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[Abstract]

PURPOSE:

To determine the value of diffusion-weighted MRI (DWI-MRI) for treatment response assessment in 2-[18F]fluoro-2-deoxy-D-glucose (FDG)-avid lymphoma.

EXPERIMENTAL DESIGN:

Patients with FDG-avid Hodgkin (HL) or non-Hodgkin lymphoma (NHL) at pretherapeutic 18F-FDG-PET/CT, who had also undergone pretherapeutic whole-body DWI-MRI, were included in this prospective study. Depending on the histologic lymphoma subtype, patients received different systemic treatment regimens, and follow-up DWI-MRI and 18F-FDG-PET/CT were performed at one or more time points, depending on the clinical course. For each follow-up DWI-MRI, region-based rates of agreement, and rates of agreement in terms of treatment response (complete remission, partial remission, stable disease, or progressive disease), relative to the corresponding 18F-FDG-PET/CT, were calculated.

RESULTS:

Sixty-four patients were included: 10 with HL, 22 with aggressive NHL, and 32 with indolent NHL. The overall region-based agreement of DWI-MRI with 18F-FDG-PET/CT was 99.4%. For the 51 interim examinations (performed after 1-3 therapy cycles), region-based agreement of DWI-MRI with 18F-FDG-PET/CT was 99.2%, and for the 48 end-of-treatment examinations, agreement was 99.8%. No significant differences, in terms of region-based agreement between DWI-MRI and 18F-FDG-PET/CT, were observed between the three lymphoma groups (HL, aggressive NHL, indolent NHL; P = 0.25), or between interim and end-of-treatment examinations (P = 0.21). With regard to treatment response assessment, DWI-MRI agreed with 18F-FDG-PET/CT in 99 of 102 follow-up examinations (97.1%), with a κ value of 0.94 (P < 0.0001).

CONCLUSIONS:

In patients with FDG-avid lymphoma, DWI-MRI may be a feasible alternative to 18F-FDG-PET/CT for follow-up and treatment response assessment. Clin Cancer Res; 21(11); 2506-13. ©2015 AACR.

©2015 American Association for Cancer Research.

[Author information]

Mayerhoefer ME1, Karanikas G2, Kletter K2, Prosch H2, Kiesewetter B3, Skrabs C3, Porpaczy E3, Weber M2, Knogler T2, Sillaber C3, Jaeger U3, Simonitsch-Klupp I4, Ubl P2, Müllauer L4, Dolak W5, Lukas J6, Raderer M3.

1 Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria. marius.mayerhoefer@meduniwien.ac.at.

2 Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria.

3 Department of Internal Medicine I, Medical University of Vienna, Vienna, Austria.

4 Institute of Pathology, Medical University Vienna, Vienna, Austria.

5 Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria.

6 Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria.