Comparison of PET-CT and magnetic resonance diffusion weighted imaging with body suppression (DWIBS) for initial staging of malignant lymphomas

Velasco, Stéphane; Burg, Samuel; Delwail, Vincent; Joelle, Guilhot; Perdrisot, R.; Francois, Guilhot Gaudeffroy; Tasu, J.P.

doi:10.1016/j.ejrad.2013.05.042

Cited by 51 publications

(43 citation statements)

References 29 publications

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“…For detection of extranodal involvement, DWI-MRI showed an almost perfect sensitivity, en par with 18F-FDG-PET/CT. Furthermore, in terms of staging, there was a strong agreement between DWI-MRI and 18F-FDG-PET/CT, in accordance with the previous smaller-sized studies in DLBCL and Hodgkin lymphoma (18)(19)(20)(21). DWI-MRI disagreed with the reference standard in 6 of 100 patients in Group A (Table 2), and in only a single case, understaging by DWI-MRI would have had a relevant effect on treatment (stage I instead of stage III).…”

Section: Discussionsupporting

confidence: 89%

“…Notably, several recent, smaller-sized studies suggest that DWI-MRI may-similar to 18F-FDG-PET/CT, and unlike standard morphologic MRI or CE-CT-possibly be able to distinguish between vital tumor tissue and residual changes (e.g., fibrosis) after therapy (13)(14)(15)(16)(17). The data that support the notion that DWI-MRI is comparable with 18F-FDG-PET/CT for lymphoma staging are, however, mainly based on patients with diffuse large B-cell lymphoma (DLBCL) and Hodgkin lymphoma, and/or a limited sample size (18)(19)(20)(21). Very little data are available with regard to the comparative performances of DWI-MRI and 18F-FDG-PET/CT in patients with indolent Non-Hodgkin lymphomas.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of Diffusion-Weighted MRI for Pretherapeutic Assessment and Staging of Lymphoma: Results of a Prospective Study in 140 Patients

Mayerhoefer

Karanikas

Kletter

et al. 2014

Clinical Cancer Research

102

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Purpose: To determine the value of diffusion-weighted MRI (DWI-MRI) for pretherapeutic imaging of fluorodeoxyglucose (FDG)-avid lymphoma and lymphoma with variable FDG avidity.Experimental Design: Treatment-na€ ve patients with lymphoma who were referred for whole-body staging were included in this prospective study. Group A included patients with FDG-avid lymphoma (e.g., Hodgkin, diffuse large B-cell, and follicular lymphoma), whereas Group B included patients with lymphoma of variable FDG avidity [e.g., extranodal marginal zone B-cell lymphoma of the mucosa-associated lymphoid tissue (MALT)]. All patients underwent DWI-MRI and 18F-FDG-positron emission tomography/ computed tomography (PET/CT). Region-based sensitivity and agreement with Ann Arbor staging, relative to the reference standard, were calculated for DWI-MRI, and, in Group B, also 18F-FDG-PET/CT and contrast-enhanced (CE-) CT.Results: In Group A (100 patients), DWI-MRI had a region-based sensitivity of 97%, and with regard to staging, agreed with the reference standard in 94 of 100 patients (k, 0.92). In Group B (40 patients; 38 MALT lymphomas and 2 small lymphocytic lymphomas/chronic lymphocytic leukemias), DWI-MRI, 18F-FDG-PET/CT, and CE-CT had region-based sensitivities of 94.4%, 60.9%, and 70.7%, respectively. With regard to staging in Group B, DWI-MRI, 18F-FDG-PET/CT, and CE-CT agreed with the reference standard in 37 of 40, 26 of 40, and 24 of 40 patients, with k values of 0.89, 0.52, and 0.43, respectively.Conclusions: In patients with FDG-avid lymphoma, DWI-MRI seems to be only slightly inferior to 18F-FDG-PET/CT with regard to pretherapeutic regional assessment and staging. In patients with lymphoma subtypes that show a variable FDG avidity (e.g., MALT lymphoma), DWI-MRI seems to be superior to both 18F-FDG-PET/CT and CE-CT. Clin Cancer Res; 20(11); 2984-93. Ó2014 AACR.

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Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Evaluation of Diffusion-Weighted MRI for Pretherapeutic Assessment and Staging of Lymphoma: Results of a Prospective Study in 140 Patients

Mayerhoefer

Karanikas

Kletter

et al. 2014

Clinical Cancer Research

102

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“…Compared to PET/CT, the reported sensitivity and specificity for assessment of lymphoma with WB-DWI is 89-100% and 97-100% respectively. 20,[22][23][24] Our results for specificity of WB-DWI are comparable to that of PET/CT (93-100%) and are in line with previous observations. In contrast, our results for sensitivity were inferior to that seen in previous studies; this may be secondary to our small sample size.…”

supporting

confidence: 92%

Evaluation of Whole Body DiffusionWeighted Imaging in the Staging and Treatment Response of Lymphoma Compared With Fluoride-Oxyglucose (FDG) PET/CT as a Reference Standard

