Skip to main content
Erschienen in: Pediatric Radiology 5/2018

23.01.2018 | Original Article

Can diffusion-weighted whole-body MRI replace contrast-enhanced CT for initial staging of Hodgkin lymphoma in children and adolescents?

verfasst von: Rodrigo Regacini, Andrea Puchnick, Flavio Augusto Vercillo Luisi, Henrique Manoel Lederman

Erschienen in: Pediatric Radiology | Ausgabe 5/2018

Einloggen, um Zugang zu erhalten

Abstract

Background

Although positron emission tomography with 18F–fluoro-2-deoxyglucose (FDG-PET/CT) has been recommended as the method of choice for lymphoma staging, it has limited availability in several countries, therefore, studies comparing whole-body magnetic resonance imaging (MRI) to conventional staging methods or to FDG-PET/CT are an important tool to establish whole-body MRI as an alternative to these methods.

Objective

To compare whole-body MRI versus conventional imaging methods for staging of Hodgkin lymphoma in children and adolescents.

Materials and methods

The study included 22 patients ages 5 to 21 years. Staging was performed using conventional imaging methods and whole-body MRI. Conventional imaging methods were defined as computed tomography (CT) of the neck, chest, abdomen and pelvis and ultrasonography of the neck and/or abdomen. We calculated the sensitivity of these methods for Hodgkin lymphoma staging and their sensitivity and specificity for detecting sites of nodal and extranodal involvement.

Results

The sensitivity of whole-body MRI for Hodgkin lymphoma staging was superior to that of conventional imaging methods (95.5% vs. 86.4%, respectively), but both methods had similar sensitivity and specificity for detecting involvement of nodal sites (99.1% and 100% vs. 97.3% and 100%, respectively) and extranodal sites (90.5% and 98.7% vs. 90.5% and 99.4%, respectively).

