title: Accuracy of whole-body MRI in the assessment of splenic involvement in lymphoma.
abstract: BACKGROUND
  Accurate evaluation of the spleen is an important component of staging lymphoma, because this may have prognostic and therapeutic implications.
  
  
  OBJECTIVE
  To determine the diagnostic value of whole-body magnetic resonance imaging (MRI), including diffusion-weighted imaging (whole-body MRI-DWI) in the detection of splenic involvement in lymphoma.
  
  
  METHODS
  This IRB approved, prospective multicenter study included a total of 107 patients with newly diagnosed, histologically proven lymphoma who underwent 1.5 T whole-body MRI-DWI and FDG-PET/CT. Whole-body MRI-DWI and FDG-PET/CT were independently evaluated by a radiologist and a nuclear medicine physician, in a blinded manner. Splenic involvement at MRI was defined as splenic index > 725 cm(3) or discrete nodules. At FDG-PET/CT splenic involvement was defined as splenic uptake greater than liver uptake or hypodense nodules at contrast-enhanced CT. FDG-PET/CT augmented with follow-up imaging after treatment was used as reference standard.
  
  
  RESULTS
  Splenic involvement was detected with FDG-PET/CT in 21 patients, all demonstrating response to treatment. The sensitivity, specificity, positive predictive value, and negative predictive value of whole-body MRI-DWI for the detection of splenic involvement were 85.7 %, 96.5 %, 85.7%, and 96.5%, respectively. Three out of six discrepancies were related to suboptimal criterion of splenic size used with whole-body MRI-DWI versus the size-independent FDG uptake.
  
  
  CONCLUSIONS
  Whole-body MRI-DWI is reasonably accurate in the detection of splenic lymphomatous involvement.
authors: Department of Radiology and Nuclear Medicine, University Medical Center Utrecht/Wilhelmina Children's Hospital, Utrecht, the Netherlands Department of Diagnostic and Interventional Imaging, KK Women's and Children's Hospital, Singapore alittooij@hotmail.com.
authors: Annemieke S
authors: AS
authors: Littooij
authors: Department of Radiology and Nuclear Medicine, University Medical Center Utrecht/Wilhelmina Children's Hospital, Utrecht, the Netherlands.
authors: Thomas C
authors: TC
authors: Kwee
authors: Department of Paediatric Radiology, Hospital Materno-Infantil Vall d'Hebron, Barcelona, Spain.
authors: Ignasi
authors: I
authors: Barber
authors: Department of Radiology, IRCCS Giannina Gaslini Hospital, Genoa, Italy.
authors: Claudio
authors: C
authors: Granata
authors: Department of Radiology and Nuclear Medicine, University Medical Center Utrecht/Wilhelmina Children's Hospital, Utrecht, the Netherlands.
authors: Bart
authors: B
authors: de Keizer
authors: Department of Radiology and Nuclear Medicine, University Medical Center Utrecht/Wilhelmina Children's Hospital, Utrecht, the Netherlands.
authors: Frederik Ja
authors: FJ
authors: Beek
authors: Department of Radiology and Nuclear Medicine, University Medical Center Utrecht/Wilhelmina Children's Hospital, Utrecht, the Netherlands.
authors: Monique G
authors: MG
authors: Hobbelink
authors: Department of Haematology, Meander Medical Center, Amersfoort, theNetherlands.
authors: Rob
authors: R
authors: Fijnheer
authors: Department of Radiology, Academic Medical Centre, Amsterdam, theNetherlands.
authors: Jaap
authors: J
authors: Stoker
authors: Department of Radiology and Nuclear Medicine, University Medical Center Utrecht/Wilhelmina Children's Hospital, Utrecht, the Netherlands.
authors: Rutger Aj
authors: RA
authors: Nievelstein
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D006801:Humans; D008223:Lymphoma / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013154:Spleen / Q000473:pathology*; D013160:Splenic Neoplasms / Q000175:diagnosis* / Q000556:secondary*; D051598:Whole Body Imaging; D055815:Young Adult
keywords: FDG PET/CT; Splenic involvement; diffusion-weighted imaging; lymphoma; magnetic resonance imaging (MRI); whole-body MRI