Hennedige¹,

Ng²,

Tao³

et al. 2017

Radiol Open J

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CitationHennedige T, Ng DCE, Tao M, Quek RHH, Lim ST, Kwek JW. Evaluation of whole body diffusion-weighted imaging in the staging and treatment response of lymphoma compared with fluoride-oxyglucose (FDG) PET/ CT as a reference standard. Radiol Open J. 2017 Positron emission tomography/computed tomography (PET/CT) is currently considered standard of practice for the management of lymphoma with sensitivity and specificity approaching 100%. However, it is expensive, time-consuming and requires exposure to ionizing radiation. Whole body-diffusion weighted imaging (WB-DWI), does not involve exposure to ionizing radiation, is more widely available and can be performed within an acceptable time frame. PET/CT will be used as a reference standard in the evaluation of the value of WB-DWI in the initial staging and treatment response in patients with lymphoma. Methods: Nine patients with newly diagnosed lymphoma and a pre-treatment PET/CT were prospectively recruited. Patients were analyzed with both imaging modalities before treatment initiation and at four-weeks post-completion of chemotherapy. The presence or absence of nodal and extra-nodal involvement was independently assessed by two radiologists blinded to the PET/CT findings. The PET/CT images were assessed by a single nuclear medicine physician.Results: Compared to PET/CT, the overall sensitivity, specificity and accuracy of WB-DWI in staging were 62%, 98% and 87% respectively and the overall specificity and accuracy for treatment response were both 99%. Majority of false negative findings were a result of small nodes which showed uptake on PET/CT but were either not identified or did not show restricted diffusion. Further false negative and positive findings were due to reduced spatial resolution and increased motion and susceptibility artefact on magnetic resonance imaging (MRI). Conclusion: WB-DWI may be a viable alternative to PET/CT in the treatment response of lymphoma. However, in terms of staging, PET/CT probably remains the imaging modality of choice.

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“…In the remaining three patients, low-grade lymphoma had higher staging through WB-MRI than through FDG-PET/ CT, which was later validated by means of clinical staging. In the studies by Stéphane et al 16 and Wu et al 34 WB-MRI and FDG-PET/CT yielded the same staging in all patients, although three were incorrectly staged with both methods in the study by Wu et al 34 In the sample of van Ufford et al, 35 Table 3. Agreement between WB-MRI and FDG-PET/CT for lymphoma staging in each of the studies included Head, neck, chest, abdomen, pelvis, proximal thigh SPAIR = spectral presaturation attenuated inversion recovery; STIR = short tau inversion recovery; DWI = diffusion-weighted imaging; SAT = fat saturation; ADC = apparent diffusion coefficient; MIP = maximum intensity projection; WB-MRI = whole-body diffusion-weighted magnetic resonance imaging.…”

Section: Agreement Between Wb-mri and Fdg-pet/ct For Lymphoma Stagingmentioning

confidence: 91%

“…Gu et al, 14 Abdulqadhr et al, 15 Stéphane et al 16 and Lin et al reported high sensitivity for both methods, whereas Wu et al 34 and van Ufford et al 35 found lower sensitivity values.…”

Section: Summary Assessment Of the Sensitivity Of Wb-mri For Lymphomamentioning

confidence: 97%

Whole-body diffusion-weighted magnetic resonance imaging versus FDG-PET/CT for initial lymphoma staging: systematic review on diagnostic test accuracy studies

et al. 2015

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CONTEXT AND OBJECTIVE: Positron emission tomography with [18]F-fluoro-2-deoxyglucose (FDG-PET/CT) has been advocated as the method of choice for lymphoma staging, since it enables whole-body analysis with high sensitivity for detection of affected areas and because it combines capacities for anatomical and functional assessment. With technological advances, magnetic resonance imaging (MRI) has emerged as an alternative to FDG-PET/CT. This systematic review with meta-analysis aimed to compare whole-body diffusion-weighted MRI (WB-MRI) with FDG-PET/CT for lymphoma staging. DESIGN AND SETTING: Systematic review on diagnostic test accuracy studies conducted at a public university. METHODS: The Medline, Scopus, Embase and Lilacs databases were searched for studies published up to September 2013 that compared WB-MRI and FDG-PET/CT for lymphoma staging. The reference lists of included studies were checked for any relevant additional citations. RESULTS: Six studies that evaluated the initial lymphoma staging in 116 patients were included. WB-MRI and FDG-PET/CT agreed in 90.5% of the cases (κ = 0.871; P < 0.0001). In most of the studies, when there was disagreement between the methods, WB-MRI overstaged in relation to FDG-PET/CT. The sensitivity of WB-MRI and FDG-PET/CT, in comparison with the clinical-radiological standard, ranged from 59 to 100% and from 63 to 100% respectively. CONCLUSION: WB-MRI is a highly sensitive method for initial lymphoma staging. It has excellent agreement with FDG-PET/CT and is a great alternative for managing lymphoma patients, without using ionizing radiation or an intravenous contrast agent.

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Comparison of PET-CT and magnetic resonance diffusion weighted imaging with body suppression (DWIBS) for initial staging of malignant lymphomas

Cited by 51 publications

References 29 publications

Evaluation of Diffusion-Weighted MRI for Pretherapeutic Assessment and Staging of Lymphoma: Results of a Prospective Study in 140 Patients

Evaluation of Diffusion-Weighted MRI for Pretherapeutic Assessment and Staging of Lymphoma: Results of a Prospective Study in 140 Patients

Evaluation of Whole Body DiffusionWeighted Imaging in the Staging and Treatment Response of Lymphoma Compared With Fluoride-Oxyglucose (FDG) PET/CT as a Reference Standard

Whole-body diffusion-weighted magnetic resonance imaging versus FDG-PET/CT for initial lymphoma staging: systematic review on diagnostic test accuracy studies

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