Original contributionThe clinical application of whole-body diffusion-weighted imaging in the early assessment of chemotherapeutic effects in lymphoma: the initial experience
Section snippets
Subjects
Consecutive patients with NHL were enrolled in this study prospectively. Patients eligible for this study met the following criteria: (a) histologically confirmed NHL by surgery or biopsy pathology and immunohistochemistry with at least one solid measurable invasive lesion, (b) a Karnofsky performance scale score of more than 70% [22], (c) nonpregnant state, (d) at least 18 years of age and (e) scheduled to begin a new chemotherapy regimen with no contraindications to chemotherapy. Human trials
Results
A total of 12 patients with NHL who had accepted complete standard chemotherapeutic treatment were eventually included in the study between March 2008 and April 2009. However, two of them subsequently withdrew: one abandoned treatment due to economic strain and one lost the early DWI scan, interrupted by the severe pulmonary infection. All the rest of the patients (n=10) received conventional whole-body imaging examination before and after the chemotherapy: seven received PET (two of whom with
Discussion
Our study showed that for the patients with effective response, the ADC values of all lesions changed significantly throughout the complete chemotherapy treatment course, even in the early stage when the change was faster than the morphology. Furthermore, all the solid invaded lymphoma lesions, whether nodal or extranodal, can be clearly displayed in the map of WB-DWI.
A challenge to oncologists in the 21st century is to optimize individual patient treatment and avoid unnecessary toxicity,
Conclusion
In conclusion, WB-DWI is a noninvasive, no-radiation, fast-scanning and large-coverage method for the assessment of the chemotherapeutic effect in NHL. Combined with the dynamic changes of ADC value, WB-DWI indirectly reflects the growth and decline process of tumor cells in the body, which is more sensitive than the morphological changes. It can eliminate the cumbersome review process, reduce inspection time and save cost. We believe that WB-DWI is a tool with promising clinical value in the
References (26)
- et al.
FDG-PET after two to three cycles of chemotherapy predicts progression-free and overall survival in high-grade non-Hodgkin lymphoma
Ann Oncol
(2005) - et al.
Changes in water mobility measured by diffusion MRI predict response of metastatic breast cancer to chemotherapy
J Neoplasia
(2004) - et al.
MR diffusion weighted imaging for evaluation of radiotherapeutic effects on rabbit VX2 tumor model
J Chin Med Sci
(2008) Lymphoma: diagnosis, staging, natural history, and treatment strategies
Semin Oncol
(2005)- et al.
Diffusion-weighted MRI: a new functional clinical technique for tumor imaging
Br J Radiol
(2006) - et al.
Gallium-67 scintigraphy: a cornerstone in functional imaging of lymphoma
Eur J Nucl Med Mol Imaging
(2003) - et al.
Response assessment of aggressive non-Hodgkin's lymphoma by integrated International Workshop Criteria and fluorine-18-fluorodeoxyglucose positron emission tomography
J Clin Oncol
(2005) - et al.
Blood flow-metabolic relationships are dependent on tumour size in non-small cell lung cancer: a study using quantitative contrast-enhanced computer tomography and positron emission tomography
Eur J Nucl Med Mol Imaging
(2006) - et al.
[(18)F]FMISO and [(18)F]FDG PET imaging in soft tissue sarcomas: correlation of hypoxia, metabolism and VEGF expression
Eur J Nucl Med Mol Imaging
(2003) - et al.
[(18)F]FDG PET monitoring of tumour response to chemotherapy: does [(18)F]FDG uptake correlate with the viable tumour cell fraction?
Eur J Nucl Med Mol Imaging
(2003)
Diffusion weighted whole body imaging with background body signal suppression (DWIBS): technical improvement using free breathing, STIR and high resolution 3D display
J Radiat Med
2-[Fluorine-18]-fluoro-2-deoxy-d-glucose positron emission tomography computed tomography versus whole-body diffusion-weighted MRI for detection of malignant lesions: initial experience
J Ann Nucl Med
Whole body diffusion weighted MRI compared to 18F-FDG position emission tomography for the detection and localization of malignant lesions
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Whole-body MRI radiomics model to predict relapsed/refractory Hodgkin Lymphoma: A preliminary study
2022, Magnetic Resonance ImagingCurrent and future best practice in imaging, staging, and response assessment for Non-Hodgkin's lymphomas: the Specialist Integrated Haematological Malignancy Imaging Reporting (SIHMIR) paradigm shift
2021, Clinical RadiologyCitation Excerpt :Fusion PET-MRI has been shown to be as effective as PET-CT in disease staging and response assessment of NHL, with added benefits including lack of ionising radiation, shorter scan time, avoidance of injection of radionuclides or contrast, and potential use in pregnancy, being particularly advantageous aspects (Fig 9).2,34 DWI can also be useful in patients with indeterminate PET-CT findings, our group having used DWI to differentiate thymic hyperplasia from active residual lymphoma in the anterior mediastinum.2,38,41–45 Many studies have also demonstrated the potential utility of whole-body DWI (WB-DWI) in tumour characterisation.
Diffusion kurtosis imaging of a human nasopharyngeal carcinoma xenograft model: Initial experience with pathological correlation
2018, Magnetic Resonance ImagingCitation Excerpt :DWI is routinely used in daily MR exams as a conventional protocol, especially in oncology [1,2]. The apparent diffusion coefficient (ADC), which is a quantitative biomarker of water diffusion in a microscopic environment, can be used to detect malignant lesions, assess tumor invasiveness, and even predict early treatment responses [1–3]. The theoretical premise of the DWI model was to assume that the water molecules in the body showed a normal distribution of diffusion, with the water motion in tissues following a Gaussian diffusion behavior.
Pitfalls in whole body MRI with diffusion weighted imaging performed on patients with lymphoma: What radiologists should know
2016, Magnetic Resonance ImagingCitation Excerpt :Computed tomography (CT) and fluorodeoxyglucose positron emission tomography (FDG-PET), are the most commonly used and recommended imaging procedures for staging and following up patients with lymphoma [1–3]. A lot of studies demonstrated the feasibility and reliability of whole body magnetic resonance imaging (WB-MRI), especially with diffusion weighted imaging (DWI), as an alternative tool for lymphoma staging [4–6] and response assessment during and after treatment [7–9]. WB-MRI provides, within quick time span, images of the entire body with high contrast resolution, avoiding intravenous contrast agent administration and radiation exposure.