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Application of DWIBS in malignant lymphoma: correlation between ADC values and Ki-67 index

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

Abstract

Objectives

We investigated the correlation between the apparent diffusion coefficient (ADC) and Ki-67 index using diffusion-weighted whole-body imaging with background body signal suppression (DWIBS), and their utility in evaluating malignant lymphoma cell proliferation.

Materials and Methods

Seventy-four patients with malignant lymphoma underwent DWIBS within 1 week before pathological confirmation. The ADC value was measured at the site of the pathological examination, and specimens were also stained with Ki-67. The ADC values and Ki-67 indices in aggressive non-Hodgkin's lymphoma (NHL), indolent NHL, and Hodgkin's lymphoma (HL) were compared using Spearman's rank correlation coefficient and the Kruskal-Wallis test.

Results

The Ki-67 indices and ADC values were inversely correlated (r = -0.289, p = 0.0125); the differences in the Ki-67 index between aggressive NHL, indolent NHL, and HL were significant (p < 0.001); this was confirmed by the Nemenyi test except for indolent NHL vs. HL. The ADC values were significantly different between the types of lymphoma (p = 0.013); the Nemenyi test showed a significant difference only between aggressive NHL and HL.

Conclusions

The Ki-67 indices and ADC values are inversely correlated in patients with lymphoma, combining DWIBS and ADC values can evaluate the proliferation level of malignant lymphoma cells noninvasively.

Key points

• By using DWIBS, malignant lymphoma cell proliferation can be assessed noninvasively.

• The ADC value and Ki-67 index are significantly and inversely correlated.

• The ADC values were lower in aggressive NHL than in HL.

• The ADC values of aggressive and indolent NHL were not significantly different.

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Abbreviations

ADC:

Apparent diffusion coefficient

DWIBS:

Diffusion-weighted whole-body imaging with background body signal suppression

NHL:

Non-Hodgkin's lymphoma

HL:

Hodgkin's lymphoma

MRI:

Magnetic resonance imaging

TI:

Inversion time

DWI:

Diffusion-weighted imaging

TR:

Repetition time

TE:

Echo time

FOV:

Field of view

ROI:

Region of interest

NK:

Natural killer

MCL:

Mantle cell lymphoma

IPI:

International Prognostic Index

References

  1. Zhang J, Grubor V, Love CL et al (2013) Genetic heterogeneity of diffuse large B-cell lymphoma. Proc Natl Acad Sci U S A 110:1398–1403

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. 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

    Article  PubMed  Google Scholar 

  3. Gu J, Chan T, Zhang J et al (2011) Whole-body diffusion-weighted imaging: the added value to whole-body MRI at initial diagnosis of lymphoma. AJR Am J Roentgenol 197:W384–W391

    Article  PubMed  Google Scholar 

  4. Chen L, Liu M, Bao J et al (2013) The correlation between apparent diffusion coefficient and tumor cellularity in patients: a meta-analysis. PLoS One 8:e79008

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Jeon JY, Chung HW, Lee MH et al (2016) Usefulness of diffusion-weighted MR imaging for differentiating between benign and malignant superficial soft tissue tumours and tumour-like lesions. Br J Radiol 89:20150929

    Article  PubMed  PubMed Central  Google Scholar 

  6. Horger M, Claussen C, Kramer U et al (2014) Very early indicators of response to systemic therapy in lymphoma patients based on alterations in water diffusivity--a preliminary experience in 20 patients undergoing whole-body diffusion-weighted imaging. Eur J Radiol 83:1655–1664

    Article  CAS  PubMed  Google Scholar 

  7. Barajas RF Jr, Rubenstein JL, Chang JS et al (2010) Diffusion-weighted MR imaging derived apparent diffusion coefficient is predictive of clinical outcome in primary central nervous system lymphoma. AJNR Am J Neuroradiol 31:60–66

    Article  PubMed  Google Scholar 

  8. Valles FE, Perez-Valles CL, Regalado S et al (2013) Combined diffusion and perfusion MR imaging as biomarkers of prognosis in immunocompetent patients with primary central nervous system lymphoma. AJNR Am J Neuroradiol 34:35–40

    Article  CAS  PubMed  Google Scholar 

  9. Schob S, Meyer J, Gawlitza M et al (2016) Diffusion-Weighted MRI Reflects Proliferative Activity in Primary CNS Lymphoma. PLoS One 11:e0161386

    Article  PubMed  PubMed Central  Google Scholar 

  10. Broyde A, Boycov O, Strenov Y et al (2009) Role and prognostic significance of the Ki-67 index in non-Hodgkin's lymphoma. Am J Hematol 84:338–343

