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European Radiology
Published in: European Radiology 8/2013

01-08-2013 | Oncology

Whole-body MRI for the detection of bone marrow involvement in lymphoma: prospective study in 116 patients and comparison with FDG-PET

Authors: Hugo J. A. Adams, Thomas C. Kwee, Malou A. Vermoolen, Bart de Keizer, John M. H. de Klerk, Judit A. Adam, Rob Fijnheer, Marie José Kersten, Jaap Stoker, Rutger A. J. Nievelstein

Published in: European Radiology | Issue 8/2013

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Abstract

Objective

To assess and compare the value of whole-body MRI with FDG-PET for detecting bone marrow involvement in lymphoma.

Methods

A total of 116 patients with newly diagnosed lymphoma prospectively underwent whole-body MRI and blind bone marrow biopsy (BMB) of the posterior iliac crest. Of 116 patients, 80 also underwent FDG-PET. Patient-based sensitivities of whole-body MRI for detecting bone marrow involvement were calculated using BMB as reference standard and compared with FDG-PET in aggressive and indolent lymphomas separately.

Results

Sensitivity of whole-body MRI in all lymphomas was 45.5 % [95 % confidence interval (CI): 29.8–62.0 %]. Sensitivity of whole-body MRI in aggressive lymphoma [88.9 % (95 % CI: 54.3–100 %)] was significantly higher (P = 0.0029) than that in indolent lymphoma [23.5 % (95 % CI: 9.1–47.8 %)]. Sensitivity of FDG-PET in aggressive lymphoma [83.3 % (95 % CI: 41.8–98.9 %)] was also significantly higher (P = 0.026) than that in indolent lymphoma [12.5 % (95 % CI: 0–49.2 %)]. There were no significant differences in sensitivity between whole-body MRI and FDG-PET (P = 1.00)

Conclusion

Sensitivity of whole-body MRI for detecting lymphomatous bone marrow involvement is too low to (partially) replace BMB. Sensitivity of whole-body MRI is significantly higher in aggressive lymphoma than in indolent lymphoma and is equal to FDG-PET in both entities.

Key Points

• Bone marrow involvement in lymphoma has prognostic and therapeutic implications.
• Blind bone marrow biopsy (BMB) is standard for bone marrow assessment.
• Neither whole-body MRI nor FDG-PET can yet replace BMB.
• Both techniques have higher sensitivity in aggressive than in indolent lymphoma.
• Both imaging techniques are complementary to BMB.
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Metadata
Title
Whole-body MRI for the detection of bone marrow involvement in lymphoma: prospective study in 116 patients and comparison with FDG-PET
Authors
Hugo J. A. Adams
Thomas C. Kwee
Malou A. Vermoolen
Bart de Keizer
John M. H. de Klerk
Judit A. Adam
Rob Fijnheer
Marie José Kersten
Jaap Stoker
Rutger A. J. Nievelstein
Publication date
01-08-2013
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 8/2013
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-013-2835-9

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