Keywords:
Tissue characterisation, Lymphoma, Image verification, Staging, Diagnostic procedure, Comparative studies, PET-CT, MR-Diffusion/Perfusion, Oncology, Radiation physics, MR physics
Authors:
K. Matera, D. Baranska, M. T. Podgórski, M. Górska-Chrząstek, K. Krajewska, J. Trelińska, P. Grzelak; Łódź/PL
DOI:
10.26044/ecr2019/C-1156
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 in recommendations [5-7].
Diffusion-weighted whole-body imaging with background body signal suppression (DWIBS) may be a good,
radiation-free alternative to 18F-FDG PET/CT [8,9].
This method is based on measurements of Brownian motion of water molecules in biological tissue.
In many pathological conditions,
water diffusivity is impeded (low) due to,
e.g.
increased neoplastic cellularity or swelling in inflammatory or infectious lesions.
It also concerns lymphomas,
where cells are densely packed and randomly organized,
inhibiting an effective motion of extracellular water [10-13].
DWIBS provides cross-sectional imaging of the entire body,
with a high soft-tissue contrast,
and functional information [14].
It is already employed in the follow-ups of patients with lymphoma [15-17].
It is included in EuroNet-PHL-Interimphase trial,
which is still being continued by some European countries.
Due to high spatial resolution,
this technique allows for evaluation of the nodal space even in children,
and thus accurately determining lymphoma involvement [18,19].
The aim of the study was to evaluate feasibility of diffusion-weighted whole-body imaging with background body signal suppression (DWIBS) method in diagnosing Hodgkin lymphoma in pediatric patients and to compare it with 18F-FDG PET/CT as a gold standard.