Lymphoma, Lung and other Tumors

Abstract

In both Hodgkin disease and non-Hodgkin lymphoma, imaging plays an important role for primary diagnosis and staging [1]. Except for cerebral lymphoma, whole-body MRI is of high research interest but not clinical routine in the staging algorithm of lymphoma patients. This situation could change quickly, and whole-body MRI might become a good alternative to CT [2]. Especially whole-body diffusion-weighted MRI, with a sensitivity of 90 % and a specificity of 94 %, is a good candidate for supplementing/replacing 18F-FDG PET-CT for the staging of Hodgkin disease and non-Hodgkin lymphoma [3, 4]. Alternatively, combing MR and 18F-FDG PET might further increase diagnostic accuracy and play an important role as research tool in evaluating the strengths and draw-backs of both modalities directly against each other. This might also give additional data on the view of some authors who argue that 18F-FDG PET-CT might even eliminate the need for bone marrow biopsy in the primary staging of Hodgkin disease because 18F-FDG PET-CT is highly sensitive and specific for bone marrow involvement in this disease, at 92 and 90 %, respectively [5]. Additional information using PET-MR could be specifically gained from diffusion-weighted sequences in the case of indolent lymphomas [6]. Finally due the lack of radiation exposure of MRI, compared with CT, PET/MRI may get an alternative to PET-CT especially in young patients with good prognosis.