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Clin Radiol. 2015 Nov;70(11):1229-36. doi: 10.1016/j.crad.2015.06.087. Epub 2015 Jul 22.

Whole-body diffusion-weighted MRI and (18)F-FDG PET/CT can discriminate between different lymphoma subtypes.

Author information

1
Section of Radiology, Department of Radiology, Oncology and Radiation Science, Uppsala University Hospital, Uppsala, Sweden. Electronic address: firas.mosavi@akademiska.se.
2
Section of Nuclear Medicine, Department of Radiology, Oncology and Radiation Science, Uppsala University Hospital, Uppsala, Sweden.
3
StatSoft Scandinavia AB, Sweden.
4
Section of Oncology, Department of Radiology, Oncology and Radiation Science, Uppsala University Hospital, Uppsala, Sweden.
5
Section of Radiology, Department of Radiology, Oncology and Radiation Science, Uppsala University Hospital, Uppsala, Sweden.

Abstract

AIM:

To determine whether combined 2-[(18)F]-fluoro-2-deoxy-d-glucose ((18)F-FDG) positron-emission tomography (PET)/computed tomography (CT) and diffusion-weighted imaging (DWI) can be used for characterisation of different lymphoma subtypes, i.e., indolent versus aggressive lymphoma, and also to assess the prognostic value of different quantitative parameters of whole-body (WB) DWI and (18)F-FDG PET/CT.

MATERIALS AND METHODS:

Pre-therapeutic WB magnetic resonance imaging (MRI) including DWI and (18)F-FDG PET/CT were performed in lymphoma patients. Different quantitative DWI and (18)F-FDG PET/CT parameters were evaluated for characterisation of different lymphoma subtypes. These parameters were also correlated, both separately and in combination, against overall survival (OS) and progression-free survival (PFS). A lesion-by-lesion analysis was performed for correlation analysis between maximum standardised uptake value (SUVmax), mean standardised uptake value (SUVmean) and mean apparent diffusion coefficient (ADC).

RESULTS:

Fifty patients were included in the study and divided into three groups: Hodgkin's lymphoma (HL), n=12; aggressive non-Hodgkin's lymphoma (NHL), n=29 (including 20 patients with diffuse large B-cell lymphoma, DLBCL); and indolent NHL, n=9. Indolent NHL showed significantly lower mean ADC values than the other two lymphoma groups (p=0.013). Aggressive NHL had a higher SUVmax than HL. The OS analysis of all patients showed a relationship (p=0.006) between increased mean ADC and longer OS. A model with both SUVmean and mean ADC, strengthened the possibility to predict PFS; however, a separate analysis of the DLBCL patients showed that none of the quantitative parameters could predict OS or PFS.

CONCLUSION:

ADC can discriminate between indolent and aggressive NHL. This finding can be useful in assessing possible transformation from indolent to aggressive NHL. ADC, ADC/SUV, and SUV cannot predict OS/PFS independent of lymphoma subtype.

PMID:
26208992
DOI:
10.1016/j.crad.2015.06.087
[Indexed for MEDLINE]

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