Conclusion

Whole-body MRI has excellent sensitivity for staging of Hodgkin lymphoma in children and adolescents. It can thus be considered an alternative for this purpose, particularly because it does not expose patients to ionizing radiation.
Literatur
1.
Zurück zum Zitat Connors JM (2005) State-of-the-art therapeutics: Hodgkin's lymphoma. J Clin Oncol 23:6400–6408CrossRefPubMed Connors JM (2005) State-of-the-art therapeutics: Hodgkin's lymphoma. J Clin Oncol 23:6400–6408CrossRefPubMed
2.
Zurück zum Zitat Lister TA, Crowther D, Sutcliffe SB et al (1989) Report of a committee convened to discuss the evaluation and staging of patients with Hodgkin's disease: Cotswolds meeting. J Clin Oncol 7:1630–1636CrossRefPubMed Lister TA, Crowther D, Sutcliffe SB et al (1989) Report of a committee convened to discuss the evaluation and staging of patients with Hodgkin's disease: Cotswolds meeting. J Clin Oncol 7:1630–1636CrossRefPubMed
3.
Zurück zum Zitat Cheson BD, Fisher RI, Barrington SF et al (2014) Recommendations for initial evaluation, staging, and response assessment of Hodgkin and non-Hodgkin lymphoma: the Lugano classification. J Clin Oncol 32:3059–3068CrossRefPubMedPubMedCentral Cheson BD, Fisher RI, Barrington SF et al (2014) Recommendations for initial evaluation, staging, and response assessment of Hodgkin and non-Hodgkin lymphoma: the Lugano classification. J Clin Oncol 32:3059–3068CrossRefPubMedPubMedCentral
4.
Zurück zum Zitat Vinnicombe SJ, Reznek RH (2003) Computerised tomography in the staging of Hodgkin's disease and non-Hodgkin's lymphoma. Eur J Nucl Med Mol Imaging 30:S42–S55CrossRefPubMed Vinnicombe SJ, Reznek RH (2003) Computerised tomography in the staging of Hodgkin's disease and non-Hodgkin's lymphoma. Eur J Nucl Med Mol Imaging 30:S42–S55CrossRefPubMed
5.
Zurück zum Zitat Balbo-Mussetto A, Cirillo S, Bruna R et al (2016) Whole-body MRI with diffusion-weighted imaging: a valuable alternative to contrast-enhanced CT for initial staging of aggressive lymphoma. Clin Radiol 71:271–279CrossRefPubMed Balbo-Mussetto A, Cirillo S, Bruna R et al (2016) Whole-body MRI with diffusion-weighted imaging: a valuable alternative to contrast-enhanced CT for initial staging of aggressive lymphoma. Clin Radiol 71:271–279CrossRefPubMed
6.
Zurück zum Zitat Kostakoglu L, Evens AM (2014) FDG-PET imaging for Hodgkin lymphoma: current use and future applications. Clin Adv Hematol Oncol 12:20–35PubMed Kostakoglu L, Evens AM (2014) FDG-PET imaging for Hodgkin lymphoma: current use and future applications. Clin Adv Hematol Oncol 12:20–35PubMed
7.
Zurück zum Zitat Huang B, Law MW, Khong PL (2009) Whole-body PET/CT scanning: estimation of radiation dose and cancer risk. Radiology 251:166–174CrossRefPubMed Huang B, Law MW, Khong PL (2009) Whole-body PET/CT scanning: estimation of radiation dose and cancer risk. Radiology 251:166–174CrossRefPubMed
8.
Zurück zum Zitat Buck AK, Herrmann K, Stargardt T et al (2010) Economic evaluation of PET and PET/CT in oncology: evidence and methodologic approaches. J Nucl Med Technol 38:6–17CrossRefPubMed Buck AK, Herrmann K, Stargardt T et al (2010) Economic evaluation of PET and PET/CT in oncology: evidence and methodologic approaches. J Nucl Med Technol 38:6–17CrossRefPubMed
9.
Zurück zum Zitat Gu J, Chan T, Zhang J et al (2011) Whole-body diffusion-weighted imaging: the added value to whole-body MRI at initial diagnosis of lymphoma. AJR Am J Roentgenol 197:W384–W391CrossRefPubMed Gu J, Chan T, Zhang J et al (2011) Whole-body diffusion-weighted imaging: the added value to whole-body MRI at initial diagnosis of lymphoma. AJR Am J Roentgenol 197:W384–W391CrossRefPubMed
10.
