DOI: 10.1007/s00259-017-3726-0Pages: 1742-1750

Imaging children suffering from lymphoma: an evaluation of different 18F-FDG PET/MRI protocols compared to whole-body DW-MRI

1. University Dusseldorf, Department of Diagnostic and Interventional Radiology, Medical Faculty

2. University Hospital Essen, University of Duisburg-Essen, Department of Diagnostic and Interventional Radiology and Neuroradiology

3. University Hospital Essen, University of Duisburg-Essen, Department of Nuclear Medicine

Correspondence to:
Julian Kirchner
Tel: +49 211 8 11 75 52
Email: Julian.Kirchner@med.uni-duesseldorf.de

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Abstract

Objectives

The objectives of this study were to evaluate and compare the diagnostic potential of different PET/MRI reading protocols, entailing non-enhanced / contrast-enhanced and diffusion-weighted 18F–FDG PET/MR imaging and whole-body diffusion-weighted MRI for lesion detection and determination of the tumor stage in pediatric lymphoma patients.

Methods

A total of 28 18F–FDG PET/MRI datasets were included for analysis of four different reading protocols: (1) PET/MRI utilizing sole unenhanced T2w and T1w imaging, (2) PET/MRI utilizing additional contrast enhanced sequences, (3) PET/MR imaging utilizing unenhanced, contrast enhanced and DW imaging or (4) WB-DW-MRI. Statistical analyses were performed on a per-patient and a per-lesion basis. Follow-up and prior examinations as well as histopathology served as reference standards.

Results

PET/MRI correctly identified all 17 examinations with active lymphoma disease, while WB-DW-MRI correctly identified 15/17 examinations. Sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy were 96%, 96.5%, 97%, 95%, and 96% for PET/MRI1; 97%, 96.5%, 97%, 96.5%, and 97% for PET/MRI2; 97%, 96.5%, 97%, 96.5%, and 97% for PET/MRI3 and 77%, 96%, 96%, 78.5% and 86% for MRI-DWI.

Conclusion

18F–FDG PET/MRI is superior to WB-DW-MRI in staging pediatric lymphoma patients. Neither application of contrast media nor DWI leads to a noticeable improvement of the diagnostic accuracy of PET/MRI. Thus, unenhanced PET/MRI may play a crucial role for the diagnostic work-up of pediatric lymphoma patients in the future.

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  • Accepted: May 9, 2017
  • Online: May 22, 2017

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