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Article: Whole-body diffusion-weighted imaging: The added value to whole-body MRI at initial diagnosis of lymphoma
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TitleWhole-body diffusion-weighted imaging: The added value to whole-body MRI at initial diagnosis of lymphoma
 
AuthorsGu, J1
Chan, T1
Zhang, J1
Leung, AYH1
Kwong, YL1
Khong, PL1
 
KeywordsDiffusion-weighted imaging
DWI
FDG-avid lymphoma
PET/CT
Whole-body MRI
 
Issue Date2011
 
PublisherAmerican Roentgen Ray Society. The Journal's web site is located at http://www.arrs.org/scriptcontent/ajr/index.cfm
 
CitationAmerican Journal Of Roentgenology, 2011, v. 197 n. 3, p. W384-W391 [How to Cite?]
DOI: http://dx.doi.org/10.2214/AJR.10.5692
 
AbstractOBJECTIVE. The objective of our study was to evaluate the diagnostic performance of conventional whole-body MRI without and with diffusion-weighted imaging (DWI) in the detection of known 18F-FDG-avid lymphomas. The conventional whole-body MRI protocol consisted of a T2-weighted sequence and a T2-weighted spectral attenuated inversion recovery (SPAIR) sequence with frequency-selective fat suppression. The second protocol used the same sequences as the first protocol but also included DWI. SUBJECTS AND METHODS. Seventeen patients with pathologically confirmed, newly diagnosed, untreated lymphoma were recruited. T2-weighted and T2-weighted SPAIR images were evaluated first, separate from the DW images, and then were evaluated with the DW images. We used 18F-FDG PET/CT as the standard of reference. True-positive, false-positive, and false-negative values were evaluated on a per-lesion basis. Tumor staging based on T2-weighted and T2-weighted SPAIR imaging without DWI and then with DWI was compared using the Ann Arbor staging system. RESULTS. True-positive lesions were increased from 89% to 97%, false-positive lesions were increased from 3% to 6%, and false-negative lesions were decreased from 11% to 3% by the addition of DWI. Diagnostic sensitivity was significantly increased (p = 0.002) by adding DWI. Lesions detected on DWI but not on T2-weighted and T2-weighted SPAIR imaging were located in renal (n = 1), paraaortic (n = 6), and pelvic (n = 3) lymph nodes. On DWI, 47% of the lesions (n = 55) were more conspicuous than on T2-weighted and T2-weighted SPAIR imaging; most of these lesions (58%, n = 32) were from lymph nodes in the pelvic or abdominal regions and bone marrow. No difference was found between T2-weighted and T2-weighted SPAIR imaging without DWI and T2-weighted and T2-weighted SPAIR imaging with DWI in lymphoma staging, being consistent with PET/CT in 88% of the patients (n = 15). CONCLUSION. The addition of DWI to conventional whole-body MRI sequences enhanced lesion conspicuity and improved diagnostic accuracy for lymphomas. With technical optimization, whole-body MRI with DWI, as a nonionizing imaging modality, may potentially be useful as an alternative method to PET/CT in the management of malignant lymphoma. © American Roentgen Ray Society.
 
