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Role of WB-MR/DWIBS compared to 18F-FDG PET/CT in the therapy response assessment of lymphoma

  • DIAGNOSTIC IMAGING IN ONCOLOGY
  • Published:
La radiologia medica Aims and scope Submit manuscript

Abstract

Introduction

This study prospectively evaluated whole-body magnetic resonance/diffusion-weighted imaging with body signal suppression (WB-MR/DWIBS) reliability compared to 18F-FDG PET/CT in the treatment response assessment of classic Hodgkin lymphomas (HL) and aggressive non-Hodgkin lymphomas (aNHL).

Materials and methods

Twenty-seven consecutive patients were prospectively enrolled at the time of diagnosis. Eighteen (11 HL and seven aNHL) were considered for the analysis. They received chemo/radiotherapy as induction and completed post-treatment evaluation performing both 18F-FDG PET/CT and WB-MR/DWIBS. The revised response criteria for malignant lymphomas were used to assess the response to treatment. We evaluated the agreement between the two methods by Cohen’s K test. Post-therapy WB-MR/DWIBS sensitivity, specificity, PPV, NPV and accuracy were then calculated, considering the 12 months of follow-up period as the gold standard.

Results

By using an evaluation on a lesion-by-lesion basis, WB-MR/DWIBS and 18F-FDG PET/CT showed an overall good agreement (K = 0.796, 95 % IC = 0.651–0.941), especially in the evaluation of the nodal basins in aNHL (K = 0.937, 95 % IC = 0.814–1). In reference to the revised response criteria for malignant lymphomas, the two methods showed a good agreement (K = 0.824, 95 % IC = 0.493–1). Post-therapy sensitivity, specificity, PPV, NPV and accuracy of WB-MR/DWIBS were 43, 91, 75, 71 and 72 %, respectively.

Conclusion

WB-MR/DWIBS seems to be an appropriate method for the post-treatment assessment of patients affected by HL and aNHL. The small discrepancies between the two methods found within HL could be due to the biological and metabolic behavior of this group of diseases. Larger prospective studies are necessary to better define the role of WB-MR/DWIBS in this setting of patients.

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Acknowledgments

The authors would like to thank C. Oakley (National Cancer Research Centre “Giovanni Paolo II”, Bari, Italy) for linguistic revision of the manuscript.

Funding

No author has financial relationships to disclose.

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Author notes

    Authors and Affiliations

    1. Department of Medicine and Health Science, University of Molise, Campobasso, Italy

      Nicola Maggialetti & Luca Brunese

    2. Department of Medical and Experimental Oncology, IRCCS National Cancer Research Centre “Giovanni Paolo II”, Bari, Italy

      Carla Minoia, Giacomo Loseto, Giacomina De Tullio, Vincenza de Fazio & Attilio Guarini

    3. D.I.M.- Diagnostic Imaging – Nuclear Medicine, University of Bari “Aldo Moro”, Bari, Italy

      Cristina Ferrari, Artor Niccoli Asabella & Giuseppe Rubini

    4. Department of Radiodiagnostic, IRCCS National Cancer Research Centre “Giovanni Paolo II”, Bari, Italy

      Michele Ficco & Angela Calabrese

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    1. Nicola Maggialetti
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    Correspondence to Nicola Maggialetti.

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    All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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    Informed consent was obtained from all individual participants included in the study.

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    Nicola Maggialetti and Cristina Ferrari have contributed equally in writing paper.

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    Maggialetti, N., Ferrari, C., Minoia, C. et al. Role of WB-MR/DWIBS compared to 18F-FDG PET/CT in the therapy response assessment of lymphoma. Radiol med 121, 132–143 (2016). https://doi.org/10.1007/s11547-015-0581-6

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