Elsevier

Magnetic Resonance Imaging

Volume 30, Issue 2, February 2012, Pages 165-170
Magnetic Resonance Imaging

Original contribution
The clinical application of whole-body diffusion-weighted imaging in the early assessment of chemotherapeutic effects in lymphoma: the initial experience

https://doi.org/10.1016/j.mri.2011.09.019Get rights and content

Abstract

At present, accurate assessment of therapeutic efficacy at the early stage of treatment is still a challenge for radiologists. As a new non-radiation whole body imaging technology, Whole body-diffusion weighted imaging (WB-DWI) had shown promising application prospects in therapeutic assessment, which confirmed by many premier animal studies. Here we report that in the chemotherapeutic assessment of malignant non-Hodgkin's lymphoma, WB-DWI can not only detect the morphological change of solid infiltrated lesion as the convention (such as CT, PET, etc.) but also provide information about the growth and decline process of tumor cells in the lesion combining with the dynamic changes of apparent diffusion coefficient (ADC) value, which is sooner than the morphological changes.

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

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