Department of Oncology, Tampere University Hospital, Teiskontie 35, Tampere, Finland.
NMR Biomed. 2011 Dec;24(10):1181-90. doi: 10.1002/nbm.1689. Epub 2011 Mar 8.
To determine the feasibility of diffusion-weighted MRI (DWI) in the evaluation of the early chemotherapeutic response in patients with aggressive non-Hodgkin's lymphoma (NHL), eight patients with histologically proven diffuse large B-cell lymphoma were imaged by MRI, including DWI, and positron emission tomography/computed tomography (PET/CT) before treatment (E1), and after 1 week (E2) and two cycles (E3) of chemotherapy. In all patients, whole-body screening using T(1) - and T(2) -weighted images in the coronal plane was performed. To quantitatively evaluate the chemotherapeutic response, axial images including DWI were acquired. Apparent diffusion coefficient (ADC) maps were reconstructed, and the ADC value of the tumor was measured. In addition, the tumor volume was estimated on axial T(2) -weighted images. The maximum standardized uptake value (SUV(max) ) and active tumor volume were measured on fused PET/CT images. Lymphomas showed high signal intensity on DW images and low signal intensity on ADC maps, except for necrotic foci. The mean pre-therapy ADC was 0.71 × 10(-3) mm(2) /s; it increased by 77% at E2 (p < 0.05) and 24% more at E3 (insignificant); the total increase was 106% (p < 0.05). The mean tumor volume by MRI was 276 mL at baseline; it decreased by 58% at E2 (p < 0.05) and 65% more at E3 (p < 0.05), giving a total decrease of 84% (p < 0.05). All the imaged pre-therapy tumors were strongly positive on PET/CT, with a mean SUV(max) of 20. The SUV(max) decreased by 60% at E2 (p < 0.05) and 59% more at E3 (p < 0.05), giving a total decrease of 83% (p < 0.05). The active tumor burden decreased by 66% at E2 (p < 0.05). At baseline, both central and peripheral tumor ADC values correlated inversely with SUV(max) (p < 0.05), and also correlated inversely with active tumor burden on PET/CT and with tumor volume on MRI at E2 (p < 0.05). In conclusion, the results of DWI in combination with whole-body MRI were comparable with those of integrated PET/CT.
为了确定弥散加权 MRI（DWI）在评估侵袭性非霍奇金淋巴瘤（NHL）患者早期化疗反应中的可行性，对 8 例经组织学证实为弥漫性大 B 细胞淋巴瘤的患者进行了 MRI 检查，包括 DWI 和正电子发射断层扫描/计算机断层扫描（PET/CT），分别在治疗前（E1）、1 周后（E2）和两个周期后（E3）进行。所有患者均在冠状面进行 T1-和 T2-加权图像的全身筛查。为了定量评估化疗反应，采集了包括 DWI 的轴位图像。重建表观扩散系数（ADC）图，并测量肿瘤的 ADC 值。此外，在轴向 T2-加权图像上估计肿瘤体积。在融合的 PET/CT 图像上测量最大标准化摄取值（SUV(max)）和活性肿瘤体积。DW 图像上的淋巴瘤呈高信号，ADC 图上呈低信号，除了坏死灶。治疗前 ADC 的平均值为 0.71×10(-3)mm2/s；E2 时增加了 77%（p<0.05），E3 时又增加了 24%（无统计学意义）；总增加 106%（p<0.05）。基线时 MRI 上的平均肿瘤体积为 276mL；E2 时减少了 58%（p<0.05），E3 时又减少了 65%（p<0.05），总减少了 84%（p<0.05）。所有成像前的肿瘤在 PET/CT 上均呈强阳性，SUV(max)的平均值为 20。E2 时 SUV(max)下降了 60%（p<0.05），E3 时又下降了 59%（p<0.05），总下降了 83%（p<0.05）。活性肿瘤负荷在 E2 时减少了 66%（p<0.05）。在基线时，中央和外周肿瘤的 ADC 值与 SUV(max)呈负相关（p<0.05），也与 E2 时的活性肿瘤负荷和 MRI 上的肿瘤体积呈负相关（p<0.05）。总之，DWI 与全身 MRI 相结合的结果与整合的 PET/CT 结果相当。
