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Comparison of whole-body MRI with diffusion-weighted imaging and PET/CT in lymphoma staging

  • Magnetic Resonance
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

To compare the diagnostic efficiency of whole-body MRI-DWI and PET/CT in lymphoma staging.

Methods

A prospective study enrolled 92 patients with lymphoma. Prior to treatment, all patients underwent whole-body MRI-DWI and PET-CT. The methods’ efficiency was compared in the diagnosis of lymph node (LN) and organ involvement, and in determining lymphoma stage.

Results

Sensitivity, specificity, and accuracy in the diagnosis of enlarged LN involvement were 98.2%, 99.9%, and 99.3%, respectively, for MRI-DWI, and 99.4%, 100.0%, and 99.8%, respectively, for PET/CT. ROC analysis showed similar methods’ efficiency in the diagnosis of enlarged LN involvement (p > 0.06). MRI-DWI and PET/CT sensitivity in the diagnosis of non-enlarged LN involvement was 77.8% and 88.1%, respectively (p < 0.001). MRI-DWI and PET/CT sensitivity, specificity, and accuracy in the diagnosis of lung involvement were 73.3%, 98.7%, 94.6% and 86.7%, 98.7%, 96.7%; spleen involvement 54.8%, 98.3%, 83.3% and 100.0%, 100.0%, 100.0%; bone marrow involvement 87.1%, 96.4%, 93.0% and 64.5%, 87.3%, 79.1%; and all-organ involvement 72.9%, 98.1%, 91.4% and 80.0%, 96.6%, 92.2%, respectively. ROC analysis showed similar methods’ efficiency in the diagnosis of lung involvement (р > 0.3), higher for PET/CT in spleen involvement (р < 0.0001), higher for MRI-DWI in bone marrow involvement (р < 0.0008), and similar in all-organ involvement (р > 0.35). MRI-DWI and PET/CT determined the correct lymphoma stage in 79 (86%) patients.

Conclusions

Whole-body MRI-DWI and PET/CT determined the correct lymphoma stage in similar numbers of patients. MRI-DWI can serve as a non-irradiative alternative to PET/CT in lymphoma staging.

Key Points

• Whole-body MRI-DWI efficiency compared with that of PET/CT is similar in the diagnosis of enlarged LN involvement, inferior in the diagnosis of non-enlarged LN and spleen involvement, but superior in the diagnosis of bone marrow involvement.

• A new efficient MRI-DWI sign for diagnosis of diffuse bone marrow involvement has been proposed, i.e., a diffuse increase in spine signal intensity on high b value DWI images above the kidney parenchyma.

• MRI-DWI and PET/CT determined the correct lymphoma stage in similar numbers of patients.

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Abbreviations

BM:

Bone marrow

DLBCL:

Diffuse large B cell lymphoma

FIESTA:

Fast imaging employing steady-state acquisition

HL:

Hodgkin lymphoma

LN:

Lymph node

MCL:

Mantle cell lymphoma

MZL:

Marginal zone lymphoma

NHL:

Non-Hodgkin lymphoma

NPV:

Negative predictive value

PPV:

Positive predictive value

SLL:

Small lymphocytic lymphoma

STIR:

Short inversion time inversion recovery

SUV:

Standardized uptake value

References

  1. Cheson BD, Fisher RI, Barrington SF et al (2014) Recommendations for initial evaluation, staging, and response assessment of Hodgkin and non-Hodgkin lymphoma: the Lugano classification. J Clin Oncol 32:3059–3068

    Article  Google Scholar 

  2. Barrington SF, Mikhaeel NG, Kostakoglu L et al (2014) Role of imaging in the staging and response assessment of lymphoma: consensus of the international conference on malignant lymphomas imaging working group. J Clin Oncol 32:3048–3058

