Role of diffusion MRI in diagnosis of mediastinal lymphoma: initial assessment and response to therapy

Youssriah Yahia Sabri1, Nourhan Mohamed Ewis1, Hamdy Zawam2, Mostafa Ahmed Khairy1
1Department of Diagnostic and Interventional Radiology, Kasr Al Ainy, Faculty of Medicine, Cairo University, Giza City, Egypt
2Department of Clinical Oncology, Kasr Al Ainy, Faculty of Medicine, Cairo University, Giza City, Egypt

Tóm tắt

Abstract Background Malignant lymphoma accounts for nearly 20% of all mediastinal neoplasms in adults and 50% in children. Hodgkin’s disease is the most common primary mediastinal lymphoma. In non-Hodgkin’s lymphoma, the two most common forms of primary mediastinal lymphoma are lymphoblastic lymphoma and diffuse large B-cell lymphoma. The aim of this study is to implement diffusion MRI in the algorithm of diagnosis of mediastinal lymphoma, differentiating Hodgkin's from non-Hodgkin's lymphoma and assessment of post therapeutic response. Results Using Diffusion weighted magnetic resonance imaging DWI-MRI, there were statistic significant difference between ADC values in lymph nodes and mediastinal masses in Hodgkin and non-Hodgkin lymphomas. ADC range in non-treated Hodgkin lymphoma cases was 0.774 to 1.4, while ADC range in in non-treated non-Hodgkin lymphoma was 0.476 to 0.668. In this study, there was statistically significant difference of ADC values in lymphoma cases presented by mediastinal masses with and without chemotherapy. Conclusions Diffusion weighted magnetic resonance imaging DWI-MRI is a promising functional technique in diagnosis of Hodgkin's and non-Hodgkin's lymphoma and assessment of response to treatment with no need for special preparation, contrast injection or radiation exposure.

Từ khóa


Tài liệu tham khảo

Cunningham J, Iyengar S, Sharma B (2017) Evolution of lymphoma staging and response evaluation: current limitations and future directions. Nat Rev Clin Oncol 14(10):631–645

Rusch VW, Asamura H, Watanabe H et al (2009) The IASLC lung cancer staging project: a proposal for a new international lymph node map in the forthcoming seventh edition of the TNM classification for lung cancer. J Thoracic Oncol 4(5):568–577

El-Sherief AH, Lau CT, Obuchowski NA et al (2017) Cross-disciplinary analysis of lymph node classification in lung cancer on CT scanning. Chest 151(4):776–785

Park BJ, Kim TH, Shin S et al (2019) Recommended change in the N descriptor proposed by the International Association for the Study of Lung Cancer: a validation study. J Thorac Oncol 14(11):1962–1969

Balbo-Mussetto A, Cirillo S, Bruna R et al (2016) Whole-body MRI with diffusion-weighted imaging: a valuable alternative to contrast-enhanced CT for initial staging of aggressive lymphoma. Clin Radiol 71(3):271–279

Sigovan M, Akl P, Mesmann C, Tronc F, Si-Mohamed S, Douek P, Boussel L (2018) Benign and malignant enlarged chest nodes staging by diffusion-weighted MRI: an alternative to mediastinoscopy. Br J Radiol 91(1082):20160919

Chavhan GB, AlSabban Z, Babyn PS (2014) Diffusion-weighted imaging in pediatric body MR imaging: principles, technique, and emerging applications. Radiographics 34(3):E73–E88

Bajada CJ, Parker GJ, Lambon Ralph MA et al (2017) Diffusion MRI: from basic principles to clinical applications. Malta Med School Gazette 1(2):41–47

Carter BW, Wu CC, Khorashadi L et al (2014) Multimodality imaging of cardiothoracic lymphoma. Eur J Radiol 83(8):1470–1482

Priola AM, Galetto G, Priola SM (2014) Diagnostic and functional imaging of thymic and mediastinal involvement in lymphoproliferative. Clin Imaging 38(6):771–784

Takahashi K, Al-Janabi NJ (2010) Computed tomography and magnetic resonance imaging of mediastinal tumors. J Magn Reson Imaging 32(6):1325–1339

Razek AA, Elkammary S, Elmorsy AS et al (2011) Characterization of mediastinal lymphadenopathy with diffusion-weighted imaging. Magn Reson Imaging 29(2):167–172

