Diffusion-weighted MRI compared to FDG PET/CT for assessment of early treatment response in lymphoma

Abstract

There was no significant correlation between ΔSUVmax and ΔADC. Thus, our data do not support that FDG PET/CT can be replaced by early DW MRI for response evaluation in lymphoma patients.

Evaluation of Diffusion-Weighted Magnetic Resonance Imaging for Follow-up and Treatment Response Assessment of Lymphoma: Results of an 18F-FDG-PET/CT–Controlled Prospective Study in 64 Patients

“…The results of our study suggest that DWI-MRI is almost equal to 18F-FDG PET/CT for follow-up and therapy response assessment in patients with lymphoma, in accordance with the results of previous smaller-sized studies (13)(14)(15)(16)(17)(18)(19)(20). This is of interest, because only the image pattern, but not the underlying information (i.e., tumor property) assessed is similar between the two techniques: DWI visualizes intercellular space narrowing, and thus, cell density (35); whereas 18F-FDG-PET visualizes glucose metabolism, which in turn has been shown to correlate with cell proliferation (36,37).…”

“…With 64 patients, our study is presently the largest on this topic -the largest previous, prospective study included 27 patients (17), and the largest retrospective study included 39 patients (20). Unlike these previous studies, we also included a considerable number of indolent lymphomas -actually, half of our patients were diagnosed with an indolent NHL, and MALT lymphoma was, with 17 patients, even the most common subtype in our study.…”

“…[13][14][15][16][17][18][19], or a retrospective design (20). In addition, these studies included almost exclusively patients with diffuse large B-cell lymphoma (DLBCL) and Hodgkin lymphoma-there are practically no data for indolent nonHodgkin lymphomas (NHL).…”

“…In addition, these studies included almost exclusively patients with diffuse large B-cell lymphoma (DLBCL) and Hodgkin lymphoma-there are practically no data for indolent nonHodgkin lymphomas (NHL). Finally, almost all previous studies focused on treatment-induced changes of apparent diffusion coefficients (ADC) in target lesions (14)(15)(16)(17)(18)(19); only a single study in 15 DLBCL patients directly compared DWI with 18F-FDG-PET/ CT in terms of detection of residual lymphoma after therapy (13), albeit without further subcategorization of the response status (i.e., complete or partial remission, stable disease, or progression).…”

Usefulness of Diffusion-weighted Magnetic Resonance Imaging-guided Biopsy: Pyothorax-associated Lymphoma

“…To date, this technique has been used to characterize, grade and stage intrathoracic lesions such as lung tumors and mediastinal masses, as well as to differentiate central tumors from post-obstructive atelectasis (6). It is beginning to be used for the staging and response assessment of lymphomas (7)(8)(9)(10). Because DW-MRI of extracranial lesions has only just begun, there are only a few reports about its usefulness for evaluating pleural disease (11,12) and identifying appropriate areas for biopsies of intrathoracic lesions (13,14).…”