Lymphomerkrankungen im Kindes- und Jugendalter

Sorge, Ina; Georgi, Thomas; Hirsch, Wolfgang

doi:10.1007/s00117-021-00873-9

Cited by 3 publications

(1 citation statement)

References 28 publications

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“…It enables a reduction of radiation exposure up to 65%, while obtaining high quality at morphologic lymphoma imaging [ 15 – 17 ]. Consequently, improvements of the diagnostic work-up therapeutic abilities build the basis of increasingly favorable prognosis for children with lymphoma, measurable with a 5-year survival of 97% for HL and 85% for NHL, respectively [ 18 – 20 ]. However, [ 18 F]FDG PET/MRI can easily reach 1 h of examination time for an adequate staging, making it stressful and challenging for pediatric and adult patients [ 21 ].…”

Section: Introductionmentioning

confidence: 99%

[18F]FDG PET/MRI in children suffering from lymphoma: does MRI contrast media make a difference?

et al. 2023

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Objectives Evaluate the influence of an MRI contrast agent application on primary and follow-up staging in pediatric patients with newly diagnosed lymphoma using [18F]FDG PET/MRI to avoid adverse effects and save time and costs during examination. Methods A total of 105 [18F]FDG PET/MRI datasets were included for data evaluation. Two different reading protocols were analyzed by two experienced readers in consensus, including for PET/MRI-1 reading protocol unenhanced T2w and/or T1w imaging, diffusion-weighted imaging (DWI), and [18F]FDG PET imaging and for PET/MRI-2 reading protocol an additional T1w post contrast imaging. Patient-based and region-based evaluation according to the revised International Pediatric Non-Hodgkin’s Lymphoma (NHL) Staging System (IPNHLSS) was performed, and a modified standard of reference was applied comprising histopathology and previous and follow-up cross-sectional imaging. Differences in staging accuracy were assessed using the Wilcoxon and McNemar tests. Results In patient-based analysis, PET/MRI-1 and PET/MRI-2 both determined a correct IPNHLSS tumor stage in 90/105 (86%) exams. Region-based analysis correctly identified 119/127 (94%) lymphoma-affected regions. Sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy for PET/MRI-1 and PET/MRI-2 were 94%, 97%, 90%, 99%, 97%, respectively. There were no significant differences between PET/MRI-1 and PET/MRI-2. Conclusions The use of MRI contrast agents in [18F]FDG PET/MRI examinations has no beneficial effect in primary and follow-up staging of pediatric lymphoma patients. Therefore, switching to a contrast agent–free [18F]FDG PET/MRI protocol should be considered in all pediatric lymphoma patients. Clinical relevance statement This study gives a scientific baseline switching to a contrast agent–free [18F]FDG PET/MRI staging in pediatric lymphoma patients. This could avoid side effects of contrast agents and saves time and costs by a faster staging protocol for pediatric patients. Key Points • No additional diagnostic benefit of MRI contrast agents at [18F]FDG PET/MRI examinations of pediatric lymphoma primary and follow-up staging • Highly accurate primary and follow-up staging of pediatric lymphoma patients at MRI contrast–free [18F]FDG PET/MRI

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