Whole-body MRI for initial staging of paediatric lymphoma: prospective comparison to an FDG-PET/CT-based reference standard

Annemieke S. Littooij; Thomas C. Kwee; Ignasi Barber; Claudio Granata; Malou A. Vermoolen; Goya Enríquez; József Zsíros; Shui Yen Soh; Bart de Keizer; Frederik J. A. Beek; Monique G. Hobbelink; Marc B. Bierings; Jaap Stoker; Rutger A. J. Nievelstein

doi:https://doi.org/10.1007/s00330-014-3114-0

Whole-body MRI for initial staging of paediatric lymphoma: prospective comparison to an FDG-PET/CT-based reference standard

Annemieke S. Littooij, Thomas C. Kwee, Ignasi Barber, Claudio Granata, Malou A. Vermoolen, Goya Enríquez, József Zsíros, Shui Yen Soh, Bart de Keizer, Frederik J. A. Beek, Monique G. Hobbelink, Marc B. Bierings, Jaap Stoker, Rutger A. J. Nievelstein

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Abstract

To compare whole-body MRI, including diffusion-weighted imaging (whole-body MRI-DWI), with FDG-PET/CT for staging newly diagnosed paediatric lymphoma. A total of 36 children with newly diagnosed lymphoma prospectively underwent both whole-body MRI-DWI and FDG-PET/CT. Whole-body MRI-DWI was successfully performed in 33 patients (mean age 13.9 years). Whole-body MRI-DWI was independently evaluated by two blinded observers. After consensus reading, an unblinded expert panel evaluated the discrepant findings between whole-body MRI-DWI and FDG-PET/CT and used bone marrow biopsy, other imaging data and clinical information to derive an FDG-PET/CT-based reference standard. Interobserver agreement of whole-body MRI-DWI was good [all nodal sites together (κ = 0.79); all extranodal sites together (κ = 0.69)]. There was very good agreement between the consensus whole-body MRI-DWI- and FDG-PET/CT-based reference standard for nodal (κ = 0.91) and extranodal (κ = 0.94) staging. The sensitivity and specificity of consensus whole-body MRI-DWI were 93 % and 98 % for nodal staging and 89 % and 100 % for extranodal staging, respectively. Following removal of MRI reader errors, the disease stage according to whole-body MRI-DWI agreed with the reference standard in 28 of 33 patients. Our results indicate that whole-body MRI-DWI is feasible for staging paediatric lymphoma and could potentially serve as a good radiation-free alternative to FDG-PET/CT. • Accurate staging is important for treatment planning and assessing prognosis • Whole-body MRI-DWI could be a good radiation-free alternative to FDG-PET/CT • Interobserver agreement of whole-body MRI-DWI is good • Agreement between whole-body MRI and the FDG-PET/CT reference standard is good • Most discrepancies were caused by suboptimal accuracy of size measurements on MRI

Original language	English
Pages (from-to)	1153-1165
Journal	European Radiology
Volume	24
Issue number	5
DOIs	https://doi.org/10.1007/s00330-014-3114-0
Publication status	Published - 2014

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https://doi.org/10.1007/s00330-014-3114-0

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Littooij, A. S., Kwee, T. C., Barber, I., Granata, C., Vermoolen, M. A., Enríquez, G., Zsíros, J., Soh, S. Y., de Keizer, B., Beek, F. J. A., Hobbelink, M. G., Bierings, M. B., Stoker, J., & Nievelstein, R. A. J. (2014). Whole-body MRI for initial staging of paediatric lymphoma: prospective comparison to an FDG-PET/CT-based reference standard. European Radiology, 24(5), 1153-1165. https://doi.org/10.1007/s00330-014-3114-0

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title = "Whole-body MRI for initial staging of paediatric lymphoma: prospective comparison to an FDG-PET/CT-based reference standard",

abstract = "To compare whole-body MRI, including diffusion-weighted imaging (whole-body MRI-DWI), with FDG-PET/CT for staging newly diagnosed paediatric lymphoma. A total of 36 children with newly diagnosed lymphoma prospectively underwent both whole-body MRI-DWI and FDG-PET/CT. Whole-body MRI-DWI was successfully performed in 33 patients (mean age 13.9 years). Whole-body MRI-DWI was independently evaluated by two blinded observers. After consensus reading, an unblinded expert panel evaluated the discrepant findings between whole-body MRI-DWI and FDG-PET/CT and used bone marrow biopsy, other imaging data and clinical information to derive an FDG-PET/CT-based reference standard. Interobserver agreement of whole-body MRI-DWI was good [all nodal sites together (κ = 0.79); all extranodal sites together (κ = 0.69)]. There was very good agreement between the consensus whole-body MRI-DWI- and FDG-PET/CT-based reference standard for nodal (κ = 0.91) and extranodal (κ = 0.94) staging. The sensitivity and specificity of consensus whole-body MRI-DWI were 93 % and 98 % for nodal staging and 89 % and 100 % for extranodal staging, respectively. Following removal of MRI reader errors, the disease stage according to whole-body MRI-DWI agreed with the reference standard in 28 of 33 patients. Our results indicate that whole-body MRI-DWI is feasible for staging paediatric lymphoma and could potentially serve as a good radiation-free alternative to FDG-PET/CT. • Accurate staging is important for treatment planning and assessing prognosis • Whole-body MRI-DWI could be a good radiation-free alternative to FDG-PET/CT • Interobserver agreement of whole-body MRI-DWI is good • Agreement between whole-body MRI and the FDG-PET/CT reference standard is good • Most discrepancies were caused by suboptimal accuracy of size measurements on MRI",

