Abstract
Objective
To design a whole-body MR protocol using exclusively diffusion-weighted imaging (DWI) with respiratory gating and to assess its value for lesion detection and staging in patients with diffuse large B-cell lymphoma (DLBCL), with integrated FDG PET/CT as the reference standard.
Methods
Fifteen patients underwent both whole-body DWI (b = 50, 400, 800 s/mm2) and PET/CT for pretreatment staging. Lymph node and organ involvement were evaluated by qualitative and quantitative image analysis, including measurement of the mean apparent diffusion coefficient (ADC).
Results
A total of 296 lymph node regions in the 15 patients were analysed. Based on International Working Group size criteria alone, DWI findings matched PET/CT findings in 277 regions (94%) (kappa score = 0.85, P < 0.0001), yielding sensitivity and specificity for DWI lymph node involvement detection of 90% and 94%. Combining visual ADC analysis with size measurement increased DWI specificity to 100% with 81% sensitivity. For organ involvement, the two techniques agreed in all 20 recorded organs (100%). All involved organ lesions showed restricted diffusion. Ann Arbor stages agreed in 14 (93%) of the 15 patients.
Conclusion
Whole-body DWI with ADC analysis can potentially be used for lesion detection and staging in patients with DLBCL.
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Acknowledgements
The authors thank David Young, BSc, for editorial assistance. C.L. was supported by the Association pour la Recherche sur le Cancer. A.V., who assisted in the protocol design, was an employee of Siemens Healthcare. The other authors had full control over the data and the information submitted for publication.
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Lin, C., Luciani, A., Itti, E. et al. Whole-body diffusion-weighted magnetic resonance imaging with apparent diffusion coefficient mapping for staging patients with diffuse large B-cell lymphoma. Eur Radiol 20, 2027–2038 (2010). https://doi.org/10.1007/s00330-010-1758-y
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DOI: https://doi.org/10.1007/s00330-010-1758-y