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European Radiology
Published in: European Radiology 8/2010

01-08-2010 | Magnetic Resonance

Whole-body diffusion-weighted magnetic resonance imaging with apparent diffusion coefficient mapping for staging patients with diffuse large B-cell lymphoma

Authors: Chieh Lin, Alain Luciani, Emmanuel Itti, Taoufik El-Gnaoui, Alexandre Vignaud, Pauline Beaussart, Shih-jui Lin, Karim Belhadj, Pierre Brugières, Eva Evangelista, Corinne Haioun, Michel Meignan, Alain Rahmouni

Published in: European Radiology | Issue 8/2010

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Abstract

Objective

To design a whole-body MR protocol using exclusively diffusion-weighted imaging (DWI) with respiratory gating and to assess its value for lesion detection and staging in patients with diffuse large B-cell lymphoma (DLBCL), with integrated FDG PET/CT as the reference standard.

Methods

Fifteen patients underwent both whole-body DWI (b = 50, 400, 800 s/mm2) and PET/CT for pretreatment staging. Lymph node and organ involvement were evaluated by qualitative and quantitative image analysis, including measurement of the mean apparent diffusion coefficient (ADC).

Results

A total of 296 lymph node regions in the 15 patients were analysed. Based on International Working Group size criteria alone, DWI findings matched PET/CT findings in 277 regions (94%) (kappa score = 0.85, P < 0.0001), yielding sensitivity and specificity for DWI lymph node involvement detection of 90% and 94%. Combining visual ADC analysis with size measurement increased DWI specificity to 100% with 81% sensitivity. For organ involvement, the two techniques agreed in all 20 recorded organs (100%). All involved organ lesions showed restricted diffusion. Ann Arbor stages agreed in 14 (93%) of the 15 patients.

