Lymphomas: The Role of CT and MRI in Staging and Restaging

Abstract

Lymphoma is a heterogeneous group of more than 30 distinct types, differing widely in epidemiology and clinical behavior. Once the pathologic diagnosis of lymphoma is established, accurate clinical staging is mandatory for prognostication and appropriate treatment planning. In practically all cases, imaging—anatomic cross sectional imaging (CT and/or MRI) and/or functional imaging (PET or PET/CT)—plays a central role in staging. Furthermore, imaging is used to restage during therapy or at the end of treatment and document or exclude a complete remission. The following chapter examines the role of CT and MRI in lymphoma staging and restaging. Advantages and drawbacks of CT in assessing nodal and extranodal disease at initial presentation are discussed, and its diagnostic value compared with PET/CT is presented. The use of CT in restaging, including its role in the revised 2007 International Harmonization Project response criteria is also addressed. The role of MRI in staging and restaging Primary CNS Lymphoma and the use of Whole-body MRI as an alternative radiation-free imaging modality for lymphoma assessment are discussed in the final section of the chapter.