Whole-body diffusion-weighted imaging with apparent diffusion coefficient mapping for treatment response assessment in patients with diffuse large B-cell lymphoma: pilot study.

Abstract

OBJECTIVES:

The aim of this pilot study was to assess post-treatment apparent diffusion coefficient (ADC) changes of diffuse large B-cell lymphoma lesions on respiratory-gated whole-body diffusion-weighted imaging (DWI), with integrated (18)F-fluoro-2-deoxyglucose positron emission tomography/computed tomography (PET/CT) as the reference standard.

MATERIALS AND METHODS:

A total of 15 patients underwent both whole-body DWI (b = 50, 400, 800 s/mm(2)) and PET/CT before initiation and after 4 cycles of chemotherapy. ADC of residual masses (lymph node and organ lesions) was assessed both visually and quantitatively, including measurement of mean ADC (ADC).(Figure is included in full-text article.)

RESULTS:

After chemotherapy, among 85 examined lymph node regions, residual nodes were present in 62 (73%) regions on DWI. Of these 62 regions, 26 had persistent lymph nodes with longest transverse diameter >10 mm, ie, positive based on DWI size criteria. The mean ADC of these 26 regions increased from 0.658 × 10(-3) ± 0.153 mm(2)/s (standard deviation) at baseline to 1.501 × 10(-3) ± 0.307 mm(2)/s (paired t test, P < 0.0001). Only 6 of these 26 regions were considered positive on PET/CT. Combining visual ADC analysis to size criteria reduced the number of false-positive results of DWI from 20 to 2 regions. For organ involvement, ADC values also increased compared with baseline (1.558 × 10(-3) ± 0.424 mm(2)/s vs. 0.675 × 10(-3) ± 0.135 mm(2)/s, respectively; P = 0.0009).

CONCLUSIONS:

Whole-body DWI with ADC mapping can show a significant increase in ADC values of residual masses persisting after treatment and may help to assess the treatment response in patients with diffuse large B-cell lymphoma.

• Authors: Chieh Lin, Emmanuel Itti, Alain Luciani, Benhalima Zegai, Shih-jui Lin, Frédérique Kuhnowski, Frédéric Pigneur, Isabelle Gaillard, Gaetano Paone, Michel Meignan, Corinne Haioun, Alain Rahmouni
• Journal: Investigative radiology (Invest Radiol) Vol. 46 Issue 5 Pg. 341-9 (May 2011) ISSN: 1536-0210 [Electronic] United States
• PMID: 21263330 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Antineoplastic Agents
• Fluorodeoxyglucose F18

Topics

• Adult
• Aged
• Antineoplastic Agents (therapeutic use)
• Diffusion Magnetic Resonance Imaging (instrumentation, methods)
• Female
• Fluorodeoxyglucose F18
• Humans
• Lymphoma, Large B-Cell, Diffuse (diagnosis, drug therapy, pathology)
• Male
• Middle Aged
• Pilot Projects
• Positron-Emission Tomography
• Prospective Studies
• Statistics, Nonparametric
• Time Factors
• Tomography, X-Ray Computed
• Young Adult