title: Whole-body MRI, including diffusion-weighted imaging, for the initial staging of malignant lymphoma: comparison to computed tomography.
abstract: OBJECTIVE
  To assess the value of whole-body magnetic resonance imaging (MRI), including diffusion-weighted imaging (DWI), for the initial staging of malignant lymphoma, compared with computed tomography (CT).
  
  
  METHODS
  Thirty-one consecutive patients with newly diagnosed malignant lymphoma prospectively underwent whole-body MRI (T1-weighted and short inversion time inversion recovery [n = 31], and DWI [n = 28]) and CT. Ann Arbor stages were assigned by 1 radiologist according to whole-body MRI findings, and by another radiologist according to CT findings. Differences in staging between whole-body MRI (without and with DWI) and CT were resolved using other (imaging) studies (including 18F-fluoro-2-deoxyglucose positron emission tomography and bone marrow biopsy) and follow-up studies as reference standard.
  
  
  RESULTS
  Staging results of whole-body MRI without DWI were equal to those of CT in 74% (23/31), higher in 26% (8/31), and lower in 0% (0/31) of patients, with correct/incorrect/unresolved overstaging relative to CT in 3, 2, and 2 patients, respectively, and incorrect staging of both modalities in 1 patient. Staging results of whole-body MRI with DWI were equal to those of CT in 75% (21/28), higher in 25% (7/28), and lower in 0% (0/28) of patients, with correct/incorrect overstaging relative to CT in 6 and 1 patient(s), respectively.
  
  
  CONCLUSIONS
  Our results suggest that initial staging of malignant lymphoma using whole-body MRI (without DWI and with DWI) equals staging using CT in the majority of patients, whereas whole-body MRI never understaged relative to CT. Furthermore, whole-body MRI mostly correctly overstaged relative to CT, with a possible advantage of using DWI.
authors.affiliation: Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands. thomaskwee@gmail.com
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Kwee
authors.forename: Henriette M E Quarles
authors.initials: HM
authors.lastname: van Ufford
authors.forename: Frederik J
authors.initials: FJ
authors.lastname: Beek
authors.forename: Taro
authors.initials: T
authors.lastname: Takahara
authors.forename: Cuno S
authors.initials: CS
authors.lastname: Uiterwaal
authors.forename: Marc B
authors.initials: MB
authors.lastname: Bierings
authors.forename: Inge
authors.initials: I
authors.lastname: Ludwig
authors.forename: Rob
authors.initials: R
authors.lastname: Fijnheer
authors.forename: Rutger A J
authors.initials: RA
authors.lastname: Nievelstein
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D008223:Lymphoma / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*; D051598:Whole Body Imaging / Q000379:methods*; D055815:Young Adult