Evaluation of Diffusion-Weighted Magnetic Resonance Imaging for Follow-up and Treatment Response Assessment of Lymphoma: Results of an 18F-FDG-PET/CT-Controlled Prospective Study in 64 Patients.

Abstract

PURPOSE:

To determine the value of diffusion-weighted MRI (DWI-MRI) for treatment response assessment in 2-[18F]fluoro-2-deoxy-D-glucose (FDG)-avid lymphoma.

EXPERIMENTAL DESIGN:

Patients with FDG-avid Hodgkin (HL) or non-Hodgkin lymphoma (NHL) at pretherapeutic 18F-FDG-PET/CT, who had also undergone pretherapeutic whole-body DWI-MRI, were included in this prospective study. Depending on the histologic lymphoma subtype, patients received different systemic treatment regimens, and follow-up DWI-MRI and 18F-FDG-PET/CT were performed at one or more time points, depending on the clinical course. For each follow-up DWI-MRI, region-based rates of agreement, and rates of agreement in terms of treatment response (complete remission, partial remission, stable disease, or progressive disease), relative to the corresponding 18F-FDG-PET/CT, were calculated.

RESULTS:

Sixty-four patients were included: 10 with HL, 22 with aggressive NHL, and 32 with indolent NHL. The overall region-based agreement of DWI-MRI with 18F-FDG-PET/CT was 99.4%. For the 51 interim examinations (performed after 1-3 therapy cycles), region-based agreement of DWI-MRI with 18F-FDG-PET/CT was 99.2%, and for the 48 end-of-treatment examinations, agreement was 99.8%. No significant differences, in terms of region-based agreement between DWI-MRI and 18F-FDG-PET/CT, were observed between the three lymphoma groups (HL, aggressive NHL, indolent NHL; P = 0.25), or between interim and end-of-treatment examinations (P = 0.21). With regard to treatment response assessment, DWI-MRI agreed with 18F-FDG-PET/CT in 99 of 102 follow-up examinations (97.1%), with a κ value of 0.94 (P < 0.0001).

CONCLUSIONS:

In patients with FDG-avid lymphoma, DWI-MRI may be a feasible alternative to 18F-FDG-PET/CT for follow-up and treatment response assessment.

• Authors: Marius E Mayerhoefer, Georgios Karanikas, Kurt Kletter, Helmut Prosch, Barbara Kiesewetter, Cathrin Skrabs, Edit Porpaczy, Michael Weber, Thomas Knogler, Christian Sillaber, Ulrich Jaeger, Ingrid Simonitsch-Klupp, Philipp Ubl, Leonhard Müllauer, Werner Dolak, Julius Lukas, Markus Raderer
• Journal: Clinical cancer research : an official journal of the American Association for Cancer Research (Clin Cancer Res) Vol. 21 Issue 11 Pg. 2506-13 (Jun 01 2015) ISSN: 1557-3265 [Electronic] United States
• PMID: 25733598 (Publication Type: Clinical Study, Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: ©2015 American Association for Cancer Research.

Chemical References

• Fluorodeoxyglucose F18

Topics

• Adult
• Aged
• Aged, 80 and over
• Diffusion Magnetic Resonance Imaging
• Female
• Fluorodeoxyglucose F18 (administration & dosage)
• Hodgkin Disease (diagnostic imaging, pathology, therapy)
• Humans
• Lymphoma, Non-Hodgkin (diagnostic imaging, pathology, therapy)
• Male
• Middle Aged
• Positron-Emission Tomography
• Radiography
• Whole Body Imaging