Whole-body MRI-DWI for assessment of residual disease after completion of therapy in lymphoma: A prospective multicenter study.
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.


CONCLUSION
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.
['Littooij|Annemieke S|AS|', 'Kwee|Thomas C|TC|', 'de Keizer|Bart|B|', 'Bruin|Marrie C A|MC|', 'Coma|Ana|A|', 'Beek|Frederik J A|FJ|', 'Fijnheer|Rob|R|', 'Nievelstein|Rutger A J|RA|']
D000465:Algorithms D000970:Antineoplastic Agents D038524:Diffusion Magnetic Resonance Imaging D005260:Female D005500:Follow-Up Studies D006801:Humans D007089:Image Enhancement D007090:Image Interpretation, Computer-Assisted D021621:Imaging, Three-Dimensional D008137:Longitudinal Studies D008223:Lymphoma D008297:Male D064847:Multimodal Imaging 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
lymphoma whole-body MRI diffusion-weighted imaging positron emission tomography restaging