Zurück zum Zitat Abdulqadhr G, Molin D, Astrom G et al (2011) Whole-body diffusion-weighted imaging compared with FDG-PET/CT in staging of lymphoma patients. Acta Radiol 52:173–180CrossRefPubMed Abdulqadhr G, Molin D, Astrom G et al (2011) Whole-body diffusion-weighted imaging compared with FDG-PET/CT in staging of lymphoma patients. Acta Radiol 52:173–180CrossRefPubMed
11.
Zurück zum Zitat Lin C, Luciani A, Itti E et al (2010) Whole-body diffusion-weighted magnetic resonance imaging with apparent diffusion coefficient mapping for staging patients with diffuse large B-cell lymphoma. Eur Radiol 20:2027–2038CrossRefPubMed Lin C, Luciani A, Itti E et al (2010) Whole-body diffusion-weighted magnetic resonance imaging with apparent diffusion coefficient mapping for staging patients with diffuse large B-cell lymphoma. Eur Radiol 20:2027–2038CrossRefPubMed
12.
Zurück zum Zitat Punwani S, Taylor SA, Bainbridge A et al (2010) Pediatric and adolescent lymphoma: comparison of whole-body STIR half-Fourier RARE MR imaging with an enhanced PET/CT reference for initial staging. Radiology 255:182–190CrossRefPubMed Punwani S, Taylor SA, Bainbridge A et al (2010) Pediatric and adolescent lymphoma: comparison of whole-body STIR half-Fourier RARE MR imaging with an enhanced PET/CT reference for initial staging. Radiology 255:182–190CrossRefPubMed
13.
Zurück zum Zitat van Ufford HM, Kwee TC, Beek FJ et al (2011) 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 196:662–669CrossRefPubMed van Ufford HM, Kwee TC, Beek FJ et al (2011) 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 196:662–669CrossRefPubMed
14.
Zurück zum Zitat Wu X, Kellokumpu-Lehtinen PL, Pertovaara H et al (2011) Diffusion-weighted MRI in early chemotherapy response evaluation of patients with diffuse large B-cell lymphoma - a pilot study: comparison with 2-deoxy-2-fluoro-D-glucose-positron emission tomography/computed tomography. NMR Biomed 24:1181–1190CrossRefPubMed Wu X, Kellokumpu-Lehtinen PL, Pertovaara H et al (2011) Diffusion-weighted MRI in early chemotherapy response evaluation of patients with diffuse large B-cell lymphoma - a pilot study: comparison with 2-deoxy-2-fluoro-D-glucose-positron emission tomography/computed tomography. NMR Biomed 24:1181–1190CrossRefPubMed
15.
Zurück zum Zitat Stephane V, Samuel B, Vincent D et al (2013) Comparison of PET-CT and magnetic resonance diffusion weighted imaging with body suppression (DWIBS) for initial staging of malignant lymphomas. Eur J Radiol 82:2011–2017CrossRefPubMed Stephane V, Samuel B, Vincent D et al (2013) Comparison of PET-CT and magnetic resonance diffusion weighted imaging with body suppression (DWIBS) for initial staging of malignant lymphomas. Eur J Radiol 82:2011–2017CrossRefPubMed
16.
Zurück zum Zitat Ferrari C, Minoia C, Asabella AN et al (2014) Whole body magnetic resonance with diffusion weighted sequence with body signal suppression compared to (18)F-FDG PET/CT in newly diagnosed lymphoma. Hell J Nucl Med 17:40–49PubMed Ferrari C, Minoia C, Asabella AN et al (2014) Whole body magnetic resonance with diffusion weighted sequence with body signal suppression compared to (18)F-FDG PET/CT in newly diagnosed lymphoma. Hell J Nucl Med 17:40–49PubMed
17.
Zurück zum Zitat Littooij AS, Kwee TC, Barber I et al (2014) Whole-body MRI for initial staging of paediatric lymphoma: prospective comparison to an FDG-PET/CT-based reference standard. Eur Radiol 24:1153–1165CrossRefPubMed Littooij AS, Kwee TC, Barber I et al (2014) Whole-body MRI for initial staging of paediatric lymphoma: prospective comparison to an FDG-PET/CT-based reference standard. Eur Radiol 24:1153–1165CrossRefPubMed
18.
Zurück zum Zitat Tsuji K, Kishi S, Tsuchida T et al (2015) 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 41:1601–1607CrossRefPubMed Tsuji K, Kishi S, Tsuchida T et al (2015) 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 41:1601–1607CrossRefPubMed
