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Open Access 20-06-2023 | Lymphoma | Paediatric

[¹⁸F]FDG PET/MRI in children suffering from lymphoma: does MRI contrast media make a difference?

Authors: Kai Jannusch, Janna Morawitz, Bernd Schweiger, Daniel Weiss, Lars Schimmöller, Peter Minko, Ken Herrmann, Wolfgang P. Fendler, Harald H. Quick, Gerald Antoch, Lale Umutlu, Julian Kirchner, Nils-Martin Bruckmann

Published in: European Radiology | Issue 11/2023

Abstract

Objectives

Evaluate the influence of an MRI contrast agent application on primary and follow-up staging in pediatric patients with newly diagnosed lymphoma using [¹⁸F]FDG PET/MRI to avoid adverse effects and save time and costs during examination.

Methods

A total of 105 [¹⁸F]FDG PET/MRI datasets were included for data evaluation. Two different reading protocols were analyzed by two experienced readers in consensus, including for PET/MRI-1 reading protocol unenhanced T2w and/or T1w imaging, diffusion-weighted imaging (DWI), and [¹⁸F]FDG PET imaging and for PET/MRI-2 reading protocol an additional T1w post contrast imaging. Patient-based and region-based evaluation according to the revised International Pediatric Non-Hodgkin’s Lymphoma (NHL) Staging System (IPNHLSS) was performed, and a modified standard of reference was applied comprising histopathology and previous and follow-up cross-sectional imaging. Differences in staging accuracy were assessed using the Wilcoxon and McNemar tests.

Results

In patient-based analysis, PET/MRI-1 and PET/MRI-2 both determined a correct IPNHLSS tumor stage in 90/105 (86%) exams. Region-based analysis correctly identified 119/127 (94%) lymphoma-affected regions. Sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy for PET/MRI-1 and PET/MRI-2 were 94%, 97%, 90%, 99%, 97%, respectively. There were no significant differences between PET/MRI-1 and PET/MRI-2.

Conclusions

The use of MRI contrast agents in [¹⁸F]FDG PET/MRI examinations has no beneficial effect in primary and follow-up staging of pediatric lymphoma patients. Therefore, switching to a contrast agent–free [¹⁸F]FDG PET/MRI protocol should be considered in all pediatric lymphoma patients.

Clinical relevance statement

This study gives a scientific baseline switching to a contrast agent–free [¹⁸F]FDG PET/MRI staging in pediatric lymphoma patients. This could avoid side effects of contrast agents and saves time and costs by a faster staging protocol for pediatric patients.

Key Points

• No additional diagnostic benefit of MRI contrast agents at [¹⁸F]FDG PET/MRI examinations of pediatric lymphoma primary and follow-up staging

• Highly accurate primary and follow-up staging of pediatric lymphoma patients at MRI contrast–free [¹⁸F]FDG PET/MRI

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Title: [18F]FDG PET/MRI in children suffering from lymphoma: does MRI contrast media make a difference?
Authors: Kai Jannusch
Janna Morawitz
Bernd Schweiger
Daniel Weiss
Lars Schimmöller
Peter Minko
Ken Herrmann
Wolfgang P. Fendler
Harald H. Quick
Gerald Antoch
Lale Umutlu
Julian Kirchner
Nils-Martin Bruckmann
Publication date: 20-06-2023
Publisher: Springer Berlin Heidelberg
Keyword: Lymphoma
Published in: European Radiology / Issue 11/2023
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-023-09840-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

[¹⁸F]FDG PET/MRI in children suffering from lymphoma: does MRI contrast media make a difference?

Abstract

Objectives

Methods

Results

Conclusions

Clinical relevance statement

Key Points

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

Clinical relevance statement

Key Points

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