nach oben

Erschienen in:

01.08.2013 | Oncology

Whole-body MRI for the detection of bone marrow involvement in lymphoma: prospective study in 116 patients and comparison with FDG-PET

verfasst von: Hugo J. A. Adams, Thomas C. Kwee, Malou A. Vermoolen, Bart de Keizer, John M. H. de Klerk, Judit A. Adam, Rob Fijnheer, Marie José Kersten, Jaap Stoker, Rutger A. J. Nievelstein

Erschienen in: European Radiology | Ausgabe 8/2013

Einloggen, um Zugang zu erhalten

Abstract

Objective

To assess and compare the value of whole-body MRI with FDG-PET for detecting bone marrow involvement in lymphoma.

Methods

A total of 116 patients with newly diagnosed lymphoma prospectively underwent whole-body MRI and blind bone marrow biopsy (BMB) of the posterior iliac crest. Of 116 patients, 80 also underwent FDG-PET. Patient-based sensitivities of whole-body MRI for detecting bone marrow involvement were calculated using BMB as reference standard and compared with FDG-PET in aggressive and indolent lymphomas separately.

Results

Sensitivity of whole-body MRI in all lymphomas was 45.5 % [95 % confidence interval (CI): 29.8–62.0 %]. Sensitivity of whole-body MRI in aggressive lymphoma [88.9 % (95 % CI: 54.3–100 %)] was significantly higher (P = 0.0029) than that in indolent lymphoma [23.5 % (95 % CI: 9.1–47.8 %)]. Sensitivity of FDG-PET in aggressive lymphoma [83.3 % (95 % CI: 41.8–98.9 %)] was also significantly higher (P = 0.026) than that in indolent lymphoma [12.5 % (95 % CI: 0–49.2 %)]. There were no significant differences in sensitivity between whole-body MRI and FDG-PET (P = 1.00)

Conclusion

Sensitivity of whole-body MRI for detecting lymphomatous bone marrow involvement is too low to (partially) replace BMB. Sensitivity of whole-body MRI is significantly higher in aggressive lymphoma than in indolent lymphoma and is equal to FDG-PET in both entities.

Key Points

• Bone marrow involvement in lymphoma has prognostic and therapeutic implications.

• Blind bone marrow biopsy (BMB) is standard for bone marrow assessment.

• Neither whole-body MRI nor FDG-PET can yet replace BMB.

• Both techniques have higher sensitivity in aggressive than in indolent lymphoma.

• Both imaging techniques are complementary to BMB.

Siegel R, Naishadham D, Jemal A (2012) Cancer statistics, 2012. CA Cancer J Clin 62:10–29PubMedCrossRef

Connors JM (2005) State-of-the-art therapeutics: Hodgkin’s lymphoma. J Clin Oncol 23:6400–6408PubMedCrossRef

Shankland KR, Armitage JO, Hancock BW (2012) Non-Hodgkin lymphoma. Lancet 380:848–587PubMedCrossRef

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 7:1630–1636PubMed

Armitage JO (2005) Staging non-Hodgkin lymphoma. CA Cancer J Clin 55:368–376PubMedCrossRef

Bain BJ (2006) Morbidity associated with bone marrow aspiration and trephine biopsy - a review of UK data for 2004. Haematologica 91:1293–1294PubMed

Brunning RD, Bloomfield CD, McKenna RW, Peterson LA (1975) Bilateral trephine bone marrow biopsies in lymphoma and other neoplastic diseases. Ann Intern Med 82:365–366PubMedCrossRef

Coller BS, Chabner BA, Gralnick HR (1977) Frequencies and patterns of bone marrow involvement in non-Hodgkin lymphomas: observations on the value of bilateral biopsies. Am J Hematol 3:105–119PubMedCrossRef

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 17:418–423PubMedCrossRef

10.

Wang J, Weiss LM, Chang KL et al (2002) Diagnostic utility of bilateral bone marrow examination: significance of morphologic and ancillary technique study in malignancy. Cancer 94:1522–1531PubMedCrossRef

11.

Bairey O, Shpilberg O (2007) Is bone marrow biopsy obligatory in all patients with non-Hodgkin’s lymphoma? Acta Haematol 118:61–64PubMedCrossRef

12.

Vande Berg BC, Malghem J, Lecouvet FE, Maldague B (1998) Magnetic resonance imaging of normal bone marrow. Eur Radiol 8:1327–1334PubMedCrossRef

13.

Vande Berg BC, Lecouvet FE, Michaux L, Ferrant A, Maldague B, Malghem J (1998) Magnetic resonance imaging of the bone marrow in hematological malignancies. Eur Radiol 8:1335–1344PubMedCrossRef

14.

