Gali Shapira-Zaltsberg1,2, Nagwa Wilson1,2, Esther Trejo Perez2,3, Lesleigh Abbott2,4, Stephen Dinning2,5, Cassandra Kapoor1, Jorge Davila1,2, Barry Smith1, Elka Miller1,2. 1. Department of Medical Imaging, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada. 2. University of Ottawa, Ontario, Canada. 3. Research Institute, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada. 4. Department of Hematology/Oncology, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada. 5. Division of Nuclear Medicine, Department of Medicine, Ottawa Hospital, Ontario, Canada.
Abstract
PURPOSE: The aim of our study was to compare whole-body diffusion-weighted MRI (WB-DWI-MRI) to fluoro-2-deoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) in the assessment of initial staging and treatment response in pediatric patients with Hodgkin lymphoma. MATERIALS AND METHODS: This prospective study comprised 11 children with Hodgkin lymphoma. Whole-body DWI-MRI and FDG-PET/CT were obtained at baseline and after 2 cycles of chemotherapy. Two radiologists measured the apparent diffusion coefficient (ADC) values of the sites of involvement agreed upon in consensus and 1 nuclear medicine physician assessed the PET/CT. Reliability of radiologists' ratings was assessed by intraclass correlation coefficients (ICC2,1). The sensitivity and positive predictive value (PPV) of DW-MRI relative to PET/CT were calculated for nodal and extranodal sites. The patients were staged according to both modalities. Association of treatment responses was assessed through the Pearson correlation between the ADC ratios and the change standardized uptake value (SUV) between baseline and follow-up. RESULTS: There was good agreement between the raters for nodal and extranodal ADC measurements. The sensitivity and PPV of DW-MRI relative to PET/CT of nodal disease was 0.651 and 1.0, respectively, at baseline, and 0.697 and 0.885 at follow-up. The sensitivity and PPV of extranodal disease were 0.545 and 0.6 at baseline, and 0.167 and 0.333 at follow-up. Diffusion-weighted MRI determined correct tumor stage in 8 of 11 examinations. There was poor correlation between the ADC ratios and the absolute change in SUV between baseline and follow-up (0.348). CONCLUSION: Our experience showed that WB-DWI-MRI is inferior to PET/CT for initial staging and assessment of treatment response of Hodgkin lymphoma in pediatric patients.
PURPOSE: The aim of our study was to compare whole-body diffusion-weighted MRI (WB-DWI-MRI) to fluoro-2-deoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) in the assessment of initial staging and treatment response in pediatric patients with Hodgkin lymphoma. MATERIALS AND METHODS: This prospective study comprised 11 children with Hodgkin lymphoma. Whole-body DWI-MRI and FDG-PET/CT were obtained at baseline and after 2 cycles of chemotherapy. Two radiologists measured the apparent diffusion coefficient (ADC) values of the sites of involvement agreed upon in consensus and 1 nuclear medicine physician assessed the PET/CT. Reliability of radiologists' ratings was assessed by intraclass correlation coefficients (ICC2,1). The sensitivity and positive predictive value (PPV) of DW-MRI relative to PET/CT were calculated for nodal and extranodal sites. The patients were staged according to both modalities. Association of treatment responses was assessed through the Pearson correlation between the ADC ratios and the change standardized uptake value (SUV) between baseline and follow-up. RESULTS: There was good agreement between the raters for nodal and extranodal ADC measurements. The sensitivity and PPV of DW-MRI relative to PET/CT of nodal disease was 0.651 and 1.0, respectively, at baseline, and 0.697 and 0.885 at follow-up. The sensitivity and PPV of extranodal disease were 0.545 and 0.6 at baseline, and 0.167 and 0.333 at follow-up. Diffusion-weighted MRI determined correct tumor stage in 8 of 11 examinations. There was poor correlation between the ADC ratios and the absolute change in SUV between baseline and follow-up (0.348). CONCLUSION: Our experience showed that WB-DWI-MRI is inferior to PET/CT for initial staging and assessment of treatment response of Hodgkin lymphoma in pediatric patients.
Authors: Adrien Holzgreve; Thomas Pfluger; Irene Schmid; Orlando Guntinas-Lichius; Wolfgang G Kunz; Jens Ricke; Peter Bartenstein; Nathalie L Albert; Marcus Unterrainer Journal: Diagnostics (Basel) Date: 2020-11-06
Authors: Suzanne Spijkers; Annemieke S Littooij; Thomas C Kwee; Nelleke Tolboom; Auke Beishuizen; Marrie C A Bruin; Goya Enríquez; Constantino Sábado; Elka Miller; Claudio Granata; Charlotte de Lange; Federico Verzegnassi; Bart de Keizer; Rutger A J Nievelstein Journal: Eur Radiol Date: 2021-05-22 Impact factor: 5.315