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Published in: BMC Cancer 1/2015

Open Access 01-12-2015 | Research article

Diagnostic performance of FDG-PET/MRI and WB-DW-MRI in the evaluation of lymphoma: a prospective comparison to standard FDG-PET/CT

Authors: Ken Herrmann, Marcelo Queiroz, Martin W. Huellner, Felipe de Galiza Barbosa, Andreas Buck, Niklaus Schaefer, Paul Stolzman, Patrick Veit-Haibach

Published in: BMC Cancer | Issue 1/2015

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Abstract

Background

Use of FDG-PET/CT for staging and restaging of lymphoma patients is widely incorporated into current practice guidelines. Our aim was to prospectively evaluate the diagnostic performance of FDG-PET/MRI and WB-DW-MRI compared with FDG-FDG-PET/CT using a tri-modality PET/CT-MRI system.

Methods

From 04/12 to 01/14, a total of 82 FDG-PET/CT examinations including an additional scientific MRI on a tri-modality setup were performed in 61 patients. FDG-PET/CT, FDG-PET/MRI, and WB-DW-MRI were independently analyzed. A lesion with a mean ADC below a threshold of 1.2 × 10−3 mm2/s was defined as positive for restricted diffusion. FDG-PET/CT and FDG-PET/MRI were evaluated for the detection of lesions corresponding to lymphoma manifestations according to the German Hodgkin Study Group. Imaging findings were validated by biopsy (n = 21), by follow-up imaging comprising CT, FDG-PET/CT, and/or FDG-PET/MRI (n = 32), or clinically (n = 25) (mean follow-up: 9.1 months).

Results

FDG-PET/MRI and FDG-PET/CT accurately detected 188 lesions in 27 patients. Another 54 examinations in 35 patients were negative. WB-DW-MRI detected 524 lesions, of which 125 (66.5 % of the aforementioned 188 lesions) were true positive. Among the 188 lesions positive for lymphoma, FDG-PET/MRI detected all 170 instances of nodal disease and also all 18 extranodal lymphoma manifestations; by comparison, WB-DW-MRI characterized 115 (67.6 %) and 10 (55.6 %) lesions as positive for nodal and extranodal disease, respectively. FDG-PET/MRI was superior to WB-DW-MRI in detecting lymphoma manifestations in patients included for staging (113 vs. 73), for restaging (75 vs. 52), for evaluation of high- (127 vs. 81) and low-grade lymphomas (61 vs. 46), and for definition of Ann Arbor stage (WB-DW-MRI resulted in upstaging in 60 cases, including 45 patients free of disease, and downstaging in 4).

