Role of diffusion MRI in diagnosis of mediastinal lymphoma: initial assessment and response to therapy

Sabri, Youssriah Yahia; Ewis, Nourhan Mohamed; Zawam, Hamdy; Khairy, Mostafa Ahmed

doi:10.1186/s43055-021-00597-9

Cited by 7 publications

(5 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It should be noted that ADC values are different in distinct subtypes of lymphomas (e.g. Hodgkin's vs. non-Hodgkin's), as shown previously [44]. The prevalence of the undifferentiated NPC subtype seems to be higher in Southeast Asia [45], while in the United States [46], most patients presented with keratinizing squamous cell carcinoma followed by undifferentiated subtype.…”

Section: Discussionsupporting

confidence: 57%

Differentiating nasopharyngeal carcinoma from lymphoma in the head and neck region using the apparent diffusion coefficient (ADC) value: a systematic review and meta-analysis

Tabnak,

HajiEsmailPoor

2023

Pol J Radiol

View full text Add to dashboard Cite

PurposeThis study aimed to assess the applicability of the apparent diffusion coefficient (ADC) for differentiating nasopharyngeal carcinoma (NPC) from lymphomas in the head and neck region.Material and methodsFour databases, including PubMed, the Cochrane Library, EMBASE, and Web of Science, were searched systematically to find relevant literature. The search date was updated to 8 September 2022, with no starting time restriction. The methodological quality of the studies was evaluated using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. Firstly, a random-effects model was used in a meta-analysis of continuous variables with low heterogeneity to determine the overall effect size, which was reported as the standard mean difference (SMD). Then, bivariate random effects modelling was used to calculate the combined sensitivity and specificity. The area under the curve (AUC) for each diffusion parameter was calculated after constructing summary receiver operating characteristic curves. The presence of heterogeneity was evaluated using subgroup and meta-regression analysis.ResultsTwelve studies involving 181 lymphoma and 449 NPC lesions (<i>N</i> = 630) in the head and neck region were included, of which 5 studies provided sufficient data for pooling diagnostic test accuracy. A meta-analysis of the 12 studies using a random-effects model yielded an SMD of 1.03 (CI = 0.76-1.30; <i>p</i> = 0.00001), implying that NPC lesions had a significantly higher ADC value than lymphoma lesions. By pooling 5 standard DWI studies, the pooled sensitivity and specificity of ADC were 0.90 (95% CI: 0.82-0.95) and 0.63 (95% CI: 0.52-0.72), respectively. The area under the curve (AUC) calculated from the SROC curve was 0.74 (95% CI: 0.70-0.78).ConclusionsAccording to this systematic review and meta-analysis, nasopharyngeal carcinoma has a significantly higher ADC value than lymphomas. Furthermore, while ADC has excellent sensitivity for distinguishing these 2 types of tumours, its specificity is relatively low, yielding a moderate diagnostic performance. Further investigations with larger sample sizes are required.

show abstract

Section: Discussionsupporting

confidence: 57%

Differentiating nasopharyngeal carcinoma from lymphoma in the head and neck region using the apparent diffusion coefficient (ADC) value: a systematic review and meta-analysis

Tabnak,

HajiEsmailPoor

2023

Pol J Radiol

View full text Add to dashboard Cite

show abstract

“…They help distinguish between lymphoma subtypes and monitor treatment response effectively. 7,8 In this report, we present the radiological findings of PEL, which were discovered incidentally and appeared similar to those seen in patients with pulmonary tuberculosis.…”

