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European Radiology
Published in: European Radiology 5/2019

01-05-2019 | Contrast Media

Gadolinium-enhanced imaging of pediatric thoracic lymphoma: is intravenous contrast really necessary?

Authors: Christophe T. Arendt, Martin Beeres, Doris Leithner, Patricia Tischendorf, Marcel Langenbach, Benjamin Kaltenbach, Jasmin Dalgicdir, Thomas J. Vogl, Tatjana Gruber-Rouh

Published in: European Radiology | Issue 5/2019

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Abstract

Objectives

Increasing awareness of potential side effects from gadolinium-based contrast agents has underlined the need for contrast-free magnetic resonance imaging (MRI). Numerous recent articles evaluated the risk of potential brain deposits, with the result that research is putting the focus more on alternative unenhanced imaging techniques. The aim of this study was to determine the need for contrast media for chest MRI in primary staging and follow-up care of lymphoma.

Methods

This monocentric, retrospective study encompassed patients under 25 years of age who had undergone histopathological examination of thoracic lymph nodes and at least one chest MRI examination with unenhanced and contrast-enhanced sequences. Seven different thoracic lymph node stations including mediastinal, hilar, periclavicular, and axillary regions were evaluated by two readers regarding lesion diameter, number, shape, necrosis, and infiltration of surrounding structures. Findings were categorized into suspicious (> 1 cm; round; necrosis; infiltration) or non-suspicious.

Results

Fifty-one patients (mean age, 16.0 ± 3.7 yrs) with thoracic Hodgkin (70.6%) and non-Hodgkin lymphoma (25.5%) and lymphadenopathy (3.9%) were retrospectively included. Most lymph nodes categorized as suspicious were located in the mediastinal station (86.4%). High agreement (κ = 0.81) between unenhanced and contrast-enhanced sequences was found for both suspicious and non-suspicious lymph nodes. Significant (p < 0.001), but small difference (1 mm) was observed only in sizing mediastinal lymph nodes (all other p > 0.05). No significant difference (smallest p = 0.08) was shown for the use of five different types of contrast media.

Conclusion

MRI in young patients with thoracic lymphoma can safely be done without the use of contrast agent.

Key Point

• Thoracic magnetic resonance imaging in young lymphoma patients can safely be done without gadolinium-based contrast agents.
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Metadata
Title
Gadolinium-enhanced imaging of pediatric thoracic lymphoma: is intravenous contrast really necessary?
Authors
Christophe T. Arendt
Martin Beeres
Doris Leithner
Patricia Tischendorf
Marcel Langenbach
Benjamin Kaltenbach
Jasmin Dalgicdir
Thomas J. Vogl
Tatjana Gruber-Rouh
Publication date
01-05-2019
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 5/2019
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-018-5859-3

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