Brennan DD, Gleeson T, Coate LE, Cronin C, Carney D, Eustace SJ (2005) A comparison of whole-body MRI and CT for the staging of lymphoma. AJR Am J Roentgenol 185:711–716PubMedCrossRef

15.

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 66:325–331PubMedCrossRef

16.

Kwee TC, Fijnheer R, Ludwig I et al (2010) Whole-body magnetic resonance imaging, including diffusion-weighted imaging, for diagnosing bone marrow involvement in malignant lymphoma. Br J Haematol 149:628–630PubMedCrossRef

17.

Delbeke D, Stroobants S, de Kerviler E, Gisselbrecht C, Meignan M, Conti PS (2009) Expert opinions on positron emission tomography and computed tomography imaging in lymphoma. Oncologist 14:30–40PubMedCrossRef

18.

Pakos EE, Fotopoulos AD, Ioannidis JP (2005) 18F-FDG PET for evaluation of bone marrow infiltration in staging of lymphoma: a meta-analysis. J Nucl Med 46:958–963PubMed

19.

Chen YK, Yeh CL, Tsui CC, Liang JA, Chen JH, Kao CH (2011) F-18 FDG PET for evaluation of bone marrow involvement in non-Hodgkin lymphoma: a meta-analysis. Clin Nucl Med 36:553–559PubMedCrossRef

20.

Salaun PY, Gastinne T, Bodet-Milin C et al (2009) Analysis of 18F-FDG PET diffuse bone marrow uptake and splenic uptake in staging of Hodgkin’s lymphoma: a reflection of disease infiltration or just inflammation? Eur J Nucl Med Mol Imaging 36:1813–1821PubMedCrossRef

21.

Basu S, Torigian D, Alavi A (2008) Evolving concept of imaging bone marrow metastasis in the twenty-first century: critical role of FDG-PET. Eur J Nucl Med Mol Imaging 35:465–471PubMedCrossRef

22.

Weiler-Sagie M, Bushelev O, Epelbaum R et al (2010) (18)F-FDG avidity in lymphoma readdressed: a study of 766 patients. J Nucl Med 51:25–30PubMedCrossRef

23.

Tsukamoto N, Kojima M, Hasegawa M et al (2007) The usefulness of (18)F-fluorodeoxyglucose positron emission tomography ((18)F-FDG-PET) and a comparison of (18)F-FDG-pet with (67)gallium scintigraphy in the evaluation of lymphoma: relation to histologic subtypes based on the World Health Organization classification. Cancer 110:652–659PubMedCrossRef

24.

Kwee TC, Ludwig I, Uiterwaal CS et al (2011) ADC measurements in the evaluation of lymph nodes in patients with non-Hodgkin lymphoma: feasibility study. MAGMA 24:1–8PubMedCrossRef

25.

Tsunoda S, Takagi S, Tanaka O, Miura Y (1997) Clinical and prognostic significance of femoral marrow magnetic resonance imaging in patients with malignant lymphoma. Blood 89:286–29PubMed

26.

Moulin-Romsee G, Hindié E, Cuenca X et al (2010) (18)F-FDG PET/CT bone/bone marrow findings in Hodgkin’s lymphoma may circumvent the use of bone marrow trephine biopsy at diagnosis staging. Eur J Nucl Med Mol Imaging 37:1095–1105PubMedCrossRef

27.

El-Galaly TC, d’Amore F, Mylam KJ et al (2012) Routine bone marrow biopsy has little or no therapeutic consequence for positron emission tomography/computed tomography-staged treatment-naive patients with Hodgkin lymphoma. J Clin Oncol 30:4508–4514PubMedCrossRef

28.

Kwee TC, Akkerman EM, Fijnheer R et al (2011) MRI for staging lymphoma: whole-body or less? J Magn Reson Imaging 33:1144–1150PubMedCrossRef

Titel: Whole-body MRI for the detection of bone marrow involvement in lymphoma: prospective study in 116 patients and comparison with FDG-PET
verfasst von: Hugo J. A. Adams
Thomas C. Kwee
Malou A. Vermoolen
Bart de Keizer
John M. H. de Klerk
Judit A. Adam
Rob Fijnheer
Marie José Kersten
Jaap Stoker
Rutger A. J. Nievelstein
Publikationsdatum: 01.08.2013
Verlag: Springer Berlin Heidelberg
Erschienen in: European Radiology / Ausgabe 8/2013
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-013-2835-9

Update Radiologie

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

Newsletter bestellen

Springer Medizin

Whole-body MRI for the detection of bone marrow involvement in lymphoma: prospective study in 116 patients and comparison with FDG-PET