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Evaluation of staging and early response to chemotherapy with whole‐body diffusion‐weighted MRI in malignant lymphoma patients: A comparison with FDG‐PET/CT
Author(s) -
Tsuji Kazunobu,
Kishi Shinji,
Tsuchida Tatsuro,
Yamauchi Takahiro,
Ikegaya Satoshi,
Urasaki Yoshimasa,
Fujiwara Yasuhiro,
Ueda Takanori,
Okazawa Hidehiko,
Kimura Hirohiko
Publication year - 2015
Publication title -
journal of magnetic resonance imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.563
H-Index - 160
eISSN - 1522-2586
pISSN - 1053-1807
DOI - 10.1002/jmri.24714
Subject(s) - medicine , chemotherapy , lymphoma , positron emission tomography , radiology , stage (stratigraphy) , nuclear medicine , concordance , standardized uptake value , magnetic resonance imaging , diffusion mri , effective diffusion coefficient , lesion , pathology , paleontology , biology
Background To examine the utility of diffusion‐weighted MRI (DW‐MRI) for staging and early response to chemotherapy assessment in lymphoma patients as compared with fluorodeoxyglucose positron emission tomography/computed tomography (FDG‐PET/CT). Methods Twenty‐eight patients with histologically confirmed malignant lymphoma underwent both MRI and FDG‐PET/CT before (pretreatment) and after two courses of chemotherapy (mid‐treatment). Staging with MRI (DW‐MRI alone and with T2‐weighted images) and FDG‐PET was compared visually, and the concordance rate (kappa value, κ) was calculated. To evaluate early response to chemotherapy, patients were divided into two groups, lesion‐positive (LP) and lesion‐negative (LN), based on a proposed original criterion. Progression‐free survival (PFS) was compared between the groups using the Kaplan‐Meier method. Results The stage diagnosed with DW‐MRI alone and with FDG‐PET/CT was concordant in 22 patients (κ = 0.71; P < 0.05), and by adding T2‐weighted images, the number of concordant patients increased to 26 (κ = 0.90; P < 0.05). On mid‐treatment imaging, 19 patients were diagnosed as LN from both modalities. PFS differed significantly between LP and LN on both DW‐MRI ( P = 0.0013) and FDG‐PET/CT ( P = 0.037). Conclusion DW‐MRI is a promising tool for staging and evaluation of early response to chemotherapy in patients with lymphoma. J. Magn. Reson. Imaging 2015;41:1601–1607 . © 2014 Wiley Periodicals, Inc .