    Article  Google Scholar 

  3. Padhani AR, Liu G, Mu-Koh D et al (2009) Diffusion-weighted magnetic resonance imaging as a cancer biomarker: consensus and recommendations. Neoplasia 11:102–125

  4. Lin C, Luciani A, Itti E et al (2010) Whole-body diffusion-weighted magnetic resonance imaging with apparent diffusion coefficient mapping for staging patients with diffuse large B-cell lymphoma. Eur Radiol 20:2027–2038

    Article  Google Scholar 

  5. Albano D, Patti C, La Grutta L et al (2016) Comparison between whole-body MRI with diffusion-weighted imaging and PET/CT in staging newly diagnosed FDG-avid lymphomas. Eur J Radiol 85:313–318

    Article  Google Scholar 

  6. Abdulqadhr G, Molin D, Aström G et al (2011) Whole-body diffusion-weighted imaging compared with FDG-PET/CT in staging of lymphoma patients. Acta Radiol 52:173–180

  7. Latifoltojar A, Punwani S, Lopes A et al (2019) Whole-body MRI for staging and interim response monitoring in paediatric and adolescent Hodgkin’s lymphoma: a comparison with multi-modality reference standard including 18F-FDG-PET-CT. Eur Radiol 29:202–212

    Article  Google Scholar 

  8. Pakos EE, Fotopoulos AD, Ioannidis JP (2005) 18F-FDG PET for evaluation of bone marrow infiltration in staging of lymphoma: a meta-analysis. J Nucl Med 46:958–963

    PubMed  Google Scholar 

  9. Adams HJ, Kwee TC, de Keizer B, Fijnheer R, de Klerk JM, Nievelstein RA (2014) FDG PET/CT for the detection of bone marrow involvement in diffuse large B-cell lymphoma: systematic review and meta-analysis. Eur J Nucl Med Mol Imaging 41:565–574

  10. Adams HJ, Kwee TC, de Keizer B et al (2014) Systematic review and meta-analysis on the diagnostic performance of FDG-PET/CT in detecting bone marrow involvement in newly diagnosed Hodgkin lymphoma: is bone marrow biopsy still necessary? Ann Oncol 25:921–927

    Article  CAS  Google Scholar 

  11. Hosein PJ, Pastorini VH, Paes FM et al (2011) Utility of positron emission tomography scans in mantle cell lymphoma. Am J Hematol 86:841–845

    Article  Google Scholar 

  12. Kwee TC, Vermoolen MA, Akkerman EA et al (2014) Whole-body MRI, including diffusion-weighted imaging, for staging lymphoma: comparison with CT in a prospective multicenter study. J Magn Reson Imaging 40:26–36

    Article  Google Scholar 

  13. Hoane BR, Shields AF, Porter BA, Shulman HM (1991) Detection of lymphomatous bone marrow involvement with magnetic resonance imaging. Blood 78:728–738

    Article  CAS  Google Scholar 

  14. Adams HJ, Kwee TC, Vermoolen MA et al (2013) Whole-body MRI for the detection of bone marrow involvement in lymphoma: prospective study in 116 patients and comparison with FDG-PET. Eur Radiol 23:2271–2278

    Article  Google Scholar 

  15. Salaun PY, Gastinne T, Bodet-Milin C et al (2009) Analysis of 18F-FDG PET diffuse bone marrow uptake and splenic uptake in staging of Hodgkin's lymphoma: a reflection of disease infiltration or just inflammation? Eur J Nucl Med Mol Imaging 36:1813–1821

    Article  Google Scholar 

  16. Adams HJ, de Klerk JM, Fijnheer R et al (2016) Variety in bone marrow 18F-FDG uptake in Hodgkin lymphoma patients without lymphomatous bone marrow involvement: does it have an explanation? Nucl Med Commun 37:23–29

    CAS  PubMed  Google Scholar 

  17. El-Galaly TC, d'Amore F, Mylam KJ et al (2012) Routine bone marrow biopsy has little or no therapeutic consequence for positron emission tomography/computed tomography-staged treatment-naive patients with Hodgkin lymphoma. J Clin Oncol 30:4508–4514

