Patyk Mateusz, Kwiatkowski Jacek, Pawluś Aleksander, Hołownia Daniel, Szymańska Kinga, Mazur Rafał, Silicki Jurand, Badowski Roman, Sokołowska-Dąbek Dąbrówka, Kuliszkiewicz-Janus Małgorzata, Zaleska-Dorobisz Urszula
Department of General and Paediatric Radiology, Wroclaw Medical University, Wroclaw, Poland.
Department and Clinic of Haematology, Blood Neoplasms, and Bone Marrow Transplantation, Wroclaw Medical University, Wroclaw, Poland.
Pol J Radiol. 2018 May 12;83:e210-e214. doi: 10.5114/pjr.2018.76007. eCollection 2018.
Lymphoproliferative neoplasms are the largest and most frequently diagnosed entities in the group of haematological malignancies. The aim of the study was to assess whether apparent diffusion coefficient (ADC) measured on the first day of the second cycle of chemotherapy could be a predictor of prognosis and of the final treatment's outcome.
The study included 27 patients with diagnosed Hodgkin's and non-Hodgkin's lymphoma, who had magnetic resonance (MR) performed with diffusion weighted imaging/apparent diffusion coefficient (DWI/ADC) before and on the first day of the second cycle of chemotherapy. Imaging was performed using a 1.5 T MR scanner. ADC was measured in lymphoma infiltration in the area of the lowest signal in the ADC map and the highest signal on β 800 images in post-treatment study. After that, the corresponding area was determined in a pre-treatment study and an ADC value was measured.
The difference between ADC values in pre-treatment (ADC = 720 mm/s) and post-treatment (ADC = 1059 mm/s) studies was statistically significant ( < 0.001). Cutoff values for estimating response to treatment were established at the level of ADC 1080 mm/s, and ADC to muscle ratio at 0.82 in post-treatment study. Patients with ADC > 752 mm/s before treatment manifested lower probability of progression than patients with ADC < 752 mm/s.
ADC measurement's before treatment and on the first day of the second cycle of chemotherapy can be used as a prognostic marker in lymphoma therapy. ADC values lower than 1080 mm/s and an increase of the ratio after the treatment can be considered as a marker of disease progression.
淋巴增殖性肿瘤是血液系统恶性肿瘤中最大且最常被诊断出的类型。本研究的目的是评估在化疗第二个周期第一天测得的表观扩散系数（ADC）是否可作为预后及最终治疗结果的预测指标。
该研究纳入了27例已确诊的霍奇金淋巴瘤和非霍奇金淋巴瘤患者，这些患者在化疗第二个周期之前及第一天进行了磁共振成像（MR）检查，包括扩散加权成像/表观扩散系数（DWI/ADC）。成像使用1.5T磁共振扫描仪。在治疗后研究中，于ADC图上信号最低且β800图像上信号最高的淋巴瘤浸润区域测量ADC值。之后，在治疗前研究中确定相应区域并测量ADC值。
治疗前（ADC = 720mm²/s）与治疗后（ADC = 1059mm²/s）研究中ADC值的差异具有统计学意义（<0.001）。在治疗后研究中，将评估治疗反应的截断值设定为ADC 1080mm²/s，以及ADC与肌肉的比值为0.82。治疗前ADC>752mm²/s的患者进展概率低于ADC<752mm²/s的患者。
治疗前及化疗第二个周期第一天的ADC测量可作为淋巴瘤治疗中的预后标志物。ADC值低于1080mm²/s以及治疗后该比值升高可被视为疾病进展的标志物。