Conclusion

Our results indicate that FDG-PET/CT and FDG-PET/MRI probably have a similar performance in the clinical work-up of lymphomas. The performance of WB-DW-MRI was generally inferior to that of both FDG-PET-based methods but the technique might be used in specific scenarios, e.g., in low-grade lymphomas and during surveillance.
Literature
1.
Cheson BD, Fisher RI, Barrington SF, Cavalli F, Schwartz LH, Zucca E, et al. Recommendations for initial evaluation, staging, and response assessment of Hodgkin and Non-Hodgkin lymphoma: the Lugano classification. J Clin Oncol. 2014;32:3059–68.PubMedCrossRef
2.
Koh D-M, Collins DJ. Diffusion-weighted MRI in the body: applications and challenges in oncology. Am J Roentgenol. 2007;188:1622–35.CrossRef
3.
Kwee TC, Vermoolen MA, Akkerman EA, Kersten MJ, Fijnheer R, Ludwig I, et al. Whole-body MRI, including diffusion-weighted imaging, for staging lymphoma: comparison with CT in a prospective multicenter study. J Magn Reson Imaging. 2014;40:26–36.PubMedCrossRef
4.
Lin C, Luciani A, Itti E, El-Gnaoui T, Vignaud A, Beaussart P, et al. Whole-body diffusion-weighted magnetic resonance imaging with apparent diffusion coefficient mapping for staging patients with diffuse large B-cell lymphoma. Eur Radiol. 2010;20:2027–38.PubMedCrossRef
5.
Van Ufford HMEQ, Kwee TC, Beek FJ, van Leeuwen MS, Takahara T, Fijnheer R, et al. Newly diagnosed lymphoma: initial results with whole-body T1-weighted, STIR, and diffusion-weighted MRI compared with 18F-FDG PET/CT. AJR Am J Roentgenol. 2011;196:662–9.PubMedCrossRef
6.
Bailey DL, Barthel H, Beyer T, Boellaard R, Gückel B, Hellwig D, et al. Summary report of the First International Workshop on PET/MR imaging, March 19–23, 2012, Tübingen, Germany. Mol Imaging Biol. 2013;15:361–71.PubMedPubMedCentralCrossRef
7.
Punwani S, Taylor SA, Saad ZZ, Bainbridge A, Groves A, Daw S, et al. Diffusion-weighted MRI of lymphoma: prognostic utility and implications for PET/MRI? Eur J Nucl Med Mol Imaging. 2013;40:373–85.PubMedCrossRef
8.
Kuhn FP, Crook DW, Mader CE, Appenzeller P, von Schulthess GK, Schmid DT. Discrimination and anatomical mapping of PET-positive lesions: comparison of CT attenuation-corrected PET images with coregistered MR and CT images in the abdomen. Eur J Nucl Med Mol Imaging. 2012;40(1):44–51. doi:10.​1007/​s00259-012-2236-3.PubMedCrossRef
9.
Veit-Haibach P, Kuhn FP, Wiesinger F, Delso G, von Schulthess G. PET-MR imaging using a tri-modality PET/CT-MR system with a dedicated shuttle in clinical routine. MAGMA. 2013;26:25–35.PubMedCrossRef
10.
11.
Appenzeller P, Mader C, Huellner MW, Schmidt D, Schmid D, Boss A, et al. PET/CT versus body coil PET/MRI: how low can you go? Insights Imaging. 2013;4:481–90.PubMedPubMedCentralCrossRef
12.
Samarin A, Kuhn FP, Brandsberg F, von Schulthess G, Burger IA. Image registration accuracy of an in-house developed patient transport system for PET/CT + MR and SPECT + CT imaging. Nucl Med Commun. 2015;36:194–200.PubMedCrossRef
13.
Perrone A, Guerrisi P, Izzo L, D’Angeli I, Sassi S, Lo ML, et al. Diffusion-weighted MRI in cervical lymph nodes: differentiation between benign and malignant lesions. Eur J Radiol. 2011;77:281–6.PubMedCrossRef
14.
Wu X, Pertovaara H, Dastidar P, Vornanen M, Paavolainen L, Marjomäki V, et al. ADC measurements in diffuse large B-cell lymphoma and follicular lymphoma: a DWI and cellularity study. Eur J Radiol. 2013;82:e158–64.PubMedCrossRef
15.
Wu X, Pertovaara H, Korkola P, Dastidar P, Järvenpää R, Eskola H, et al. Correlations between functional imaging markers derived from PET/CT and diffusion-weighted MRI in diffuse large B-cell lymphoma and follicular lymphoma. PLoS One. 2014;9:e84999.PubMedPubMedCentralCrossRef
16.
Meignan M, Gallamini A, Haioun C. Report on the first international workshop on interim-PET-scan in lymphoma. Leuk Lymphoma. 2009;50:1257–60.PubMedCrossRef
17.
Kwee TC, Kwee RM, Verdonck LF, Bierings MB, Nievelstein RAJ. Magnetic resonance imaging for the detection of bone marrow involvement in malignant lymphoma. Br J Haematol. 2008;141:60–8.PubMedCrossRef
18.
Platzek I, Beuthien-Baumann B, Ordemann R, Maus J, Schramm G, Kitzler HH, et al. FDG PET/MR for the assessment of lymph node involvement in lymphoma. Initial results and role of diffusion-weighted MR. Acad Radiol. 2014;21(10):1314–9. doi:10.​1016/​j.​acra.​2014.​05.​019.PubMedCrossRef
19.
Wu X, Korkola P, Pertovaara H, Eskola H, Järvenpää R, Kellokumpu-Lehtinen P-L. No correlation between glucose metabolism and apparent diffusion coefficient in diffuse large B-cell lymphoma: a PET/CT and DW-MRI study. Eur J Radiol. 2011;79:e117–21.PubMedCrossRef
20.
Tsuji K, Kishi S, Tsuchida T, Yamauchi T, Ikegaya S, Urasaki Y, et al. Evaluation of staging and early response to chemotherapy with whole-body diffusion-weighted MRI in malignant lymphoma patients: A comparison with FDG-PET/CT. J Magn Reson Imaging. 2015;41:1601–7.PubMedCrossRef
21.
Mayerhoefer ME, Karanikas G, Kletter K, Prosch H, Kiesewetter B, Skrabs C, et al. Evaluation of diffusion-weighted MRI for pretherapeutic assessment and staging of lymphoma: results of a prospective study in 140 patients. Clin Cancer Res. 2014;20:2984–93.PubMedCrossRef
22.
Toledano-Massiah S, Luciani A, Itti E, Zerbib P, Vignaud A, Belhadj K, et al. Whole-body diffusion-weighted imaging in Hodgkin lymphoma and diffuse large B-cell lymphoma. Radiographics. 2015;35:747–64.PubMedCrossRef
23.
Heacock L, Weissbrot J, Raad R, Campbell N, Friedman KP, Ponzo F, et al. PET/MRI for the evaluation of patients with lymphoma: initial observations. Am J Roentgenol. 2015;204(April):842–8.CrossRef
24.
Platzek I, Beuthien-Baumann B, Langner J, Popp M, Schramm G, Ordemann R, et al. PET/MR for therapy response evaluation in malignant lymphoma: initial experience. Magn Reson Mater Physics Biol Med. 2013;26:49–55.CrossRef
25.
Wu X, Nerisho S, Dastidar P, Ryymin P, Järvenpää R, Pertovaara H, et al. Comparison of different MRI sequences in lesion detection and early response evaluation of diffuse large B-cell lymphoma--a whole-body MRI and diffusion-weighted imaging study. NMR Biomed. 2013;26:1186–94.PubMedCrossRef
26.
Lin C, Itti E, Luciani A, Zegai B, Lin S, Kuhnowski F, et al. Whole-body diffusion-weighted imaging with apparent diffusion coefficient mapping for treatment response assessment in patients with diffuse large B-cell lymphoma: pilot study. Invest Radiol. 2011;46:341–9.PubMed
27.
Chen Y, Zhong J, Wu H, Chen N. The clinical application of whole-body diffusion-weighted imaging in the early assessment of chemotherapeutic effects in lymphoma: the initial experience. Magn Reson Imaging. 2012;30:165–70.PubMedCrossRef
28.
Kwee TC. Can whole-body MRI replace (18)F-fluorodeoxyglucose PET/CT? Lancet Oncol. 2014;15:243–4.PubMedCrossRef
Metadata
Title
Diagnostic performance of FDG-PET/MRI and WB-DW-MRI in the evaluation of lymphoma: a prospective comparison to standard FDG-PET/CT
Authors
Ken Herrmann
Marcelo Queiroz
Martin W. Huellner
Felipe de Galiza Barbosa
Andreas Buck
Niklaus Schaefer
Paul Stolzman
Patrick Veit-Haibach
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2015
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/s12885-015-2009-z

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