Whole-body magnetic resonance imaging provides accurate staging of diffuse large B-cell lymphoma, but is less preferred by patients

BACKGROUND Whole-body magnetic resonance imaging(wbMRI)allows general assessment of systemic cancers including lymphomas without radiation burden.AIM To evaluate the diagnostic performance of wbMRI in the staging of diffuse large B-cell lymphoma(DLBCL),determine the value of individual MRI sequences,and assess patients’concerns with wbMRI.METHODS In this single-center prospective study,adult patients newly diagnosed with systemic DLBCL underwent wbMRI on a 3T scanner[diffusion weighted images with background suppression(DWIBS),T2,short tau inversion recovery(STIR),contrast-enhanced T1]and fluorodeoxyglucose(18F-FDG)positron emission tomo-graphy/computed tomography(PET/CT)(reference standard).The involvement of 12 nodal regions and extranodal sites was evaluated on wbMRI and PET/CT.The utility of wbMRI sequences was rated on a five-point scale(0=not useful,4=very useful).Patients received a questionnaire regarding wbMRI.RESULTS Of 60 eligible patients,14(23%)were enrolled and completed the study.The sensitivity of wbMRI in the nodal involvement(182 nodal sites)was 0.84,with 0.99 specificity,positive predictive value of 0.96,negative predictive value of 0.97,and 0.97 accuracy.PET/CT and wbMRI were concordant both in extranodal involvement(13 instances)and staging(κ=1.0).The mean scores of the utility of MRI sequences were 3.71±0.73 for DWIBS,2.64±0.84 for T1,2.14±0.77 for STIR,and 1.29±0.73 for T2(P<0.0001).Patients were mostly concerned about the enclosed environment and duration of the MRI examination(27%of patients).CONCLUSION The wbMRI exhibited excellent sensitivity and specificity in staging DLBCL.DWIBS and contrast-enhanced T1 were rated as the most useful sequences.Patients were less willing to undergo wbMRI as a second examination parallel to PET/CT,especially owing to the long duration and the enclosed environment.

Quantitative T2＊-Mapping of the Knee Using a Spoiled Gradient Echo Sequence at 3 Tesla： Preliminary Results

Purpose： To evaluate a me-vTE-SPGR （multi echo variable TE Spoiled Gradient Echo Sequence） approach for quantitative T2＊ mapping of the ME （menisci）, the PT （patellar tendon）, the ACL （anterior cruciate ligament）, the PCL （posterior cruciate ligament） and to compare the results between normal and pathological tissue of the ME in the knee joint at 3T （3 Tesla）. Methods： Eighteen consecutive knee patients （35.7± 11.6 years） were examined on 3T. In addition to standard morphological MRI, T2＊-maps were derived from a 0.7 mm isotropic me-vTE-SPGR scan. T2＊-values were assessed by two independent observers using an ROI analysis for the ME （4 different regions： posterior and anterior horn of the medial and lateral meniscus）, PT, ACL and PCL. Intra-class correlation between readers was calculated. Results： On morphological MRI, the PT, ACL and PCL were diagnosed as normal in all cases. Degenerative meniscus and meniscal tears were diagnosed in 13 cases and 9 cases, respectively. T2＊-values of the menisci on me-vTE-SPGR scans, in relation to morphological imaging, were normal （N = 50; 6.0 ±0.9 ms）; degenerative meniscus （N = 13; 8.0± 1.6 ms）; meniscal tears （N = 9; 12.9 ±3.9 ms）, with significant differences between all groups （P 〈 0.05）/ significantly higher T2＊-values in degenerative meniscus and meniscal tears. Mean T2＊ relaxation times for the PT, ACL and PCL were 2.9± 0.8 ms, 8.4 ± 1.6 ms and 8.9 ＋ 1.3 ms respectively. Intra-class correlation values between readers for the ME, PT, ACL and PCL were R2 = 0.962, R2 = 0.927, R2 = 0.594 and R2= 0.648, respectively. Conclusion： Isotropic 3D （three-dimensional） me vTE-SPGR imaging is able to quantify T2＊ values of multiple tissues in the knee joint with short T2 relaxation times.