title: Whole-body MRI-DWI for assessment of residual disease after completion of therapy in lymphoma: A prospective multicenter study.
abstract: BACKGROUND
  To assess the performance of whole-body MRI including diffusion-weighted imaging (whole-body MRI-DWI) for the detection of residual disease after completion of treatment in lymphoma patients.
  
  
  METHODS
  Twenty-six patients with lymphoma prospectively underwent whole-body MRI-DWI (1.5 Tesla MR) and 18F-fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET)/computed tomography (CT) for posttreatment evaluation which were visually assessed. Apparent diffusion coefficient (ADC) and FDG-PET/CT standardized uptake value measurements were performed in all residual lesions. An unblinded expert panel reviewed all cases and determined the presence or absence of posttreatment residual disease using all available imaging (except for whole-body MRI-DWI), clinical, and histopathological information with a follow-up of at least 6 months. The performance of whole-body MRI-DWI was compared with this panel reference standard.
  
  
  RESULTS
  Five of 26 patients were diagnosed with residual disease. Sensitivity and specificity for detection of residual disease with whole-body MRI-DWI were 100% and 62%, respectively. By ROC analysis, the optimal threshold of ADC was 1.21 × 10(-3) mm(2) /s with sensitivity and specificity of 100% and 91.7%, respectively.
  
  
  CONCLUSIONS
  Our initial results suggest that visual whole-body MRI-DWI analysis has a very good sensitivity for detecting viable residual lesions after completion of therapy but lacks specificity. ADC measurements could potentially increase the specificity of whole-body MRI.
authors.affiliation: Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, Utrecht, The Netherlands.|Department of Diagnostic and Interventional Imaging, KK Women's and Children's Hospital, Singapore.
authors.forename: Annemieke S
authors.initials: AS
authors.lastname: Littooij
authors.affiliation: Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Kwee
authors.affiliation: Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Bart
authors.initials: B
authors.lastname: de Keizer
authors.affiliation: Department of Paediatric Haematology-Oncology, University Medical Centre Utrecht/Wilhelmina Children's Hospital, Utrecht, The Netherlands.
authors.forename: Marrie C A
authors.initials: MC
authors.lastname: Bruin
authors.affiliation: Department of Paediatric Radiology, Hospital Materno-Infantil Vall d'Hebron, P. de la Vall d'Hebron, Barcelona, Spain.
authors.forename: Ana
authors.initials: A
authors.lastname: Coma
authors.affiliation: Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Frederik J A
authors.initials: FJ
authors.lastname: Beek
authors.affiliation: Department of Haematology, Meander Medical Center, Amersfoort, The Netherlands.
authors.forename: Rob
authors.initials: R
authors.lastname: Fijnheer
authors.affiliation: Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Rutger A J
authors.initials: RA
authors.lastname: Nievelstein
mesh_terms: D000465:Algorithms; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008137:Longitudinal Studies; D008223:Lymphoma / Q000188:drug therapy* / Q000473:pathology*; D008297:Male; D064847:Multimodal Imaging / Q000379:methods; D018365:Neoplasm, Residual; D009426:Netherlands; D015588:Observer Variation; D011446:Prospective Studies; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012846:Singapore; D013030:Spain; D016896:Treatment Outcome; D051598:Whole Body Imaging / Q000379:methods*
chemical_list: D000970:Antineoplastic Agents
keywords: diffusion-weighted imaging; lymphoma; positron emission tomography; restaging; whole-body MRI