title: Evaluation of staging and early response to chemotherapy with whole-body diffusion-weighted MRI in malignant lymphoma patients: A comparison with FDG-PET/CT.
abstract: BACKGROUND
  To examine the utility of diffusion-weighted MRI (DW-MRI) for staging and early response to chemotherapy assessment in lymphoma patients as compared with fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT).
  
  
  METHODS
  Twenty-eight patients with histologically confirmed malignant lymphoma underwent both MRI and FDG-PET/CT before (pretreatment) and after two courses of chemotherapy (mid-treatment). Staging with MRI (DW-MRI alone and with T2-weighted images) and FDG-PET was compared visually, and the concordance rate (kappa value, κ) was calculated. To evaluate early response to chemotherapy, patients were divided into two groups, lesion-positive (LP) and lesion-negative (LN), based on a proposed original criterion. Progression-free survival (PFS) was compared between the groups using the Kaplan-Meier method.
  
  
  RESULTS
  The stage diagnosed with DW-MRI alone and with FDG-PET/CT was concordant in 22 patients (κ = 0.71; P < 0.05), and by adding T2-weighted images, the number of concordant patients increased to 26 (κ = 0.90; P < 0.05). On mid-treatment imaging, 19 patients were diagnosed as LN from both modalities. PFS differed significantly between LP and LN on both DW-MRI (P = 0.0013) and FDG-PET/CT (P = 0.037).
  
  
  CONCLUSIONS
  DW-MRI is a promising tool for staging and evaluation of early response to chemotherapy in patients with lymphoma.
authors.affiliation: Department of Radiology, University of Fukui Hospital, Fukui, Japan.
authors.forename: Kazunobu
authors.initials: K
authors.lastname: Tsuji
authors.affiliation: Department of Hematology, University of Fukui Hospital, Fukui, Japan.
authors.forename: Shinji
authors.initials: S
authors.lastname: Kishi
authors.affiliation: Department of Radiology, University of Fukui Hospital, Fukui, Japan.
authors.forename: Tatsuro
authors.initials: T
authors.lastname: Tsuchida
authors.affiliation: Department of Hematology, University of Fukui Hospital, Fukui, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Yamauchi
authors.affiliation: Department of Hematology, University of Fukui Hospital, Fukui, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Ikegaya
authors.affiliation: Department of Hematology, University of Fukui Hospital, Fukui, Japan.
authors.forename: Yoshimasa
authors.initials: Y
authors.lastname: Urasaki
authors.affiliation: Division of Radiology, University of Fukui Hospital, Fukui, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Fujiwara
authors.affiliation: Department of Hematology, University of Fukui Hospital, Fukui, Japan.
authors.forename: Takanori
authors.initials: T
authors.lastname: Ueda
authors.affiliation: Biomedical Imaging Research Center, University of Fukui, Fukui, Japan.
authors.forename: Hidehiko
authors.initials: H
authors.lastname: Okazawa
authors.affiliation: Department of Radiology, University of Fukui Hospital, Fukui, Japan.
authors.forename: Hirohiko
authors.initials: H
authors.lastname: Kimura
mesh_terms: D000328:Adult; D000368:Aged; D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D003287:Contrast Media; D003520:Cyclophosphamide / Q000627:therapeutic use; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods; D004317:Doxorubicin / Q000627:therapeutic use; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008223:Lymphoma / Q000188:drug therapy* / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography / Q000379:methods; D011241:Prednisone / Q000627:therapeutic use; D019275:Radiopharmaceuticals; D000069283:Rituximab; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D014750:Vincristine / Q000627:therapeutic use; D051598:Whole Body Imaging
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D003287:Contrast Media; C571759:R-CHOP protocol; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D000069283:Rituximab; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone
keywords: FDG-PET/CT; chemotherapy; diffusion-weighted imaging; malignant lymphoma