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- Annemieke S Littooij, Thomas C Kwee, Ignasi Barber, Claudio Granata, Bart de Keizer, Frederik Ja Beek, Monique G Hobbelink, Rob Fijnheer, Jaap Stoker, and Rutger Aj Nievelstein.
- Department of Radiology and Nuclear Medicine, University Medical Center Utrecht/Wilhelmina Children's Hospital, Utrecht, the Netherlands Department of Diagnostic and Interventional Imaging, KK Women's and Children's Hospital, Singapore alittooij@hotmail.com.
- Acta Radiol. 2016 Feb 1; 57 (2): 142-51.
BackgroundAccurate evaluation of the spleen is an important component of staging lymphoma, because this may have prognostic and therapeutic implications.PurposeTo determine the diagnostic value of whole-body magnetic resonance imaging (MRI), including diffusion-weighted imaging (whole-body MRI-DWI) in the detection of splenic involvement in lymphoma.Material And MethodsThis IRB approved, prospective multicenter study included a total of 107 patients with newly diagnosed, histologically proven lymphoma who underwent 1.5 T whole-body MRI-DWI and FDG-PET/CT. Whole-body MRI-DWI and FDG-PET/CT were independently evaluated by a radiologist and a nuclear medicine physician, in a blinded manner. Splenic involvement at MRI was defined as splenic index > 725 cm(3) 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.ResultsSplenic 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.ConclusionWhole-body MRI-DWI is reasonably accurate in the detection of splenic lymphomatous involvement.© The Foundation Acta Radiologica 2015.
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