Whole-body MRI for staging and interim response monitoring in paediatric and adolescent Hodgkin’s lymphoma: a comparison with multi-modality reference standard including 18F-FDG-PET-CT

Latifoltojar, Arash; Punwani, Shonit; Lopes, Andre; Humphries, Paul; Klusmann, Maria; Menezes, Leon; Daw, Stephen; Shankar, Ananth; Neriman, Deena; Fitzke, H; Clifton‐Hadley, Laura; Smith, Paul J.; Taylor, Stuart A.

doi:10.1007/s00330-018-5445-8

Cited by 31 publications

(51 citation statements)

References 34 publications

(55 reference statements)

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“…Size changes were also recorded although at a less marked extent between responding and nonresponding lesions . Latifoltojar et al recently confirmed the value of WB‐MRI for the assessment of both nodal and extranodal involvement in pediatric HL patients . However, they stressed that disease response might have been underestimated by WB‐MRI in extranodal sites, making questionable the use of this modality in place of standard examinations, namely, 18 F‐FDG‐PET/CT.…”

Section: Hodgkin Lymphomasmentioning

confidence: 99%

Whole‐body magnetic resonance imaging (WB‐MRI) in lymphoma: State of the art

Albano

Bruno

Patti

et al. 2019

Hematological Oncology

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The improvements in magnetic resonance imaging (MRI) technology and the concern related to the increased cancer risk in patients with lymphoma, also due to radiation exposure associated with imaging examinations, have led to the introduction of whole‐body MRI (WB‐MRI) as a radiation‐free alternative to standard imaging procedures. WB‐MRI seems a less histology‐dependent functional imaging test than 18F‐fluorodeoxyglucose‐positron emission tomography/CT (18F‐FDG‐PET/CT). In patients with FDG‐avid lymphomas, such as diffuse large B‐cell lymphoma (DLBCL) and Hodgkin lymphoma (HL), 18F‐FDG‐PET/CT remains the imaging reference standard for staging, with WB‐MRI potentially being a complementary modality that could replace CT, especially in young patients. On the other hand, WB‐MRI is a valuable imaging procedure for lymphoma surveillance and in lymphomas with variable/low FDG avidity and nonfollicular indolent lymphomas. The aim of this paper is to discuss the current state of the art of WB‐MRI in lymphoma by evaluating its diagnostic performance in different lymphoma subtypes: Hodgkin, aggressive, and indolent lymphomas.

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Section: Hodgkin Lymphomasmentioning

confidence: 99%

Whole‐body magnetic resonance imaging (WB‐MRI) in lymphoma: State of the art

Albano

Bruno

Patti

et al. 2019

Hematological Oncology

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“…Whole-body magnetic resonance imaging with diffusionweighted imaging (WB-MRI with DWI) is a radiation-free method which allows imaging of the body with excellent soft tissue contrast in a single examination and could therefore be an attractive alternative to FDG-PET/CT for the staging of HL in children [15][16][17][18]. With the addition of DWI to the WB-MRI protocols, it is suggested that not only anatomical but functional information is provided as well, offering a possible surrogate to the functional information provided with FDG-PET/ CT [19].…”

Section: Introductionmentioning

confidence: 99%

Whole-body MRI versus an FDG-PET/CT-based reference standard for staging of paediatric Hodgkin lymphoma: a prospective multicentre study

et al. 2020

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Objectives To assess the concordance of whole-body MRI (WB-MRI) and an FDG-PET/CT-based reference standard for the initial staging in children with Hodgkin lymphoma (HL) Methods Children with newly diagnosed HL were included in this prospective, multicentre, international study and underwent WB-MRI and FDG-PET/CT at staging. Two radiologists and a nuclear medicine physician independently evaluated all images. Discrepancies between WB-MRI and FDG-PET/CT were assessed by an expert panel. All FDG-PET/CT errors were corrected to derive the FDG-PET/CT-based reference standard. The expert panel corrected all reader errors in the WB-MRI DWI dataset to form the intrinsic MRI data. Inter-observer agreement for WB-MRI DWI was calculated using overall agreement, specific agreements and kappa statistics. Concordance for correct classification of all disease sites and disease stage between WB-MRI (without DWI, with DWI and intrinsic WB-MRI DWI) and the reference standard was calculated as primary outcome. Secondary outcomes included positive predictive value, negative predictive value and kappa statistics. Clustering within patients was accounted for using a mixed-effect logistic regression model with random intercepts and a multilevel kappa analysis. Results Sixty-eight children were included. Inter-observer agreement between WB-MRI DWI readers was good for disease stage (κ = 0.74). WB-MRI DWI agreed with the FDG-PET/CT-based reference standard for determining disease stage in 96% of the Electronic supplementary material The online version of this article (

