Role of WB-MR/DWIBS compared to (18)F-FDG PET/CT in the therapy response assessment of lymphoma.
BACKGROUND
This study prospectively evaluated whole-body magnetic resonance/diffusion-weighted imaging with body signal suppression (WB-MR/DWIBS) reliability compared to (18)F-FDG PET/CT in the treatment response assessment of classic Hodgkin lymphomas (HL) and aggressive non-Hodgkin lymphomas (aNHL).


METHODS
Twenty-seven consecutive patients were prospectively enrolled at the time of diagnosis. Eighteen (11 HL and seven aNHL) were considered for the analysis. They received chemo/radiotherapy as induction and completed post-treatment evaluation performing both (18)F-FDG PET/CT and WB-MR/DWIBS. The revised response criteria for malignant lymphomas were used to assess the response to treatment. We evaluated the agreement between the two methods by Cohen's K test. Post-therapy WB-MR/DWIBS sensitivity, specificity, PPV, NPV and accuracy were then calculated, considering the 12 months of follow-up period as the gold standard.


RESULTS
By using an evaluation on a lesion-by-lesion basis, WB-MR/DWIBS and (18)F-FDG PET/CT showed an overall good agreement (K = 0.796, 95% IC = 0.651-0.941), especially in the evaluation of the nodal basins in aNHL (K = 0.937, 95% IC = 0.814-1). In reference to the revised response criteria for malignant lymphomas, the two methods showed a good agreement (K = 0.824, 95% IC = 0.493-1). Post-therapy sensitivity, specificity, PPV, NPV and accuracy of WB-MR/DWIBS were 43, 91, 75, 71 and 72%, respectively.


CONCLUSIONS
WB-MR/DWIBS seems to be an appropriate method for the post-treatment assessment of patients affected by HL and aNHL. The small discrepancies between the two methods found within HL could be due to the biological and metabolic behavior of this group of diseases. Larger prospective studies are necessary to better define the role of WB-MR/DWIBS in this setting of patients.
Department of Medicine and Health Science, University of Molise, Campobasso, Italy. n.maggialetti@gmail.com.
Nicola
N
Maggialetti
D.I.M.- Diagnostic Imaging - Nuclear Medicine, University of Bari "Aldo Moro", Bari, Italy.
Cristina
C
Ferrari
Department of Medical and Experimental Oncology, IRCCS National Cancer Research Centre "Giovanni Paolo II", Bari, Italy.
Carla
C
Minoia
D.I.M.- Diagnostic Imaging - Nuclear Medicine, University of Bari "Aldo Moro", Bari, Italy.
Artor Niccoli
AN
Asabella
Department of Radiodiagnostic, IRCCS National Cancer Research Centre "Giovanni Paolo II", Bari, Italy.
Michele
M
Ficco
Department of Medical and Experimental Oncology, IRCCS National Cancer Research Centre "Giovanni Paolo II", Bari, Italy.
Giacomo
G
Loseto
Department of Medical and Experimental Oncology, IRCCS National Cancer Research Centre "Giovanni Paolo II", Bari, Italy.
Giacomina
G
De Tullio
Department of Medical and Experimental Oncology, IRCCS National Cancer Research Centre "Giovanni Paolo II", Bari, Italy.
Vincenza
V
de Fazio
Department of Radiodiagnostic, IRCCS National Cancer Research Centre "Giovanni Paolo II", Bari, Italy.
Angela
A
Calabrese
Department of Medical and Experimental Oncology, IRCCS National Cancer Research Centre "Giovanni Paolo II", Bari, Italy.
Attilio
A
Guarini
D.I.M.- Diagnostic Imaging - Nuclear Medicine, University of Bari "Aldo Moro", Bari, Italy.
Giuseppe
G
Rubini
Department of Medicine and Health Science, University of Molise, Campobasso, Italy.
Luca
L
Brunese
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D019788:Fluorodeoxyglucose F18; D006689:Hodgkin Disease / Q000175:diagnosis* / Q000628:therapy; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000175:diagnosis* / Q000628:therapy; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods; D049268:Positron-Emission Tomography / Q000379:methods; D019275:Radiopharmaceuticals; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D051598:Whole Body Imaging / Q000379:methods; D055815:Young Adult
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
18F-FDG PET/CT; Hodgkin lymphoma; Non-Hodgkin lymphoma; Revised response criteria for malignant lymphoma; Therapy response; WB-MR/DWIBS