    Article  PubMed  Google Scholar 

  11. Cuenca X, Xhaard A, Mounier N (2009) Prognostic factors in Hodgkin and non-Hodgkin lymphomas. Bull Cancer 96:461–473

    CAS  PubMed  Google Scholar 

  12. Swerdlow SH, Campo E, Harris NL et al (2008) WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues. IARC Press, Lyon, France

    Google Scholar 

  13. Huang HH, Xiao F, Chen FY et al (2012) Reassessment of the prognostic value of the International Prognostic Index and the revised InternationalPrognostic Index in patients with diffuse large B-cell lymphoma: A multicentre study. Exp Ther Med 4:475–480

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Sehn LH, Berry B, Chhanabhai M et al (2007) The revised International Prognostic Index (R-IPI) is a better predictor of outcome than the standard IPI for patients with diffuse large B-cell lymphoma treated with R-CHOP. Blood 109:1857–1861

    Article  CAS  PubMed  Google Scholar 

  15. Prochazka KT, Melchardt T, Posch F et al (2016) NCCN-IPI score-independent prognostic potential of pretreatment uric acid levels for clinical outcome of diffuse large B-cell lymphoma patients. Br J Cancer 115:1264–1272

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Gerdes J, Schwab U, Lemke H et al (1983) Production of a mouse monoclonal antibody reactive with a human nuclear antigen associated with cell proliferation. Int J Cancer 31:13–20

    Article  CAS  PubMed  Google Scholar 

  17. Jakovic LR, Mihaljevic BS, Jovanovic MD et al (2007) The expression of Ki-67 and Bcl-2 in Hodgkin's lymphoma: correlation with the International Prognostic Score and bulky disease: a study by the Serbian Lymphoma Study Group (SLG). Med Oncol 24:45–53

    Article  CAS  PubMed  Google Scholar 

  18. Hoster E, Rosenwald A, Berger F et al (2016) Prognostic value of Ki-67 index, cytology, and growth pattern in mantle-cell lymphoma: results from randomized trials of the European Mantle Cell Lymphoma Network. J Clin Oncol 34:1386–1394

    Article  CAS  PubMed  Google Scholar 

  19. Küppers R (2009) The biology of Hodgkin's lymphoma. Nat Rev Cancer 9:15–27

    Article  PubMed  Google Scholar 

  20. Huang Z, Xu X, Meng X et al (2015) Correlations between ADC values and molecular markers of Ki-67 and HIF-1α in hepatocellular carcinoma. Eur J Radiol 84:2464–2469

    Article  PubMed  Google Scholar 

  21. Meng X, Li H, Kong L et al (2016) MRI In rectal cancer: Correlations between MRI features and molecular markers Ki-67, HIF-1α, and VEGF. J Magn Reson Imaging 44:594–600

    Article  PubMed  Google Scholar 

  22. Guo AC, Cummings TJ, Dash RC et al (2002) Lymphomas and high-grade astrocytomas: comparison of water diffusibility and histologic characteristics. Radiology 224:177–183

    Article  PubMed  Google Scholar 

  23. Wu X, Pertovaara H, Dastidar P et al (2013) ADC measurements in diffuse large B-cell lymphoma and follicular lymphoma: a DWI and cellularity study. Eur J Radiol 82:e158–e164

    Article  PubMed  Google Scholar 

  24. Fernebro J, Engellau J, Persson A et al (2007) Standardizing evaluation of sarcoma proliferation- higher Ki-67 expression in the tumor periphery than the center. APMIS 115:707–712

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Magnetic Resonance, The First Affiliated Hospital of Zhengzhou University, 1st, Jianshe Dong Road, Zhengzhou, Henan Province, 450052, People’s Republic of China

    Mengtian Sun, Jingliang Cheng, Yong Zhang, Jie Bai, Feifei Wang, Yun Meng & Zhenqian Li

Authors
  1. Mengtian Sun
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  2. Jingliang Cheng
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  3. Yong Zhang
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  4. Jie Bai
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  5. Feifei Wang
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  6. Yun Meng
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  7. Zhenqian Li
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Corresponding author

Correspondence to Jingliang Cheng.

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Guarantor

The scientific guarantor of this publication is Jingliang Cheng.

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.

Funding

This study has received funding by a key project grant from the Technology Department of Henan Province, China. No.112102310703

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.

Ethical approval

Institutional Review Board approval was obtained.

Methodology

• retrospective

• diagnostic study

• performed at one institution

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Sun, M., Cheng, J., Zhang, Y. et al. Application of DWIBS in malignant lymphoma: correlation between ADC values and Ki-67 index. Eur Radiol 28, 1701–1708 (2018). https://doi.org/10.1007/s00330-017-5135-y

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  • DOI: https://doi.org/10.1007/s00330-017-5135-y

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