Conclusion

Whole-body DWI with ADC analysis can potentially be used for lesion detection and staging in patients with DLBCL.
Literature
1.
Cheson BD, Horning SJ, Coiffier B et al (1999) Report of an international workshop to standardize response criteria for non-Hodgkin's lymphomas. NCI Sponsored International Working Group. J Clin Oncol 17:1244–1253
2.
Kwee TC, Kwee RM, Nievelstein RA (2008) Imaging in staging of malignant lymphoma: a systematic review. Blood 111:504–516CrossRefPubMed
3.
Moog F, Bangerter M, Diederichs CG et al (1997) Lymphoma: role of whole-body 2-deoxy-2-[F-18]fluoro-D-glucose (FDG) PET in nodal staging. Radiology 203:795–800PubMed
4.
Moog F, Bangerter M, Diederichs CG et al (1998) Extranodal malignant lymphoma: detection with FDG PET versus CT. Radiology 206:475–481PubMed
5.
Schaefer NG, Hany TF, Taverna C et al (2004) Non-Hodgkin lymphoma and Hodgkin disease: coregistered FDG PET and CT at staging and restaging—do we need contrast-enhanced CT? Radiology 232:823–829CrossRefPubMed
6.
Cheson BD, Pfistner B, Juweid ME et al (2007) Revised response criteria for malignant lymphoma. J Clin Oncol 25:579–586CrossRefPubMed
7.
Juweid ME, Stroobants S, Hoekstra OS et al (2007) Use of positron emission tomography for response assessment of lymphoma: consensus of the Imaging Subcommittee of International Harmonization Project in Lymphoma. J Clin Oncol 25:571–578CrossRefPubMed
8.
Schoder H, Noy A, Gonen M et al (2005) Intensity of 18fluorodeoxyglucose uptake in positron emission tomography distinguishes between indolent and aggressive non-Hodgkin's lymphoma. J Clin Oncol 23:4643–4651CrossRefPubMed
9.
Hutchings M, Loft A, Hansen M et al (2006) FDG-PET after two cycles of chemotherapy predicts treatment failure and progression-free survival in Hodgkin lymphoma. Blood 107:52–59CrossRefPubMed
10.
Lin C, Itti E, Haioun C et al (2007) Early 18F-FDG PET for prediction of prognosis in patients with diffuse large B-cell lymphoma: SUV-based assessment versus visual analysis. J Nucl Med 48:1626–1632CrossRefPubMed
11.
Itti E, Lin C, Dupuis J et al (2009) Prognostic value of interim 18F-FDG PET in patients with diffuse large B-cell lymphoma: SUV-based assessment at four cycles of chemotherapy. J Nucl Med 50:527–533CrossRefPubMed
12.
Sumi M, Ichikawa Y, Nakamura T (2007) Diagnostic ability of apparent diffusion coefficients for lymphomas and carcinomas in the pharynx. Eur Radiol 17:2631–2637CrossRefPubMed
13.
Nakayama T, Yoshimitsu K, Irie H et al (2004) Usefulness of the calculated apparent diffusion coefficient value in the differential diagnosis of retroperitoneal masses. J Magn Reson Imaging 20:735–742CrossRefPubMed
14.
King AD, Ahuja AT, Yeung DK et al (2007) Malignant cervical lymphadenopathy: diagnostic accuracy of diffusion-weighted MR imaging. Radiology 245:806–813CrossRefPubMed
15.
Toh CH, Castillo M, Wong AM et al (2008) Primary cerebral lymphoma and glioblastoma multiforme: differences in diffusion characteristics evaluated with diffusion tensor imaging. AJNR Am J Neuroradiol 29:471–475CrossRefPubMed
16.
Takahara T, Imai Y, Yamashita T et al (2004) Diffusion weighted whole body imaging with background body signal suppression (DWIBS): technical improvement using free breathing, STIR and high resolution 3D display. Radiat Med 22:275–282PubMed
17.
Thoeny HC, De Keyzer F (2007) Extracranial applications of diffusion-weighted magnetic resonance imaging. Eur Radiol 17:1385–1393CrossRefPubMed
18.
Koh DM, Collins DJ (2007) Diffusion-weighted MRI in the body: applications and challenges in oncology. AJR Am J Roentgenol 188:1622–1635CrossRefPubMed
19.
Kwee TC, Takahara T, Ochiai R et al (2008) Diffusion-weighted whole-body imaging with background body signal suppression (DWIBS): features and potential applications in oncology. Eur Radiol 18:1937–1952CrossRefPubMed
20.
Padhani AR, Liu G, Koh DM et al (2009) Diffusion-weighted magnetic resonance imaging as a cancer biomarker: consensus and recommendations. Neoplasia (New York, NY 11:102–125
21.
Lichy MP, Aschoff P, Plathow C et al (2007) Tumor detection by diffusion-weighted MRI and ADC-mapping–initial clinical experiences in comparison to PET-CT. Invest Radiol 42:605–613CrossRefPubMed
22.
Li S, Xue HD, Li J et al (2008) Application of whole body diffusion weighted MR imaging for diagnosis and staging of malignant lymphoma. Chin Med Sci J 23:138–144CrossRefPubMed
23.
Stecco A, Romano G, Negru M et al (2009) Whole-body diffusion-weighted magnetic resonance imaging in the staging of oncological patients: comparison with positron emission tomography computed tomography (PET-CT) in a pilot study. Radiol Med 114:1–17CrossRefPubMed
24.
