A prospective study of magnetic resonance imaging in lymphoma staging

Abstract

In this prospective study, magnetic resonance imaging (MRI) was compared with computed tomography (CT) in patients with non-Hodgkin's lymphoma (NHDL), and with CT and laparotomy in patients with Hodgkin's disease (HD). Among 31 patients with NHDL, there was agreement between MRI and CT findings in 21 patients; MRI findings were positive and CT findings were negative in 8 patients; and MRI findings were negative and CT findings were positive in 2 patients. The false-negative findings of MRI included a laparotomy-proven mesenteric mass and a 6.6-cm lesion in the spleen, both shown by CT. In 13 evaluable patients with HD, there was agreement between MRI and laparotomy findings in 8 patients; MRI findings were positive and laparotomy findings were negative in 4 patients; and MRI findings were negative and laparotomy findings were positive in 1 patient. CT findings agreed with laparotomy findings in nine patients; CT findings were positive and laparotomy findings were negative in one patient: and CT findings were negative and laparotomy findings were positive in three patients. This suggested that MRI, although more sensitive than CT, was less specific with more false-positive findings. The spin-lattice relaxation time (T1) for the spleen was generally higher in patients with HD who had pathologically confirmed splenic involvement, and tended to increase with increasing spleen weight. This study was performed on a prototype 0.15 Tesla (Technicare Inc., Solon, OH) resistive unit at a time when methods and reporting for MRI were still being developed. Although MRI appears to have fewer false-negative findings than CT in evaluating the abdomen of lymphoma patients, the lack of a gastrointestinal contrast agent and specificity of T1 elevations in the spleen would not suggest that MRI could replace CT or laparotomy as a staging technique.

A Huge Retroperitoneal Large B-Cell Lymphoma Presenting As Chronic Small Bowel Obstruction: A Case Report

“…Diagnosis is often delayed and the mass lesions often assume a significant size before they are recognised. The early parts of the 19 th century came with improved diagnostic imaging tools, such as PET scan and scintigraphy, Computed Tomographic (CT) scanning and magnetic resonance imaging [22][23][24][25][26].…”

Littoral cell angioma of the spleen: CT and MR imaging appearance

“…Numerous cases have been examined and published [8,10,12,13,22]. Typically, lymphomas are hypointense on T1-weighted and demonstrate high SI on T2-weighted images in comparison with surrounding splenic tissue.…”

Changing role of surgery in childhood lymphomas

“…Group I11 had neither splenic surface changes or enlarged associated nodes. Since combined chemo and radiotherapy was planned for the next study, if it was highly likely that the spleen was involved (group I, 11) splenectomy was recommended to avoid irradiation of the splenic area. When splenectomy had not been done but other biopsied abdominal lymph nodes were reported to be positive, the spleen would also be irradiated.…”

“…The CT scan and MRI can identify enlarged abdominal nodes but cannot determine the presence or absence of tumor in the nodes. [10,11] In addition it is known that normal sized lymph nodes can contain HD. Diagnosis of tumor involvement based on enlarged size can be particularly difficult in the pediatric patient because of an increased possibility of hyperplastic nodes.…”

“…The unfavorable risk factors included B symptoms, ESR ~7 0 , histology other than nodular sclerosis or lymphocyte predominant, > 4 sites of involvement and on enlarged spleen. If four of these risk factors or three which included both an enlarged spleen plus B [11,12]. symptoms were present, the probability of extensive spleen involvement was >80%.…”