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


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.
Imagerie Médicale, AP-HP, Groupe Henri-Mondor Albert-Chenevier, CHU Henri Mondor, Créteil, France.
Chieh
C
Lin
Emmanuel
E
Itti
Alain
A
Luciani
Benhalima
B
Zegai
Shih-jui
SJ
Lin
Frédérique
F
Kuhnowski
Frédéric
F
Pigneur
Isabelle
I
Gaillard
Gaetano
G
Paone
Michel
M
Meignan
Corinne
C
Haioun
Alain
A
Rahmouni
D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D038524:Diffusion Magnetic Resonance Imaging / Q000295:instrumentation / Q000379:methods*; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D016403:Lymphoma, Large B-Cell, Diffuse / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D049268:Positron-Emission Tomography; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D055815:Young Adult
D000970:Antineoplastic Agents; D019788:Fluorodeoxyglucose F18