Comparison of PET-CT and magnetic resonance diffusion weighted imaging with body suppression (DWIBS) for initial staging of malignant lymphomas

Eur J Radiol. 2013 Nov;82(11):2011-7. doi: 10.1016/j.ejrad.2013.05.042. Epub 2013 Aug 9.


Objective: To evaluate the clinical impact of diffusion-weighted whole-body imaging with background body signal suppression (DWIBS) in staging of malignant lymphoma.

Methods: Twenty-three patients with proven malignant lymphomas were prospectively enrolled. DWIBS (b=0, 1000 s/mm(2)) examinations and PET-CT were performed respectively on an Intera 1.5 T unit and a Gyroscan PET-CT scan (Philips Medical system, Best, the Netherland). The criteria for positive node involvement were a size over 10 mm or an apparent diffusion coefficient (ADC) value under 0.7510(-3) mm(2)/s for nodes under 10mm. For extranodal analysis, a high or heterogeneous signal on DWIBS was considered as positive. In cases of discordance, the reference standard for each region or organ was established at 6 months after the diagnosis according to all available clinical, biological information, as well as histological evidence or follow-up to prove or disprove the presence of disease.

Results: DWIBS and PET-CT results were congruent in 333 node regions on the 345 areas analyzed, with excellent agreement (κ=0.97, P<0.0001). From 433 organs analyzed (one patient had splenectomy) extranodal disease was detected in 22 organs on DWIBS. The two imaging techniques agreed on 430 organs (κ=0.99, P<0.0001). Finally, Ann Arbor stages based on DWIBS and those of PET/CT were in agreement for 23 patients.

Conclusions: For malignant lymphoma in a pre-therapeutic context, agreement between diffusion-weighted whole-body imaging and PET/CT is high for Ann Arbor staging.

Keywords: DWIBS; FDG PET/CT; Lymphoma; Staging.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Diffusion Magnetic Resonance Imaging / methods*
  • Female
  • Humans
  • Lymphoma / pathology*
  • Male
  • Middle Aged
  • Multimodal Imaging / methods*
  • Neoplasm Staging
  • Positron-Emission Tomography / methods*
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Subtraction Technique*
  • Tomography, X-Ray Computed / methods*
  • Whole Body Imaging / methods*
  • Young Adult