author = "Littooij, {Annemieke S.} and Kwee, {Thomas C.} and Ignasi Barber and Claudio Granata and Vermoolen, {Malou A.} and Goya Enr{\'i}quez and J{\'o}zsef Zs{\'i}ros and Soh, {Shui Yen} and {de Keizer}, Bart and Beek, {Frederik J. A.} and Hobbelink, {Monique G.} and Bierings, {Marc B.} and Jaap Stoker and Nievelstein, {Rutger A. J.}",

year = "2014",

doi = "https://doi.org/10.1007/s00330-014-3114-0",

language = "English",

volume = "24",

pages = "1153--1165",

journal = "European Radiology",

issn = "0938-7994",

publisher = "Springer Verlag",

number = "5",

}

Littooij, AS, Kwee, TC, Barber, I, Granata, C, Vermoolen, MA, Enríquez, G, Zsíros, J, Soh, SY, de Keizer, B, Beek, FJA, Hobbelink, MG, Bierings, MB, Stoker, J & Nievelstein, RAJ 2014, 'Whole-body MRI for initial staging of paediatric lymphoma: prospective comparison to an FDG-PET/CT-based reference standard', European Radiology, vol. 24, no. 5, pp. 1153-1165. https://doi.org/10.1007/s00330-014-3114-0

TY - JOUR

T1 - Whole-body MRI for initial staging of paediatric lymphoma: prospective comparison to an FDG-PET/CT-based reference standard

AU - Littooij, Annemieke S.

AU - Kwee, Thomas C.

AU - Barber, Ignasi

AU - Granata, Claudio

AU - Vermoolen, Malou A.

AU - Enríquez, Goya

AU - Zsíros, József

AU - Soh, Shui Yen

AU - de Keizer, Bart

AU - Beek, Frederik J. A.

AU - Hobbelink, Monique G.

AU - Bierings, Marc B.

AU - Stoker, Jaap

AU - Nievelstein, Rutger A. J.

PY - 2014

Y1 - 2014

N2 - To compare whole-body MRI, including diffusion-weighted imaging (whole-body MRI-DWI), with FDG-PET/CT for staging newly diagnosed paediatric lymphoma. A total of 36 children with newly diagnosed lymphoma prospectively underwent both whole-body MRI-DWI and FDG-PET/CT. Whole-body MRI-DWI was successfully performed in 33 patients (mean age 13.9 years). Whole-body MRI-DWI was independently evaluated by two blinded observers. After consensus reading, an unblinded expert panel evaluated the discrepant findings between whole-body MRI-DWI and FDG-PET/CT and used bone marrow biopsy, other imaging data and clinical information to derive an FDG-PET/CT-based reference standard. Interobserver agreement of whole-body MRI-DWI was good [all nodal sites together (κ = 0.79); all extranodal sites together (κ = 0.69)]. There was very good agreement between the consensus whole-body MRI-DWI- and FDG-PET/CT-based reference standard for nodal (κ = 0.91) and extranodal (κ = 0.94) staging. The sensitivity and specificity of consensus whole-body MRI-DWI were 93 % and 98 % for nodal staging and 89 % and 100 % for extranodal staging, respectively. Following removal of MRI reader errors, the disease stage according to whole-body MRI-DWI agreed with the reference standard in 28 of 33 patients. Our results indicate that whole-body MRI-DWI is feasible for staging paediatric lymphoma and could potentially serve as a good radiation-free alternative to FDG-PET/CT. • Accurate staging is important for treatment planning and assessing prognosis • Whole-body MRI-DWI could be a good radiation-free alternative to FDG-PET/CT • Interobserver agreement of whole-body MRI-DWI is good • Agreement between whole-body MRI and the FDG-PET/CT reference standard is good • Most discrepancies were caused by suboptimal accuracy of size measurements on MRI

AB - To compare whole-body MRI, including diffusion-weighted imaging (whole-body MRI-DWI), with FDG-PET/CT for staging newly diagnosed paediatric lymphoma. A total of 36 children with newly diagnosed lymphoma prospectively underwent both whole-body MRI-DWI and FDG-PET/CT. Whole-body MRI-DWI was successfully performed in 33 patients (mean age 13.9 years). Whole-body MRI-DWI was independently evaluated by two blinded observers. After consensus reading, an unblinded expert panel evaluated the discrepant findings between whole-body MRI-DWI and FDG-PET/CT and used bone marrow biopsy, other imaging data and clinical information to derive an FDG-PET/CT-based reference standard. Interobserver agreement of whole-body MRI-DWI was good [all nodal sites together (κ = 0.79); all extranodal sites together (κ = 0.69)]. There was very good agreement between the consensus whole-body MRI-DWI- and FDG-PET/CT-based reference standard for nodal (κ = 0.91) and extranodal (κ = 0.94) staging. The sensitivity and specificity of consensus whole-body MRI-DWI were 93 % and 98 % for nodal staging and 89 % and 100 % for extranodal staging, respectively. Following removal of MRI reader errors, the disease stage according to whole-body MRI-DWI agreed with the reference standard in 28 of 33 patients. Our results indicate that whole-body MRI-DWI is feasible for staging paediatric lymphoma and could potentially serve as a good radiation-free alternative to FDG-PET/CT. • Accurate staging is important for treatment planning and assessing prognosis • Whole-body MRI-DWI could be a good radiation-free alternative to FDG-PET/CT • Interobserver agreement of whole-body MRI-DWI is good • Agreement between whole-body MRI and the FDG-PET/CT reference standard is good • Most discrepancies were caused by suboptimal accuracy of size measurements on MRI

U2 - https://doi.org/10.1007/s00330-014-3114-0

DO - https://doi.org/10.1007/s00330-014-3114-0

M3 - Article

C2 - 24563179

SN - 0938-7994

VL - 24

SP - 1153

EP - 1165

JO - European Radiology

JF - European Radiology

IS - 5

ER -