Accuracy of whole-body MRI in the assessment of splenic involvement in lymphoma

Annemieke S. Littooij, Thomas C. Kwee, Ignasi Barber, Claudio Granata, Bart De Keizer, Frederik J A Beek, Monique G. Hobbelink, Rob Fijnheer, Jaap Stoker, Rutger A J Nievelstein

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Abstract

Background: Accurate evaluation of the spleen is an important component of staging lymphoma, because this may have prognostic and therapeutic implications. Purpose: To determine the diagnostic value of whole-body magnetic resonance imaging (MRI), including diffusionweighted imaging (whole-body MRI-DWI) in the detection of splenic involvement in lymphoma. Material and Methods: This IRB approved, prospective multicenter study included a total of 107 patients with newly diagnosed, histologically proven lymphoma who underwent 1.5 Twhole-body MRI-DWI and FDG-PET/CT. Whole-body MRI-DWI and FDG-PET/CTwere independently evaluated by a radiologist and a nuclear medicine physician, in a blinded manner. Splenic involvement at MRI was defined as splenic index >725 cm3 or discrete nodules. At FDG-PET/CT splenic involvement was defined as splenic uptake greater than liver uptake or hypodense nodules at contrast-enhanced CT. FDG-PET/CT augmented with follow-up imaging after treatment was used as reference standard. Results: Splenic involvement was detected with FDG-PET/CT in 21 patients, all demonstrating response to treatment. The sensitivity, specificity, positive predictive value, and negative predictive value of whole-body MRI-DWI for the detection of splenic involvement were 85.7 %, 96.5 %, 85.7%, and 96.5%, respectively. Three out of six discrepancies were related to suboptimal criterion of splenic size used with whole-body MRI-DWI versus the size-independent FDG uptake. Conclusion: Whole-body MRI-DWI is reasonably accurate in the detection of splenic lymphomatous involvement.

Original languageEnglish
Pages (from-to)142-151
Number of pages10
JournalActa Radiologica
Volume57
Issue number2
DOIs
Publication statusPublished - Feb 1 2016

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Keywords

  • Diffusion-weighted imaging
  • FDG PET/CT
  • Lymphoma
  • Magnetic resonance imaging (MRI)
  • Splenic involvement
  • Whole-body MRI

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

Cite this

Littooij, A. S., Kwee, T. C., Barber, I., Granata, C., De Keizer, B., Beek, F. J. A., Hobbelink, M. G., Fijnheer, R., Stoker, J., & Nievelstein, R. A. J. (2016). Accuracy of whole-body MRI in the assessment of splenic involvement in lymphoma. Acta Radiologica, 57(2), 142-151. https://doi.org/10.1177/0284185115571657