Correlations between functional imaging markers derived from PET/CT and diffusion-weighted MRI in diffuse large B-cell lymphoma and follicular lymphoma.
OBJECTIVE
To investigate the correlations between functional imaging markers derived from positron emission tomography/computed tomography (PET/CT) and diffusion-weighted magnetic resonance imaging (DWI) in diffuse large B-cell lymphoma (DLBCL) and follicular lymphoma (FL). Further to compare the usefulness of these tumor markers in differentiating diagnosis of the two common types of Non-Hodgkin's lymphoma (NHL).


METHODS
Thirty-four consecutive pre-therapy adult patients with proven NHL (23 DLBCL and 11 FL) underwent PET/CT and MRI examinations and laboratory tests. The maximum standardized uptake value (SUV(max)), metabolic tumor volume (MTV), and metabolic tumor burden (MTB) were determined from the PET/CT images. DWI was performed in addition to conventional MRI sequences using two b values (0 and 800 s/mm(2)). The minimum and mean apparent diffusion coefficient (ADC(min) and ADC(mean)) were measured on the parametric ADC maps.


RESULTS
The SUV(max) correlated inversely with the ADC(min) (r =  -0.35, p<0.05). The ADC(min), ADC(mean), serum thymidine kinase (TK), Beta 2-microglobulin (B2m), lactate dehydrogenase (LD), and C-reactive protein (CRP) correlated with both whole-body MTV and whole-body MTB (p<0.05 or 0.01). The SUV(max), TK, LD, and CRP were significantly higher in the DLBCL group than in the FL group. Receiver operating characteristic curve analysis showed that they were reasonable predictors in differentiating DLBCL from FL.


CONCLUSIONS
The functional imaging markers determined from PET/CT and DWI are associated, and the SUV(max) is superior to the ADC(min) in differentiating DLBCL from FL. All the measured serum markers are associated with functional imaging markers. Serum LD, TK, and CRP are useful in differentiating DLBCL from FL.
Department of Oncology, Tampere University Hospital, Tampere, Finland ; Medical Imaging Centre, Department of Radiology, Tampere University Hospital, Tampere, Finland ; Medical School, University of Tampere, Tampere, Finland.
Xingchen
X
Wu
Department of Oncology, Tampere University Hospital, Tampere, Finland.
Hannu
H
Pertovaara
Medical Imaging Centre, Department of Nuclear Medicine, Tampere University Hospital, Tampere, Finland.
Pasi
P
Korkola
Medical Imaging Centre, Department of Radiology, Tampere University Hospital, Tampere, Finland ; Medical School, University of Tampere, Tampere, Finland.
Prasun
P
Dastidar
Medical Imaging Centre, Department of Radiology, Tampere University Hospital, Tampere, Finland.
Ritva
R
Järvenpää
Medical Imaging Centre, Department of Radiology, Tampere University Hospital, Tampere, Finland ; Department of Electronics and Telecommunications, Tampere University of Technology, Tampere, Finland.
Hannu
H
Eskola
Department of Oncology, Tampere University Hospital, Tampere, Finland ; Medical School, University of Tampere, Tampere, Finland.
Pirkko-Liisa
PL
Kellokumpu-Lehtinen
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood*; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D006801:Humans; D008224:Lymphoma, Follicular / Q000201:enzymology / Q000378:metabolism / Q000473:pathology*; D016403:Lymphoma, Large B-Cell, Diffuse / Q000201:enzymology / Q000378:metabolism / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D049268:Positron-Emission Tomography; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed
D015415:Biomarkers