Section: Introductionsupporting

confidence: 59%

Rare Case of Primary Effusion Lymphoma mimicking Pulmonary Tuberculosis

Idris,

Gubali

2024

Jambura Med. and Health Sci J

View full text Add to dashboard Cite

Primary effusion lymphoma (PEL) is a rare large B-cell non-Hodgkin lymphoma (NHL) that usually occurs in immunosuppressed individuals in advanced stages of the disease, presenting as body cavity effusions without detectable tumor mass. We report a 61-years old man presented to the emergency room complaining of effort-related dyspnoea, low-grade fever, night sweats, and a dry cough for several days. He was then put on empirical anti-tubercular treatment (ATT) suspecting Pulmonary Tuberculosis. General examination revealed a decrease oxygen saturation, tachypnea, a bulging tenderness lymph node on the neck. Chest computerized tomography (CT) scan indicated pericardial and pleural effusion with mediastinal dilatation suspected thymoma or lymphoma. A Cardiocentesis needle aspiration was performed; however, the histological pattern was not specific. The patient underwent a surgical biopsy of a left supra-clavicular lymph node. A Classical Hodgkin lymphoma nodular sclerosis type was found in the histopathology examination. Immunohistochemistry detected the tumour cellular markers (i.e., CD30). Chemotherapy treatment for 6 cycles resulted an excellent outcome. In conclusion, radiologists play a vital role in the diagnosis of PEL, detecting effusions in body cavities and excluding the existence of solitary masses or pleural nodules or masses, ultimately narrowing down the differential diagnoses.

show abstract

“…To our knowledge, only a previous study focused on the role of DW-MRI in the evaluation of the specific group of mediastinal lymphomas, asserting that DWI is a valid and promising technique for the diagnosis and therapy response assessments in these patients [46]. This trial included only two cases with a residual mediastinal mass after treatment, and unlike our study it did not evaluate the tissue metabolic activity by 18 F-FDG PET/CT [46].…”

Section: Discussionmentioning

confidence: 86%

Comparison between diffusion-weighted magnetic resonance and positron-emission tomography in the evaluation of treated lymphomas with mediastinal involvement

Giuliano

Picchi

Pucci

et al. 2022

Egypt J Radiol Nucl Med

View full text Add to dashboard Cite

Background The persistence of residual tissue after treatment is frequent in patients with mediastinal lymphomas and it is often characterized by 18F-Flurodeoxyglucose Positron Emission Tomography (18F-FDG PET) uptake. This study aims to investigate the usefulness of diffusion-weighted whole-body imaging with background body signal suppression (DWIBS) sequence in residual tissues of treated mediastinal lymphomas and to compare it with 18F-FDG PET-CT. Results We included 21 patients with mediastinal Hodgkin and non-Hodgkin lymphomas who showed residual masses on PET-CT imaging at end of treatment and underwent DWIBS-Magnetic Resonance Imaging (MRI). SUVmax and Apparent Diffusion Coefficient (ADC) values of residual masses were assessed quantitatively, including measurement of mean ADC. 15 patients showed radiotracer uptake at 18F-FDG PET-CT, among them only 3 had positive DWIBS-MRI with low ADC values (median value: 0.90 mm2/s). The mediastinal biopsy in these 3 “double positive” patients confirmed pathological residual tissue. All the patients with positive 18F-FDG PET-CT but negative DWIBS-MRI (n = 18) with high ADC values (median value: 2.05 mm2/s) were confirmed negative by biopsy. Conclusions DWIBS-MRI examination combined with ADC measurement allowed to discriminate pathological and non-pathological residual tissue in patients with treated mediastinal lymphoma. These preliminary results seem to pave the way for a leading role of the MRI which could be a useful alternative to the 18F-FDG PET/CT.

show abstract

Role of diffusion MRI in diagnosis of mediastinal lymphoma: initial assessment and response to therapy

Cited by 7 publications

References 31 publications

Differentiating nasopharyngeal carcinoma from lymphoma in the head and neck region using the apparent diffusion coefficient (ADC) value: a systematic review and meta-analysis

Differentiating nasopharyngeal carcinoma from lymphoma in the head and neck region using the apparent diffusion coefficient (ADC) value: a systematic review and meta-analysis

Rare Case of Primary Effusion Lymphoma mimicking Pulmonary Tuberculosis

Comparison between diffusion-weighted magnetic resonance and positron-emission tomography in the evaluation of treated lymphomas with mediastinal involvement

Contact Info

Product

Resources

About