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Article: Whole-body diffusion-weighted imaging: The added value to whole-body MRI at initial diagnosis of lymphoma

TitleWhole-body diffusion-weighted imaging: The added value to whole-body MRI at initial diagnosis of lymphoma
Authors
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
Citation
American Journal Of Roentgenology, 2011, v. 197 n. 3, p. W384-W391 How to Cite?
Abstract
OBJECTIVE. 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.
Persistent Identifierhttp://hdl.handle.net/10722/139130
ISSN
2013 Impact Factor: 2.744
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorGu, Jen_HK
dc.contributor.authorChan, Ten_HK
dc.contributor.authorZhang, Jen_HK
dc.contributor.authorLeung, AYHen_HK
dc.contributor.authorKwong, YLen_HK
dc.contributor.authorKhong, PLen_HK
dc.date.accessioned2011-09-23T05:45:38Z-
dc.date.available2011-09-23T05:45:38Z-
dc.date.issued2011en_HK
dc.identifier.citationAmerican Journal Of Roentgenology, 2011, v. 197 n. 3, p. W384-W391en_HK
dc.identifier.issn0361-803Xen_HK
dc.identifier.urihttp://hdl.handle.net/10722/139130-
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.en_HK
dc.languageengen_US
dc.publisherAmerican Roentgen Ray Society. The Journal's web site is located at http://www.arrs.org/scriptcontent/ajr/index.cfmen_HK
dc.relation.ispartofAmerican Journal of Roentgenologyen_HK
dc.subjectDiffusion-weighted imagingen_HK
dc.subjectDWIen_HK
dc.subjectFDG-avid lymphomaen_HK
dc.subjectPET/CTen_HK
dc.subjectWhole-body MRIen_HK
dc.titleWhole-body diffusion-weighted imaging: The added value to whole-body MRI at initial diagnosis of lymphomaen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0361-803X&volume=197&issue=3&spage=W384&epage=W391&date=2011&atitle=Whole-body+diffusion+weighted+imaging:+the+added+value+to+whole-body+MRI+at+initial+diagnosis+of+lymphomaen_US
dc.identifier.emailChan, T: taochan@hku.hken_HK
dc.identifier.emailLeung, AYH: ayhleung@hku.hken_HK
dc.identifier.emailKwong, YL: ylkwong@hku.hken_HK
dc.identifier.emailKhong, PL: plkhong@hkucc.hku.hken_HK
dc.identifier.authorityChan, T=rp00289en_HK
dc.identifier.authorityLeung, AYH=rp00265en_HK
dc.identifier.authorityKwong, YL=rp00358en_HK
dc.identifier.authorityKhong, PL=rp00467en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.2214/AJR.10.5692en_HK
dc.identifier.pmid21862763en_HK
dc.identifier.scopuseid_2-s2.0-80052213872en_HK
dc.identifier.hkuros192101en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-80052213872&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume197en_HK
dc.identifier.issue3en_HK
dc.identifier.spageW384en_HK
dc.identifier.epageW391en_HK
dc.identifier.isiWOS:000294165600003-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridGu, J=55456867800en_HK
dc.identifier.scopusauthoridChan, T=35147479300en_HK
dc.identifier.scopusauthoridZhang, J=15752209000en_HK
dc.identifier.scopusauthoridLeung, AYH=7403012668en_HK
dc.identifier.scopusauthoridKwong, YL=7102818954en_HK
dc.identifier.scopusauthoridKhong, PL=7006693233en_HK
dc.identifier.citeulike10624993-

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