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  • Title: Comparison of PET-CT and magnetic resonance diffusion weighted imaging with body suppression (DWIBS) for initial staging of malignant lymphomas.
    Author: Stéphane V, Samuel B, Vincent D, Joelle G, Remy P, Francois GG, Jean-Pierre T.
    Journal: Eur J Radiol; 2013 Nov; 82(11):2011-7. PubMed ID: 23932096.
    Abstract:
    OBJECTIVE: To evaluate the clinical impact of diffusion-weighted whole-body imaging with background body signal suppression (DWIBS) in staging of malignant lymphoma. METHODS: Twenty-three patients with proven malignant lymphomas were prospectively enrolled. DWIBS (b=0, 1000 s/mm(2)) examinations and PET-CT were performed respectively on an Intera 1.5 T unit and a Gyroscan PET-CT scan (Philips Medical system, Best, the Netherland). The criteria for positive node involvement were a size over 10 mm or an apparent diffusion coefficient (ADC) value under 0.7510(-3) mm(2)/s for nodes under 10mm. For extranodal analysis, a high or heterogeneous signal on DWIBS was considered as positive. In cases of discordance, the reference standard for each region or organ was established at 6 months after the diagnosis according to all available clinical, biological information, as well as histological evidence or follow-up to prove or disprove the presence of disease. RESULTS: DWIBS and PET-CT results were congruent in 333 node regions on the 345 areas analyzed, with excellent agreement (κ=0.97, P<0.0001). From 433 organs analyzed (one patient had splenectomy) extranodal disease was detected in 22 organs on DWIBS. The two imaging techniques agreed on 430 organs (κ=0.99, P<0.0001). Finally, Ann Arbor stages based on DWIBS and those of PET/CT were in agreement for 23 patients. CONCLUSIONS: For malignant lymphoma in a pre-therapeutic context, agreement between diffusion-weighted whole-body imaging and PET/CT is high for Ann Arbor staging.
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