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“…В других опубликованных работах число пациентов в исследуемых группах было сравнительно небольшим -от 15 до 68 человек. Чувствительность диагностики поражения ЛУ при МРТ-ДВИ составила 90-98%, специфичность -94-99%, органов -79-100 и 99-100% соответственно [8][9][10][11], что соответствует полученным нами данным. Лишь в одной из указанных работ учитывали поражение неувеличенных ЛУ [11].…”

Section: Discussionunclassified

“…Еще одной особенностью большинства опубликованных работ является оценка возможностей МРТ-ДВИ по отношению к стандарту диагностики, в качестве которого использовали ПЭТ/КТ. В единичных публикациях в качестве стандарта применяли комплекс методов диагностики (включая ПЭТ/КТ), биопсию и наблюдение в динамике [10,11]. По нашему мнению, такой стандарт более обоснован, поскольку при ПЭТ/КТ возможны как ложноположительные, так и ложноотрицательные результаты.…”

Section: Discussionunclassified

“…Показано преимущество МРТ-ДВИ при стадировании лимфом по сравнению с КТ, ультразвуковым исследованием (УЗИ) и биопсией костного мозга (КМ) [3][4][5][6][7]. В ряде исследований проведено сравнение МРТ-ДВИ и ПЭТ/КТ, в основном на небольших группах пациентов [8][9][10][11]. При анализе данных работ следует обратить внимание на несколько нерешенных вопросов.…”

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Whole-Body Diffusion-Weighted Magnetic Resonance Imaging and Positron Emission Tomography Combined with Computed Tomography in the Staging of Lymphomas

Kharuzhyk

Zhavrid

Dzyuban

et al. 2020

Vestn. rentgenol. radiol.

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Objective – to compare the diagnostic efficiency of whole-body diffusion-weighted magnetic resonance imaging (DW-MRI) and positron emission tomography combined with computed tomography (PET/CT) in the staging of lymphomas.Material and methods. The prospective study enrolled 92 adult patients with Hodgkin's lymphoma or non-Hodgkin's lymphoma. Before treatment, all the patients underwent whole-body DW-MRI and PET/CT. The techniques were compared for their efficiency in diagnosing damage to lymph nodes (LNs) and organs and in determining the stage of lymphoma.Results. The sensitivity, specificity, and accuracy of DW-MRI in diagnosing a lesion in the enlarged LNs were 98.2%, 99.9%, and 99.3%, respectively; those of PET/CT were 99.4%, 100.0%, and 99.8%. ROC analysis showed that the efficiency of the techniques in diagnosing a lesion in the enlarged LNs did not differ (p>0.06). The sensitivity of DW-MRI and PET/CT in diagnosing a lesion in the unenlarged LNs was 77.8% and 88.1%, respectively (p<0.001). The sensitivity, specificity, and accuracy of DW-MRI in diagnosing lung damage were 73.3%, 98.7%, 94.6%; those of PET/CT were 86.7%, 98.7%, and 96.7%; those for the spleen were 54.8%, 98.3%, 83.3% and 100.0%, 100.0%, 100.0%; those for bone marrow (BM) were 87.1%, 96.4%, 93.0% and 64.5%, 87.3%, 79.1%,; those for all organs were 72.9%, 98.1%, 91.4% and 80.0%, 96.6%, 92.2%. The ROC analysis indicated that the efficiency of the techniques in diagnosing a lesion in the lung did not differ (p>0.3), that of PET/CT for the spleen was higher (p <0.0001); that of DW-MRI for BM was higher (p<0.0008); that for all organs did not differ (p>0.35). DW-MRI and PET/CT could determine the correct stage of lymphoma in the same number of patients (86%). The new lymphoma staging algorithm involving whole-body DW-MRI in all patients, PET/CT, and BM biopsies according to the established indications made it possible to determine the correct stage of lymphoma in 95% of patients.Conclusion. Whole-body DW-MRI has comparable efficiency to PET/CT in the staging of lymphoma. The new lymphoma staging algorithm based on whole-body DW-MRI is superior to PET/CT and PET/CT with BM biopsy.

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Whole-body MRI for staging and interim response monitoring in paediatric and adolescent Hodgkin’s lymphoma: a comparison with multi-modality reference standard including 18F-FDG-PET-CT

Cited by 31 publications

References 34 publications

Whole‐body magnetic resonance imaging (WB‐MRI) in lymphoma: State of the art

Whole‐body magnetic resonance imaging (WB‐MRI) in lymphoma: State of the art

Whole-body MRI versus an FDG-PET/CT-based reference standard for staging of paediatric Hodgkin lymphoma: a prospective multicentre study

Whole-Body Diffusion-Weighted Magnetic Resonance Imaging and Positron Emission Tomography Combined with Computed Tomography in the Staging of Lymphomas

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