title: Dynamic contrast-enhanced MRI improves accuracy for detecting focal splenic involvement in children and adolescents with Hodgkin disease.
abstract: BACKGROUND
  Accurate assessment of splenic disease is important for staging Hodgkin lymphoma.
  
  
  OBJECTIVE
  The purpose of this study was to assess T2-weighted imaging with and without dynamic contrast-enhanced (DCE) MRI for evaluation of splenic Hodgkin disease.
  
  
  METHODS
  Thirty-one children with Hodgkin lymphoma underwent whole-body T2-weighted MRI with supplementary DCE splenic imaging, and whole-body PET-CT before and following chemotherapy. Two experienced nuclear medicine physicians derived a PET-CT reference standard for splenic disease, augmented by follow-up imaging. Unaware of the PET-CT, two experienced radiologists independently evaluated MRI exercising a locked sequential read paradigm (T2-weighted then DCE review) and recorded the presence/absence of splenic disease at each stage. Performance of each radiologist was determined prior to and following review of DCE-MRI. Incorrect MRI findings were ascribed to reader (lesion present on MRI but missed by reader) or technical (lesion not present on MRI) error.
  
  
  RESULTS
  Seven children had splenic disease. Sensitivity/specificity of both radiologists for the detection of splenic involvement using T2-weighted images alone was 57%/100% and increased to 100%/100% with DCE-MRI. There were three instances of technical error on T2-weighted imaging; all lesions were visible on DCE-MRI.
  
  
  CONCLUSIONS
  T2-weighted imaging when complemented by DCE-MRI imaging may improve evaluation of Hodgkin disease splenic involvement.
authors: Centre for Medical Imaging, University College London, 3rd Floor East Wing, 250 Euston Road, London, UK, NW1 2PG. shonit.punwani@gmail.com
authors: Shonit
authors: S
authors: Punwani
authors: King Kenneth
authors: KK
authors: Cheung
authors: Nicholas
authors: N
authors: Skipper
authors: Nichola
authors: N
authors: Bell
authors: Alan
authors: A
authors: Bainbridge
authors: Stuart A
authors: SA
authors: Taylor
authors: Ashley M
authors: AM
authors: Groves
authors: Sharon F
authors: SF
authors: Hain
authors: Simona
authors: S
authors: Ben-Haim
authors: Ananth
authors: A
authors: Shankar
authors: Stephen
authors: S
authors: Daw
authors: Steve
authors: S
authors: Halligan
authors: Paul D
authors: PD
authors: Humphries
mesh_terms: D000293:Adolescent; D000465:Algorithms; D002648:Child; D003287:Contrast Media; D005260:Female; D006689:Hodgkin Disease / Q000473:pathology*; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008536:Meglumine; D009367:Neoplasm Staging; D009942:Organometallic Compounds; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013160:Splenic Neoplasms / Q000473:pathology*
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; D008536:Meglumine; C072417:gadoterate meglumine
references: Radiology. 2009 Apr;251(1):166-74
references: 19251940
references: Radiographics. 2011 Oct;31(6):1757-72
references: 21997993
references: Invest Radiol. 1998 Jan;33(1):45-50
references: 9438509
references: Radiology. 2010 Apr;255(1):182-90
references: 20308456
references: J Nucl Med. 2003 Jul;44(7):1072-4
references: 12843223
references: Radiology. 1991 Jun;179(3):681-6
references: 2027974
references: Expert Opin Pharmacother. 2010 Dec;11(17):2891-906
references: 21050034
references: Eur J Nucl Med Mol Imaging. 2009 Jan;36(1):23-36
references: 18719909
references: Invest Radiol. 2009 Oct;44(10):683-90
references: 19724232
references: AJR Am J Roentgenol. 2001 Feb;176(2):289-96
references: 11159059
references: Acad Radiol. 2003 Jun;10(6):664-9
references: 12809421
references: Radiographics. 2004 Sep-Oct;24(5):1317-30
references: 15371611
references: AJR Am J Roentgenol. 2011 Mar;196(3):662-9
references: 21343511
references: Br J Haematol. 2006 Nov;135(3):293-302
references: 17032175
references: Biometrics. 1977 Jun;33(2):363-74
references: 884196
references: Clin Nucl Med. 2002 Aug;27(8):572-7
references: 12170002
references: Cancer. 1992 Oct 1;70(7):1985-7
references: 1525776
references: Br J Radiol. 2007 Jan;80(949):e4-6
references: 17267469
references: AJR Am J Roentgenol. 2009 Mar;192(3):745-53
references: 19234273
references: Ann Hematol. 2003 Jul;82(7):390-6
references: 12764547
references: J Clin Oncol. 1989 Nov;7(11):1630-6
references: 2809679
references: Semin Ultrasound CT MR. 2007 Feb;28(1):12-20
references: 17366704
references: Radiographics. 2005 Jul-Aug;25(4):967-82
references: 16009818
references: Blood. 1994 Jan 15;83(2):318-29
references: 8286731
references: Pediatr Radiol. 2006 Sep;36 Suppl 2:121-5
references: 16862418
references: Am J Hematol. 1994 Oct;47(2):100-5
references: 8092123
references: Acta Radiol. 2011 Mar 1;52(2):173-80
references: 21498346