ISSN0361-803X
2013 Impact Factor: 2.744
 
DOIhttp://dx.doi.org/10.2214/AJR.10.5692
 
ISI Accession Number IDWOS:000294165600003
 
ReferencesReferences in Scopus
 
DC FieldValue
dc.contributor.authorGu, J
 
dc.contributor.authorChan, T
 
dc.contributor.authorZhang, J
 
dc.contributor.authorLeung, AYH
 
dc.contributor.authorKwong, YL
 
dc.contributor.authorKhong, PL
 
dc.date.accessioned2011-09-23T05:45:38Z
 
dc.date.available2011-09-23T05:45:38Z
 
dc.date.issued2011
 
dc.description.abstractOBJECTIVE. The objective of our study was to evaluate the diagnostic performance of conventional whole-body MRI without and with diffusion-weighted imaging (DWI) in the detection of known 18F-FDG-avid lymphomas. The conventional whole-body MRI protocol consisted of a T2-weighted sequence and a T2-weighted spectral attenuated inversion recovery (SPAIR) sequence with frequency-selective fat suppression. The second protocol used the same sequences as the first protocol but also included DWI. SUBJECTS AND METHODS. Seventeen patients with pathologically confirmed, newly diagnosed, untreated lymphoma were recruited. T2-weighted and T2-weighted SPAIR images were evaluated first, separate from the DW images, and then were evaluated with the DW images. We used 18F-FDG PET/CT as the standard of reference. True-positive, false-positive, and false-negative values were evaluated on a per-lesion basis. Tumor staging based on T2-weighted and T2-weighted SPAIR imaging without DWI and then with DWI was compared using the Ann Arbor staging system. RESULTS. True-positive lesions were increased from 89% to 97%, false-positive lesions were increased from 3% to 6%, and false-negative lesions were decreased from 11% to 3% by the addition of DWI. Diagnostic sensitivity was significantly increased (p = 0.002) by adding DWI. Lesions detected on DWI but not on T2-weighted and T2-weighted SPAIR imaging were located in renal (n = 1), paraaortic (n = 6), and pelvic (n = 3) lymph nodes. On DWI, 47% of the lesions (n = 55) were more conspicuous than on T2-weighted and T2-weighted SPAIR imaging; most of these lesions (58%, n = 32) were from lymph nodes in the pelvic or abdominal regions and bone marrow. No difference was found between T2-weighted and T2-weighted SPAIR imaging without DWI and T2-weighted and T2-weighted SPAIR imaging with DWI in lymphoma staging, being consistent with PET/CT in 88% of the patients (n = 15). CONCLUSION. The addition of DWI to conventional whole-body MRI sequences enhanced lesion conspicuity and improved diagnostic accuracy for lymphomas. With technical optimization, whole-body MRI with DWI, as a nonionizing imaging modality, may potentially be useful as an alternative method to PET/CT in the management of malignant lymphoma. © American Roentgen Ray Society.
 
dc.description.naturelink_to_subscribed_fulltext
 
dc.identifier.citationAmerican Journal Of Roentgenology, 2011, v. 197 n. 3, p. W384-W391 [How to Cite?]
DOI: http://dx.doi.org/10.2214/AJR.10.5692
 
dc.identifier.citeulike10624993
 
dc.identifier.doihttp://dx.doi.org/10.2214/AJR.10.5692
 
dc.identifier.epageW391
 
dc.identifier.hkuros192101
 
dc.identifier.isiWOS:000294165600003
 
dc.identifier.issn0361-803X
2013 Impact Factor: 2.744
 
dc.identifier.issue3
 
dc.identifier.openurl
 
dc.identifier.pmid21862763
 
dc.identifier.scopuseid_2-s2.0-80052213872
 
dc.identifier.spageW384
 
dc.identifier.urihttp://hdl.handle.net/10722/139130
 
dc.identifier.volume197
 
dc.languageeng
 
dc.publisherAmerican Roentgen Ray Society. The Journal's web site is located at http://www.arrs.org/scriptcontent/ajr/index.cfm
 
dc.publisher.placeUnited States
 
dc.relation.ispartofAmerican Journal of Roentgenology
 
dc.relation.referencesReferences in Scopus
 
dc.subjectDiffusion-weighted imaging
 
dc.subjectDWI
 
dc.subjectFDG-avid lymphoma
 
dc.subjectPET/CT
 
dc.subjectWhole-body MRI
 
dc.titleWhole-body diffusion-weighted imaging: The added value to whole-body MRI at initial diagnosis of lymphoma
 
dc.typeArticle
 
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Author Affiliations
  1. The University of Hong Kong