    Article  Google Scholar 

  18. El Khouli RH, Macura KJ, Barker PB, Habba MR, Jacobs MA, Bluemke DA (2009) Relationship of temporal resolution to diagnostic performance for dynamic contrast enhanced MRI of the breast. J Magn Reson Imaging 30:999–1004

  19. Crewson PE (2005) Reader agreement studies. AJR Am J Roentgenol 184:1391–1397

    Article  Google Scholar 

  20. Mayerhoefer ME, Karanikas G, Kletter K et al (2014) Evaluation of diffusion-weighted MRI for pretherapeutic assessment and staging of lymphoma: results of a prospective study in 140 patients. Clin Cancer Res 20:2984–2993

    Article  Google Scholar 

  21. Reinert CP, Hinterleitner C, Fritz J, Nikolaou K, Horger M (2019) Diagnosis of diffuse spleen involvement in haematological malignancies using a spleen-to-liver attenuation ratio on contrast-enhanced CT images. Eur Radiol 2:450–457

  22. Larbi A, Omoumi P, Pasoglou V et al (2019) Whole-body MRI to assess bone involvement in prostate cancer and multiple myeloma: comparison of the diagnostic accuracies of the T1, short tau inversion recovery (STIR), and high b-values diffusion-weighted imaging (DWI) sequences. Eur Radiol 29:4503–4513

    Article  Google Scholar 

  23. Lecouvet FE, Boyadzhiev D, Collette L et al (2019) MRI versus 18F-FDG-PET/CT for detecting bone marrow involvement in multiple myeloma: diagnostic performance and clinical relevance. Eur Radiol. https://doi.org/10.1007/s00330-019-06469-1

  24. De Paepe KN, De Keyzer F, Wolter P et al (2018) Improving lymph node characterization in staging malignant lymphoma using first-order ADC texture analysis from whole-body diffusion-weighted MRI. J Magn Reson Imaging 48:897–906

    Article  Google Scholar 

  25. Rutherford SC, Andemariam B, Philips SM et al (2008) FDG-PET in prediction of splenectomy findings in patients with known or suspected lymphoma. Leuk Lymphoma 49:719–726

    Article  Google Scholar 

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Funding

The authors state that this work has not received any funding.

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Authors and Affiliations

  1. Department of Radiology, N.N. Alexandrov National Cancer Center, agr. Lesnoy, 223040, Minsk district, Belarus

    Siarhei Kharuzhyk

  2. Department of Medical Oncology, N.N. Alexandrov National Cancer Center, agr. Lesnoy, 223040, Minsk district, Belarus

    Edward Zhavrid, Elena Sukolinskaja & Olga Kalenik

  3. PET Department, N.N. Alexandrov National Cancer Center, agr. Lesnoy, 223040, Minsk district, Belarus

    Andrei Dziuban

Authors
  1. Siarhei Kharuzhyk
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  2. Edward Zhavrid
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  3. Andrei Dziuban
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  4. Elena Sukolinskaja
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  5. Olga Kalenik
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Corresponding author

Correspondence to Siarhei Kharuzhyk.

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Guarantor

The scientific guarantor of this publication is Siarhei Kharuzhyk.

Conflict of interest

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was obtained from all subjects (patients) in this study.

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Institutional Review Board approval was obtained.

Methodology

• Prospective

• Diagnostic or prognostic study

• Performed at one institution

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Kharuzhyk, S., Zhavrid, E., Dziuban, A. et al. Comparison of whole-body MRI with diffusion-weighted imaging and PET/CT in lymphoma staging. Eur Radiol 30, 3915–3923 (2020). https://doi.org/10.1007/s00330-020-06732-w

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  • DOI: https://doi.org/10.1007/s00330-020-06732-w

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