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Published in: Pediatric Radiology 8/2013

01-08-2013 | Original Article

Dynamic contrast-enhanced MRI improves accuracy for detecting focal splenic involvement in children and adolescents with Hodgkin disease

Authors: Shonit Punwani, King Kenneth Cheung, Nicholas Skipper, Nichola Bell, Alan Bainbridge, Stuart A. Taylor, Ashley M. Groves, Sharon F. Hain, Simona Ben-Haim, Ananth Shankar, Stephen Daw, Steve Halligan, Paul D. Humphries

Published in: Pediatric Radiology | Issue 8/2013

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Abstract

Background

Accurate assessment of splenic disease is important for staging Hodgkin lymphoma.

Objective

The purpose of this study was to assess T2-weighted imaging with and without dynamic contrast-enhanced (DCE) MRI for evaluation of splenic Hodgkin disease.

Materials and methods

Thirty-one children with Hodgkin lymphoma underwent whole-body T2-weighted MRI with supplementary DCE splenic imaging, and whole-body PET-CT before and following chemotherapy. Two experienced nuclear medicine physicians derived a PET-CT reference standard for splenic disease, augmented by follow-up imaging. Unaware of the PET-CT, two experienced radiologists independently evaluated MRI exercising a locked sequential read paradigm (T2-weighted then DCE review) and recorded the presence/absence of splenic disease at each stage. Performance of each radiologist was determined prior to and following review of DCE-MRI. Incorrect MRI findings were ascribed to reader (lesion present on MRI but missed by reader) or technical (lesion not present on MRI) error.

Results

Seven children had splenic disease. Sensitivity/specificity of both radiologists for the detection of splenic involvement using T2-weighted images alone was 57%/100% and increased to 100%/100% with DCE-MRI. There were three instances of technical error on T2-weighted imaging; all lesions were visible on DCE-MRI.

Conclusions

T2-weighted imaging when complemented by DCE-MRI imaging may improve evaluation of Hodgkin disease splenic involvement.
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Metadata
Title
Dynamic contrast-enhanced MRI improves accuracy for detecting focal splenic involvement in children and adolescents with Hodgkin disease
Authors
Shonit Punwani
King Kenneth Cheung
Nicholas Skipper
Nichola Bell
Alan Bainbridge
Stuart A. Taylor
Ashley M. Groves
Sharon F. Hain
Simona Ben-Haim
Ananth Shankar
Stephen Daw
Steve Halligan
Paul D. Humphries
Publication date
01-08-2013
Publisher
Springer Berlin Heidelberg
Published in
Pediatric Radiology / Issue 8/2013
Print ISSN: 0301-0449
Electronic ISSN: 1432-1998
DOI
https://doi.org/10.1007/s00247-012-2616-7

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