MRI versus CT and PET/CT in the Preoperative Assessment of Hodgkin and Non-Hodgkin Lymphomas

Abstract

(1) Background: The purpose of this study is to retrospectively compare CT, MRI, and PET/CT in detecting lymphadenopathies and extra-nodal lesions in lymphoma and in disease staging. (2) Methods: Inclusion criteria were the availability of TB (Total Body) CT and/or PET/CT performed before treatment; MRI performed no later than 2 weeks after TBCT; histological confirmation of lymphoma; clinical-diagnostic follow-up. Using these criteria, we included 64/353 patients with TBCT and MRI performed at our hospital; 20/64 had PET/CT performed in other hospitals. Histology and follow-up were gold standard. (3) Results: The sensitivity, specificity, and accuracy in lymph nodes detection was 84.5%, 94.4%, and 91% for CT and 95%, 98.9%, and 95.6% for MRI. High agreement was observed between CT and MRI regarding the number and size of positive lymph nodes and for disease staging. MRI identified eight more extra-nodal lesions than CT. In the subgroup of 20 patients, PET/CT did not show a significant superiority in sensitivity, specificity, accuracy, and staging ability than CT and MRI. (4) Conclusions: Our study demonstrates a mild superiority of MRI over CT in lymphoma staging. Although PET/CT remains the reference standard, MRI demonstrated a similar diagnostic accuracy, with the added value of being radiation-free.

A Rare Finding of Pancreatic Involvement in a Case of Burkitt's Lymphoma

“…In the same study, sensitivity, specificity, and accuracy for the detection of lymph nodes were found to be 96.2%, 97.0%, and 96.7% for MRI and 83.7%, 96.2%, and 90.6% for CT, respectively. [ 18 ]…”

Whole body MRI with Diffusion Weighted Imaging versus 18F-fluorodeoxyglucose-PET/CT in the staging of lymphomas

“…Disease staging was assessed using the Revised Staging System for Primary Nodal Lymphomas (Supplemental Material - Table 2) [ 4 ]. Nodal involvement was assessed in 10 nodal stations: cervical, supraclavicular, axillary, mediastinal, hilar, para-aortic, mesenteric, iliac, inguinal regions, and other regions (such as liver hilum) [ 26 , 27 ]. Lymph nodes were considered involved when on axial images the largest diameter was greater than 1.5 cm or the short axis was greater than 1 cm or when they coalesced into large nodal masses, the DWI signal was higher than that of the spinal cord, or in the presence of central necrosis, regardless of the diameter [ 28 ].…”

Magnetic Resonance Imaging of the Gastrointestinal Tract: Current Role, Recent Advancements and Future Prospectives

“…Another gastrointestinal inflammatory disease recently investigated with MRI is the intestinal graft-versus-host-disease (GVHD), a severe acute or chronic complication of hematopoietic stem cell transplantation, difficult to diagnose. Multiparametric MRI can be useful for both diagnosis and staging of acute and chronic GVHD, being able to identify many specific intestinal and extraintestinal signs (biomarkers), such as predominant and continuous small bowel involvement, edema of the intestinal wall, stratified "target" wall appearance on both T2-weighted and post contrast T1-weighted images, subcutaneous fat tissue edema, and mesenteric and retroperitoneal edema [28,29].…”