19.
Zurück zum Zitat Montoro J, Laszlo D, Zing NP et al (2014) Comparison of whole-body diffusion-weighted magnetic resonance and FDG-PET/CT in the assessment of Hodgkin's lymphoma for staging and treatment response. Ecancermedicalscience 8:429CrossRefPubMedPubMedCentral Montoro J, Laszlo D, Zing NP et al (2014) Comparison of whole-body diffusion-weighted magnetic resonance and FDG-PET/CT in the assessment of Hodgkin's lymphoma for staging and treatment response. Ecancermedicalscience 8:429CrossRefPubMedPubMedCentral
20.
Zurück zum Zitat Hagtvedt T, Seierstad T, Lund KV et al (2015) Diffusion-weighted MRI compared to FDG PET/CT for assessment of early treatment response in lymphoma. Acta Radiol 56:152–158CrossRefPubMed Hagtvedt T, Seierstad T, Lund KV et al (2015) Diffusion-weighted MRI compared to FDG PET/CT for assessment of early treatment response in lymphoma. Acta Radiol 56:152–158CrossRefPubMed
21.
Zurück zum Zitat Mayerhoefer ME, Karanikas G, Kletter K et al (2014) Evaluation of diffusion-weighted MRI for pretherapeutic assessment and staging of lymphoma: results of a prospective study in 140 patients. Clin Cancer Res 20:2984–2993CrossRefPubMed Mayerhoefer ME, Karanikas G, Kletter K et al (2014) Evaluation of diffusion-weighted MRI for pretherapeutic assessment and staging of lymphoma: results of a prospective study in 140 patients. Clin Cancer Res 20:2984–2993CrossRefPubMed
22.
Zurück zum Zitat Adams HJ, Kwee TC, Vermoolen MA et al (2013) Whole-body MRI for the detection of bone marrow involvement in lymphoma: prospective study in 116 patients and comparison with FDG-PET. Eur Radiol 23:2271–2278CrossRefPubMed Adams HJ, Kwee TC, Vermoolen MA et al (2013) Whole-body MRI for the detection of bone marrow involvement in lymphoma: prospective study in 116 patients and comparison with FDG-PET. Eur Radiol 23:2271–2278CrossRefPubMed
23.
Zurück zum Zitat Wu X, Pertovaara H, Korkola P et al (2014) Correlations between functional imaging markers derived from PET/CT and diffusion-weighted MRI in diffuse large B-cell lymphoma and follicular lymphoma. PLoS One 9:e84999CrossRefPubMedPubMedCentral Wu X, Pertovaara H, Korkola P et al (2014) Correlations between functional imaging markers derived from PET/CT and diffusion-weighted MRI in diffuse large B-cell lymphoma and follicular lymphoma. PLoS One 9:e84999CrossRefPubMedPubMedCentral
24.
Zurück zum Zitat Herrmann K, Queiroz M, Huellner MW et al (2015) Diagnostic performance of FDG-PET/MRI and WB-DW-MRI in the evaluation of lymphoma: a prospective comparison to standard FDG-PET/CT. BMC Cancer 15:1002CrossRefPubMedPubMedCentral Herrmann K, Queiroz M, Huellner MW et al (2015) Diagnostic performance of FDG-PET/MRI and WB-DW-MRI in the evaluation of lymphoma: a prospective comparison to standard FDG-PET/CT. BMC Cancer 15:1002CrossRefPubMedPubMedCentral
25.
Zurück zum Zitat Kwee TC, Vermoolen MA, Akkerman EA et al (2014) Whole-body MRI, including diffusion-weighted imaging, for staging lymphoma: comparison with CT in a prospective multicenter study. J Magn Reson Imaging 40:26–36CrossRefPubMed Kwee TC, Vermoolen MA, Akkerman EA et al (2014) Whole-body MRI, including diffusion-weighted imaging, for staging lymphoma: comparison with CT in a prospective multicenter study. J Magn Reson Imaging 40:26–36CrossRefPubMed
26.
Zurück zum Zitat Brennan DD, Gleeson T, Coate LE et al (2005) A comparison of whole-body MRI and CT for the staging of lymphoma. AJR Am J Roentgenol 185:711–716CrossRefPubMed Brennan DD, Gleeson T, Coate LE et al (2005) A comparison of whole-body MRI and CT for the staging of lymphoma. AJR Am J Roentgenol 185:711–716CrossRefPubMed
27.
Zurück zum Zitat Kwee TC, 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. Investig Radiol 44:683–690CrossRef Kwee TC, 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. Investig Radiol 44:683–690CrossRef