Ranganath SH, Lee EY, Restrepo R et al (2012) Mediastinal masses in children. Am J Roentgenol 198(3):W197–W216

De Paepe K, Bevernage C, De Keyzer F et al (2013) Whole-body diffusion-weighted magnetic resonance imaging at 3 Tesla for early assessment of treatment response in non-Hodgkin lymphoma: a pilot study. Cancer Imaging 13(1):53

Gümüştaş S, İnan N, Sarisoy HT et al (2011) Malignant versus benign mediastinal lesions: quantitative assessment with diffusion weighted MR imaging. Eur Radiol 21(11):2255–2260

Yabuuchi H, Matsuo Y, Abe K, Baba S et al (2015) Anterior mediastinal solid tumours in adults: characterisation using dynamic contrast-enhanced MRI, diffusion-weighted MRI, and FDG-PET/CT. Clin Radiol 70(11):1289–1298

Sabri YY, Kolta MFF, Khairy MA (2017) MR diffusion imaging in mediastinal masses the differentiation between benign and malignant lesions. Egypt J Radiol Nucl Med 48(3):569–580

Akshatha RA, Seshadri S, Teerthanath S et al (2014) A study of clinical characteristicsof mediastinal mass. J Clin Diagn Res: JCDR 8(2):77

Chira RI, Chira A, Mircea PA et al (2017) Mediastinal masses—transthoracic ultrasonography aspects. Medicine 96(49):e9082

Hagtvedt T, Seierstad T, Lunet KV et al (2015) Diffusion-weighted MRI compared to FDG PET/CT for assessment of early treatment response in lymphoma. Acta Radiol 56(2):152–158

Sabri YY, Nossair EZB, Assal HH et al (2020) Role of diffusion weighted MR-imaging in the evaluation of malignant mediastinal lesions. Egypt J Radiol Nucl Med 51(1):32

Broncano J, Alvarado-Benavides AM, Bhalla S et al (2019) Role of advanced magnetic resonance imaging in the assessment of malignancies of the mediastinum. World J Radiol 11(3):27

Çakmak V, Ufuk F, Karabulut N (2017) Diffusion-weighted MRI of pulmonary lesions: comparison of apparent diffusion coefficient and lesion-to-spinal cord signal intensity ratio in lesion characterization. J Magn Reson Imaging 45(3):845–854

Abou Youssef HA, Elzorkany MA, Hussein SAM et al (2019) Evaluation of mediastinal lymphadenopathy by diffusion weighted MRI; correlation with histopathological results. Adv Resp Med 87(3):175–183

Razek AA, Gaballa G, Elashry R et al (2015) Diffusion-weighted MR imaging of mediastinal lymphadenopathy in children. Jpn J Radiol 33(8):449–454

Shahrzad M, Le TSM, Silva M et al (2014) Anterior mediastinal masses. Am J Roentgenol 203(2):W128–W138

Mehrian P, Ebrahimzadeh SA (2013) Differentiation between sarcoidosis and Hodgkin’s lymphoma based on mediastinal lymph node involvement pattern: evaluation using spiral CT scan. Pol J Radiol 78(3):15

Lin C, Lucianib A, Itti E et al (2012) Whole-body diffusion magnetic resonance imaging in the assessment of lymphoma. Cancer Imaging 12(2):403

Littooij AS, Kwee TC, de Keizer B et al (2015) Whole-body MRI-DWI for assessment of residual disease after completion of therapy in lymphoma: a prospective multicenter study. J Magn Reson Imaging 42(6):1646–1655

Zhen Z, Sun X, Xia Y et al (2010) Clinical analysis of thymic regrowth following chemotherapy in children and adolescents with malignant lymphoma. Jpn J Clin Oncol 40(12):1128–1134

Chowdhury FU, Sheerin F, Bradley KM et al (2009) Sarcoid-like reaction to malignancy on whole-body integrated 18F-FDG PET/CT: prevalence and disease pattern. Clin Radiol 64(7):675–681

Spiekermann C, Kuhlencord M, Huss S et al (2017) Coexistence of sarcoidosis and metastatic lesions: a diagnostic and therapeutic dilemma. Oncol Lett 14(6):7643–7652

Ibrahim TE, Elia RZ, Hussien RS et al (2020) MR diffusion imaging in mediastinal masses the differentiation between benign and malignant lesions. QJM: Int J Med 113(Supplement_1):pp.hcaa068-008