Abstract
This article discusses a study performed with an aim to determine the usefulness of diffusion-weighted MRI in pre-treatment assessment and evaluation of chemotherapy response of mediastinal lesions of malignant lymphoma by analysing signal intensity, accumulation of contrast agent and changes in values of ADC. Comparing the results of PET/CT and DW-MRI was another goal of this study. We reviewed data of 21 patients that underwent treatment during years 2013-2014 at the Hospital of Lithuanian University of Health Sciences Kaunas Clinics and had DW-MRI and PET/CT scans carried out. For all patients the diagnosis of malignant lymphoma in mediastinal lymph nodes was confirmed histological. Whether the lymphoma was in active state was determined by PET/CT or histological data. In MRI scans, signal intensity and ADC values were evaluated, while in PET/CT maximum and average standardized uptake values were assessed. Patients underwent chemotherapy and follow up scans were performed to evaluate response. In total, 25 PET/CT and 50 DW-MRI scans were analysed. We found statistically significant difference of values of ADC in active and inactive states of malignant lymphoma of mediastinal lymph nodes. In follow up tests, performed during 2 years after treatment, a tendency of decreasing ADC values over time was seen when chemotherapy was successful and no relapse was observed. Among the reviewed cases, DW-MRI had slightly worse specificity than PET/CT in differentiation of malignant and benign changes in lymph nodes.
Highlights
Lymphomas are a group of lymph proliferative diseases, classified into two types – Hodgkin’s and non-Hodgkin’s lymphomas
Malignant lymphomas show great response to chemotherapy, the treatment has harsh side effects and oftentimes can be hard for patients to tolerate
This study aimed to compare the diagnostic value of diffusion-weighted magnetic resonance imaging (DW-MRI) and positron emission tomography/computed tomography (PET/computed tomography (CT)) and specify whether it can be used as an alternative in diagnostics of mediastinal lesions of lymphomas
Summary
Lymphomas are a group of lymph proliferative diseases, classified into two types – Hodgkin’s and non-Hodgkin’s lymphomas. Morbidity for this illness seems to be rising lately, as about 450 new cases of lymphoma are found in Lithuania yearly [1]. Malignant lymphomas show great response to chemotherapy, the treatment has harsh side effects and oftentimes can be hard for patients to tolerate. Employing radiologic methods for correct primary staging of tumour and evaluation of response to treatment allows optimising the use of chemotherapy. Assessment of the effect of chemotherapy means that treatment tactics can be changed or corrected on an early stage of disease, if seen not to be
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