28.
Zurück zum Zitat Kellenberger CJ, Miller SF, Khan M et al (2004) Initial experience with FSE STIR whole-body MR imaging for staging lymphoma in children. Eur Radiol 14:1829–1841CrossRefPubMed Kellenberger CJ, Miller SF, Khan M et al (2004) Initial experience with FSE STIR whole-body MR imaging for staging lymphoma in children. Eur Radiol 14:1829–1841CrossRefPubMed
29.
Zurück zum Zitat 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 18:1937–1952CrossRefPubMedPubMedCentral 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 18:1937–1952CrossRefPubMedPubMedCentral
30.
Zurück zum Zitat 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 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
31.
Zurück zum Zitat Kwee TC, Takahara T, Vermoolen MA et al (2010) Whole-body diffusion-weighted imaging for staging malignant lymphoma in children. Pediatr Radiol 40:1592–1602CrossRefPubMedPubMedCentral Kwee TC, Takahara T, Vermoolen MA et al (2010) Whole-body diffusion-weighted imaging for staging malignant lymphoma in children. Pediatr Radiol 40:1592–1602CrossRefPubMedPubMedCentral
32.
Zurück zum Zitat Littooij AS, Kwee TC, Barber I et al (2016) Accuracy of whole-body MRI in the assessment of splenic involvement in lymphoma. Acta Radiol 57:142–151CrossRefPubMed Littooij AS, Kwee TC, Barber I et al (2016) Accuracy of whole-body MRI in the assessment of splenic involvement in lymphoma. Acta Radiol 57:142–151CrossRefPubMed
33.
Zurück zum Zitat Haddy TB, Parker RI, Magrath IT (1989) Bone marrow involvement in young patients with non-Hodgkin's lymphoma: the importance of multiple bone marrow samples for accurate staging. Med Pediatr Oncol 17:418–423CrossRefPubMed Haddy TB, Parker RI, Magrath IT (1989) Bone marrow involvement in young patients with non-Hodgkin's lymphoma: the importance of multiple bone marrow samples for accurate staging. Med Pediatr Oncol 17:418–423CrossRefPubMed
34.
Zurück zum Zitat Shields AF, Porter BA, Churchley S et al (1987) The detection of bone marrow involvement by lymphoma using magnetic resonance imaging. J Clin Oncol 5:225–230CrossRefPubMed Shields AF, Porter BA, Churchley S et al (1987) The detection of bone marrow involvement by lymphoma using magnetic resonance imaging. J Clin Oncol 5:225–230CrossRefPubMed
35.
Zurück zum Zitat Tardivon AA, Munck JN, Shapeero LG et al (1995) Can clinical data help to screen patients with lymphoma for MR imaging of bone marrow? Ann Oncol 6:795–800CrossRefPubMed Tardivon AA, Munck JN, Shapeero LG et al (1995) Can clinical data help to screen patients with lymphoma for MR imaging of bone marrow? Ann Oncol 6:795–800CrossRefPubMed
36.
Zurück zum Zitat Ribrag V, Vanel D, Leboulleux S et al (2008) Prospective study of bone marrow infiltration in aggressive lymphoma by three independent methods: whole-body MRI, PET/CT and bone marrow biopsy. Eur J Radiol 66:325–331CrossRefPubMed Ribrag V, Vanel D, Leboulleux S et al (2008) Prospective study of bone marrow infiltration in aggressive lymphoma by three independent methods: whole-body MRI, PET/CT and bone marrow biopsy. Eur J Radiol 66:325–331CrossRefPubMed
Metadaten
Titel
Can diffusion-weighted whole-body MRI replace contrast-enhanced CT for initial staging of Hodgkin lymphoma in children and adolescents?
verfasst von
Rodrigo Regacini
Andrea Puchnick
Flavio Augusto Vercillo Luisi
Henrique Manoel Lederman
Publikationsdatum
23.01.2018
Verlag
Springer Berlin Heidelberg
Erschienen in
Pediatric Radiology / Ausgabe 5/2018
Print ISSN: 0301-0449
Elektronische ISSN: 1432-1998
DOI
https://doi.org/10.1007/s00247-018-4071-6

Weitere Artikel der Ausgabe 5/2018

Pediatric Radiology 5/2018 Zur Ausgabe

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.