Whole-body diffusion-weighted MRI and (18)F-FDG PET/CT can discriminate between different lymphoma subtypes.

Abstract

AIM:

To determine whether combined 2-[(18)F]-fluoro-2-deoxy-d-glucose ((18)F-FDG) positron-emission tomography (PET)/computed tomography (CT) and diffusion-weighted imaging (DWI) can be used for characterisation of different lymphoma subtypes, i.e., indolent versus aggressive lymphoma, and also to assess the prognostic value of different quantitative parameters of whole-body (WB) DWI and (18)F-FDG PET/CT.

MATERIALS AND METHODS:

Pre-therapeutic WB magnetic resonance imaging (MRI) including DWI and (18)F-FDG PET/CT were performed in lymphoma patients. Different quantitative DWI and (18)F-FDG PET/CT parameters were evaluated for characterisation of different lymphoma subtypes. These parameters were also correlated, both separately and in combination, against overall survival (OS) and progression-free survival (PFS). A lesion-by-lesion analysis was performed for correlation analysis between maximum standardised uptake value (SUVmax), mean standardised uptake value (SUVmean) and mean apparent diffusion coefficient (ADC).

RESULTS:

Fifty patients were included in the study and divided into three groups: Hodgkin's lymphoma (HL), n=12; aggressive non-Hodgkin's lymphoma (NHL), n=29 (including 20 patients with diffuse large B-cell lymphoma, DLBCL); and indolent NHL, n=9. Indolent NHL showed significantly lower mean ADC values than the other two lymphoma groups (p=0.013). Aggressive NHL had a higher SUVmax than HL. The OS analysis of all patients showed a relationship (p=0.006) between increased mean ADC and longer OS. A model with both SUVmean and mean ADC, strengthened the possibility to predict PFS; however, a separate analysis of the DLBCL patients showed that none of the quantitative parameters could predict OS or PFS.

CONCLUSION:

ADC can discriminate between indolent and aggressive NHL. This finding can be useful in assessing possible transformation from indolent to aggressive NHL. ADC, ADC/SUV, and SUV cannot predict OS/PFS independent of lymphoma subtype.

• Authors: F Mosavi, C Wassberg, J Selling, D Molin, H Ahlström
• Journal: Clinical radiology (Clin Radiol) Vol. 70 Issue 11 Pg. 1229-36 (Nov 2015) ISSN: 1365-229X [Electronic] England
• PMID: 26208992 (Publication Type: Evaluation Study, Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2015 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

Chemical References

• Radiopharmaceuticals
• Fluorodeoxyglucose F18

Topics

• Adolescent
• Adult
• Aged
• Analysis of Variance
• Diagnosis, Differential
• Diffusion Magnetic Resonance Imaging (methods, standards)
• Female
• Fluorodeoxyglucose F18
• Humans
• Lymphoma, Non-Hodgkin (diagnosis)
• Male
• Middle Aged
• Multimodal Imaging (methods, standards)
• Positron-Emission Tomography (methods, standards)
• Radiopharmaceuticals
• Sensitivity and Specificity
• Tomography, X-Ray Computed (methods, standards)
• Whole Body Imaging (methods, standards)
• Young Adult