Aims and objectives
Hodgkin lymphoma (HL) is the third most common malignancies among children [1].
There are several diagnostic options for the initial staging and restaging of the Hodgkin lymphoma.
According to latest European recommendations (EuroNet-Pediatric Hodgkin’s Lymphoma Group-C2,
EuroNet-PHL-C2) the whole body PET/MR (Positron Emission Tomography- Magnetic Resonance),
both method combined with chest CT (Computed Tomography) and abdominal ultrasound are recommended.
However,
due to low availability more commonly whole body 18F-FDG PET/CT (2-[Fluorine-18]-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography) is used [2-4].
This examination is a gold standard method...
Methods and materials
Patients
In 11 patients with Hodgkin lymphoma,
who followed a standard diagnostic EuroNET protocol with 18F-FDG PET/CT examination,
we performed DWIBS study in short time intervals (3 days).
All visible groups of lymphatic nodes were included in the analysis (with the exclusion of extra-nodal lesions).
Newly diagnosed,
histologically proven lymphoma and age below 18 years were inclusion criteria.
18F-FDG PET/CT procedure
18F-FDG PET/CT procedure was performed using a PET/CT (Discovery iQ 4-Ring,
General Electric Healthcare Milwaukee,
WI,
USA) scanner.
Images were acquired in cauda-cranial direction...
Results
All patients were diagnosed with multiple locations of neoplastic process (median number of 16 locations,
range 7-26).
All regions of increased metabolism visible in 18F-FDG PET/CT presented decreased diffusion in DWIBS (Fig.
2).
Moreover,
values of ADCmean and SUVmax correlated significantly with each other (R2 = - 0.36; p = 0.0002) (Fig.
3).
In addition,
33 regions with restricted diffusion were not recognized in 18F-FDG PET/CT.
These regions were significantly smaller (35.2,
SD=30.9 mm2) than localizations visible in both techniques (86.2 SD=70.3 mm2) (p=0.0001).
There...
Conclusion
Our study showed that the WB MRI with DWIBS technique is useful in identifying and staging affected lymph nodes in the pretreatment group of newly diagnosed children with Hodgkin’s lymphoma.
This method is also superior to 18F-FDG PET/CT in recognizing small lesions.
WB MRI examination,
firstly,
allows to obtain high resolution diagnostic images.
Secondly,
it allows to perform evaluation without contrast and radiation in a relatively short time [23].
Personal information
Authors details:
Katarzyna Matera1 (
[email protected]),
Dobromila Baranska1,
Michal Podgorski1,
Magdalena Gorska-Chrzastek2,
Karolina Krajewska3,
Joanna Trelinska3,
Piotr Grzelak1
1Department of Diagnostic Imaging,
Polish Mother’s Memorial Hospital- Research Institute in Lodz,
281/289 Rzgowska St.,
93-338,
Lodz,
Poland.
2PET/CT Laboratory,
NZOZ MCD Voxel,
Lodz,
42 Polnocna St.,
91-425 Lodz,
Poland.
3 Department of Pediatrics,
Oncology,
Hematology and Diabetology Medical University of Lodz,
16 Pankiewicza St.,
91-738 Lodz,
Poland.
References
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Körholz D.
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