title: Whole-body MRI for the detection of bone marrow involvement in lymphoma: prospective study in 116 patients and comparison with FDG-PET.
abstract: OBJECTIVE
  To assess and compare the value of whole-body MRI with FDG-PET for detecting bone marrow involvement in lymphoma.
  
  
  METHODS
  A total of 116 patients with newly diagnosed lymphoma prospectively underwent whole-body MRI and blind bone marrow biopsy (BMB) of the posterior iliac crest. Of 116 patients, 80 also underwent FDG-PET. Patient-based sensitivities of whole-body MRI for detecting bone marrow involvement were calculated using BMB as reference standard and compared with FDG-PET in aggressive and indolent lymphomas separately.
  
  
  RESULTS
  Sensitivity of whole-body MRI in all lymphomas was 45.5 % [95 % confidence interval (CI): 29.8-62.0 %]. Sensitivity of whole-body MRI in aggressive lymphoma [88.9 % (95 % CI: 54.3-100 %)] was significantly higher (P = 0.0029) than that in indolent lymphoma [23.5 % (95 % CI: 9.1-47.8 %)]. Sensitivity of FDG-PET in aggressive lymphoma [83.3 % (95 % CI: 41.8-98.9 %)] was also significantly higher (P = 0.026) than that in indolent lymphoma [12.5 % (95 % CI: 0-49.2 %)]. There were no significant differences in sensitivity between whole-body MRI and FDG-PET (P = 1.00) CONCLUSION: Sensitivity of whole-body MRI for detecting lymphomatous bone marrow involvement is too low to (partially) replace BMB. Sensitivity of whole-body MRI is significantly higher in aggressive lymphoma than in indolent lymphoma and is equal to FDG-PET in both entities.
  
  
  CONCLUSIONS
  • Bone marrow involvement in lymphoma has prognostic and therapeutic implications. • Blind bone marrow biopsy (BMB) is standard for bone marrow assessment. • Neither whole-body MRI nor FDG-PET can yet replace BMB. • Both techniques have higher sensitivity in aggressive than in indolent lymphoma. • Both imaging techniques are complementary to BMB.
authors.affiliation: Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.
authors.forename: Hugo J A
authors.initials: HJ
authors.lastname: Adams
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Kwee
authors.forename: Malou A
authors.initials: MA
authors.lastname: Vermoolen
authors.forename: Bart
authors.initials: B
authors.lastname: de Keizer
authors.forename: John M H
authors.initials: JM
authors.lastname: de Klerk
authors.forename: Judit A
authors.initials: JA
authors.lastname: Adam
authors.forename: Rob
authors.initials: R
authors.lastname: Fijnheer
authors.forename: Marie José
authors.initials: MJ
authors.lastname: Kersten
authors.forename: Jaap
authors.initials: J
authors.lastname: Stoker
authors.forename: Rutger A J
authors.initials: RA
authors.lastname: Nievelstein
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D001853:Bone Marrow / Q000473:pathology*; D019046:Bone Marrow Neoplasms / Q000473:pathology* / Q000556:secondary; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008223:Lymphoma / Q000175:diagnosis / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography / Q000379:methods*; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D051598:Whole Body Imaging; D055815:Young Adult
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18