body magnetic resonance imaging: techniques, clinical indications, and future applications. Semin Musculoskelet Radiol 5:5–20Google Scholar
  20. 20.
    Kavanagh E, Smith C, Eustace S (2003) Whole-body turbo STIR MR imaging: controversies and avenues for development. Eur Radiol 13:2196–2205CrossRefPubMedGoogle Scholar
  21. 21.
    Eustace S, Tello R, DeCarvalho V, Carey J, Wroblicka JT, Melhem ER, Yucel EK (1997) A comparison of whole-body turboSTIR MR imaging and planar 99mTc-methylene diphosphonate scintigraphy in the examination of patients with suspected skeletal metastases. Am J Roentgenol 169:1655–1661Google Scholar
  22. 22.
    Steinborn MM, Heuck AF, Tiling R, Bruegel M, Gauger L, Reiser MF (1999) Whole-body bone marrow MRI in patients with metastatic disease to the skeletal system. J Comput Assist Tomogr 23:123–129CrossRefPubMedGoogle Scholar
  23. 23.
    Walker R, Kessar P, Blanchard R, Dimasi M, Harper K, DeCarvalho V, Yucel EK, Patriquin L, Eustace S (2000) Turbo STIR magnetic resonance imaging as a whole-body screening tool for metastases in patients with breast carcinoma: preliminary clinical experience. J Magn Reson Imaging 11:343–350CrossRefPubMedGoogle Scholar
  24. 24.
    Iizuka-Mikami M, Nagai K, Yoshida K, Sugihara T, Suetsugu Y, Mikami M, Tamada T, Imai S, Kajihara Y, Fukunaga M (2004) Detection of bone marrow and extramedullary involvement in patients with non-Hodgkin’s lymphoma by whole-body MRI: comparison with bone and (67)Ga scintigraphies. Eur Radiol 14:1074–1081CrossRefPubMedGoogle Scholar
  25. 25.
    Mazumdar A, Siegel MJ, Narra V, Luchtman-Jones L (2002) Whole-body fast inversion recovery MR imaging of small cell neoplasms in pediatric patients: a pilot study. Am J Roentgenol 179:1261–1266Google Scholar
  26. 26.
    Mouratidis B, Gilday DL, Ash JM (1994) Comparison of bone and 67Ga scintigraphy in the initial diagnosis of bone involvement in children with malignant lymphoma. Nucl Med Commun 15:144–147PubMedGoogle Scholar
  27. 27.
    Lister TA, Crowther D, Sutcliffe SB, Glatstein E, Canellos GP, Young RC, Rosenberg SA, Coltman CA, Tubiana M (1989) Report of a committee convened to discuss the evaluation and staging of patients with Hodgkin’s disease: Cotswolds meeting. J Clin Oncol 7:1630–1636PubMedGoogle Scholar
  28. 28.
    Murphy SB (1980) Classification, staging and end results of treatment of childhood non-Hodgkin’s lymphomas: dissimilarities from lymphomas in adults. Semin Oncol 7:332–339PubMedGoogle Scholar
  29. 29.
    Hargaden G, O’Connell M, Kavanagh E, Powell T, Ward R, Eustace S (2003) Current concepts in whole-body imaging using turbo short tau inversion recovery MR imaging. Am J Roentgenol 180:247–252Google Scholar
  30. 30.
    O’Connell MJ, Powell T, Brennan D, Lynch T, McCarthy CJ, Eustace SJ (2002) Whole-body MR imaging in the diagnosis of polymyositis. Am J Roentgenol 179:967–971Google Scholar
  31. 31.
    Vande Berg BC, Lecouvert FE, Michaux L, Ferrant A, Maldague B, Malghem J (1998) Magnetic resonance imaging of the bone marrow in hematological malignancies. Eur Radiol 8:1335–1344CrossRefPubMedGoogle Scholar
  32. 32.
    Boxen I (1999) Gallium accumulation in marrow lymphocytes. Clin Nucl Med 24:173–176CrossRefPubMedGoogle Scholar
  33. 33.
    Tsunoda S, Takagi S, Tanaka O, Miura Y (1997) Clinical and prognostic significance of femoral marrow magnetic resonance imaging in patients with malignant lymphoma. Blood 89:286–290PubMedGoogle Scholar
  34. 34.
    Altehoefer C, Blum U, Bathmann J, Wüstenberg C, Uhrmeister P, Laubenberger J, Lange W, Schwarzkopf J, Moser E, Langer M (1997) Comperative diagnostic accuracy of magnetic resonance imaging and immunoscintigraphy for detection of bone marrow involvement in patients with malignant lymphoma. J Clin Oncol 15:1754–1760PubMedGoogle Scholar
  35. 35.
    Hanna SL, Fletcher BD, Fairclough DL, Jenkins JH III, Le AH (1991) Magnetic resonance imaging of disseminated bone marrow disease in patients treated for malignancy. Skeletal Radiol 20:79–84PubMedGoogle Scholar
  36. 36.
    Fletcher BD, Wall JE, Hanna SL (1993) Effect of hematopoietic growth factors on MR images of bone marrow in children undergoing chemotherapy. Radiology 189:745–751PubMedGoogle Scholar
  37. 37.
    Hudson MM, Krasin MJ, Kaste SC (2004) PET imaging in pediatric Hodgkin’s lymphoma. Pediatr Radiol 34:190–198Google Scholar

Copyright information

©  2004

Authors and Affiliations

  • Christian J. Kellenberger
    • 1
  • Stephen F. Miller
    • 1
  • Mustafa Khan
    • 1
  • David L. Gilday
    • 1
  • Sheila Weitzman
    • 2
  • Paul S. Babyn
    • 1
  1. 1.Department of Diagnostic ImagingThe Hospital for Sick ChildrenTorontoCanada
  2. 2.Department of PaediatricsThe Hospital for Sick ChildrenTorontoCanada

Personalised recommendations