Kwee TC, Quarles van Ufford HM, Beek FJ et al (2009) Whole-body MRI, including diffusion-weighted imaging, for the initial staging of malignant lymphoma: comparison to computed tomography. Invest Radiol 44:683–690CrossRefPubMed
25.
Rahmouni A, Luciani A, Itti E (2005) Quantitative CT analysis for assessing response in lymphoma (Cheson's criteria). Cancer Imaging 5(Spec No A):S102–S106CrossRefPubMed
26.
Picardi M, Soricelli A, Pane F et al (2009) Contrast-enhanced harmonic compound US of the spleen to increase staging accuracy in patients with Hodgkin lymphoma: a prospective study. Radiology 251:574–582CrossRefPubMed
27.
Koh DM, Takahara T, Imai Y et al (2007) Practical aspects of assessing tumors using clinical diffusion-weighted imaging in the body. Magn Reson Med Sci 6:211–224CrossRefPubMed
28.
Nguyen TD, de Rochefort L, Spincemaille P et al (2008) Effective motion-sensitizing magnetization preparation for black blood magnetic resonance imaging of the heart. J Magn Reson Imaging 28:1092–1100CrossRefPubMed
29.
Uto T, Takehara Y, Nakamura Y et al (2009) Higher sensitivity and specificity for diffusion-weighted imaging of malignant lung lesions without apparent diffusion coefficient quantification. Radiology 252:247–254CrossRefPubMed
30.
Bernstein MA, King KF, Zhou ZJ (2004) Handbook of MRI pulse sequences. Elsevier Academic Press, Amsterdam
31.
Luciani A, Vignaud A, Cavet M et al (2008) Liver cirrhosis: intravoxel incoherent motion MR imaging–pilot study. Radiology 249:891–899CrossRefPubMed
32.
Kato H, Kanematsu M, Tanaka O et al (2009) Head and neck squamous cell carcinoma: usefulness of diffusion-weighted MR imaging in the prediction of a neoadjuvant therapeutic effect. Eur Radiol 19:103–109CrossRefPubMed
33.
Rini JN, Leonidas JC, Tomas MB et al (2003) 18F-FDG PET versus CT for evaluating the spleen during initial staging of lymphoma. J Nucl Med 44:1072–1074PubMed
34.
de Jong PA, van Ufford HM, Baarslag HJ et al (2009) CT and 18F-FDG PET for noninvasive detection of splenic involvement in patients with malignant lymphoma. AJR Am J Roentgenol 192:745–753CrossRefPubMed
35.
Landis JR, Koch GG (1977) The measurement of observer agreement for categorical data. Biometrics 33:159–174CrossRefPubMed
36.
Mori T, Nomori H, Ikeda K et al (2008) Diffusion-weighted magnetic resonance imaging for diagnosing malignant pulmonary nodules/masses: comparison with positron emission tomography. J Thorac Oncol 3:358–364CrossRefPubMed
37.
Ho KC, Lin G, Wang JJ et al (2009) Correlation of apparent diffusion coefficients measured by 3T diffusion-weighted MRI and SUV from FDG PET/CT in primary cervical cancer. Eur J Nucl Med Mol Imaging 36:200–208CrossRefPubMed
38.
Komori T, Narabayashi I, Matsumura K et al (2007) 2-[Fluorine-18]-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography versus whole-body diffusion-weighted MRI for detection of malignant lesions: initial experience. Ann Nucl Med 21:209–215CrossRefPubMed
39.
Kwee TC, Takahara T, Koh DM et al (2008) Comparison and reproducibility of ADC measurements in breathhold, respiratory triggered, and free-breathing diffusion-weighted MR imaging of the liver. J Magn Reson Imaging 28:1141–1148CrossRefPubMed
40.
Wang J, Takashima S, Takayama F et al (2001) Head and neck lesions: characterization with diffusion-weighted echo-planar MR imaging. Radiology 220:621–630CrossRefPubMed
41.
Pileri SA, Dirnhofer S, Went P et al (2002) Diffuse large B-cell lymphoma: one or more entities? Present controversies and possible tools for its subclassification. Histopathology 41:482–509CrossRefPubMed
42.
Hunt KE, Reichard KK (2008) Diffuse large B-cell lymphoma. Arch Pathol Lab Med 132:118–124PubMed
43.
Vandecaveye V, De Keyzer F, Vander Poorten V et al (2009) Head and neck squamous cell carcinoma: value of diffusion-weighted MR imaging for nodal staging. Radiology 251:134–146CrossRefPubMed
44.
Reese TG, Heid O, Weisskoff RM et al (2003) Reduction of eddy-current-induced distortion in diffusion MRI using a twice-refocused spin echo. Magn Reson Med 49:177–182CrossRefPubMed
45.
A predictive model for aggressive non-Hodgkin's lymphoma. The International Non-Hodgkin's Lymphoma Prognostic Factors Project. N Engl J Med 329:987–994
Metadata
Title
Whole-body diffusion-weighted magnetic resonance imaging with apparent diffusion coefficient mapping for staging patients with diffuse large B-cell lymphoma
Authors
Chieh Lin
Alain Luciani
Emmanuel Itti
Taoufik El-Gnaoui
Alexandre Vignaud
Pauline Beaussart
Shih-jui Lin
Karim Belhadj
Pierre Brugières
Eva Evangelista
Corinne Haioun
Michel Meignan
Alain Rahmouni
Publication date
01-08-2010
Publisher
Springer-Verlag
Published in
European Radiology / Issue 8/2010
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-010-1758-y

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