Evaluation of diffusion-weighted imaging datasets for the assessment of disease activity in lymphoma patients

IF 3.3 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology Pub Date : 2025-09-16 DOI:10.1016/j.ejrad.2025.112423

Jennifer Haferkamp , Michal-Kamil Chodyla , Aydin Demircioglu , Kim M. Pabst , Kai Jannusch , Christine Hanoun , Lale Umutlu , Bastian von Tresckow , Benedikt M. Schaarschmidt , Johannes M. Ludwig , Johannes Grueneisen , Aleksandar Milosevic

{"title":"Evaluation of diffusion-weighted imaging datasets for the assessment of disease activity in lymphoma patients","authors":"Jennifer Haferkamp , Michal-Kamil Chodyla , Aydin Demircioglu , Kim M. Pabst , Kai Jannusch , Christine Hanoun , Lale Umutlu , Bastian von Tresckow , Benedikt M. Schaarschmidt , Johannes M. Ludwig , Johannes Grueneisen , Aleksandar Milosevic","doi":"10.1016/j.ejrad.2025.112423","DOIUrl":null,"url":null,"abstract":"<div><h3>Purpose</h3><div>To assess the clinical applicability of Diffusion Weighted Imaging (DWI) datasets as a radiation-free alternative to 18F-FDG PET for the evaluation of the vitality of lymphoma lesions.</div></div><div><h3>Material and Methods</h3><div>A total of 181 patients (mean age: 30.9 ± 19.1 years) with confirmed lymphoma underwent 258 whole-body 18F-FDG PET/MR examinations for primary staging (n = 98), as interim scan during treatment (n = 67), as a follow-up examination (n = 49) or in case of suspected recurrence (n = 44). In each examination, the metabolic activity using standardized uptake values (SUVs) of lymphoma manifestations was measured and disease activity was determined according to the Deauville five-point-scale. In addition, DWI-derived ADC-values as well as the size and volume of the lesions were determined. Correlations between the different quantitative parameters were assessed using Spearman‘s rank test to evaluate the applicability of DWI-data for the discrimination between vital and non-vital lymphoma lesions.</div></div><div><h3>Results</h3><div>A total of 745 lymphoma manifestations were analyzed, comprising 622 nodal and 123 extranodal lesions. Spearman’s rank correlation revealed a strong/good inverse correlation between the ADCmean (r = 0.83) or ADCmin (0.69) and the SUVs, whereas for the size (r = 0.41) and volume (r = 0.52) a poor/moderate association was found. Furthermore, lymphoma lesions with a Deauville score of 1–3 had significantly higher ADCmean and ADCmin values than lesions with a score of 4–5. ROC-Analysis revealed an area under the curve of 0.95 (ADCmean) or 0.91 (ADCmin) to discriminate lymphoma manifestations with a Deauville-score of 1–3 from lesions with a score of 4 or 5.</div></div><div><h3>Conclusion</h3><div>The present study demonstrates a strong association between metabolic activity and the cellularity of lymphomas. Furthermore, our results reveal a good performance of DWI-derived ADC values for the differentiation between vital and avital lymphoma lesions. Therefore, DWI-sequences should be considered as a promising radiation-free alternative to FDG-PET, especially for the assessment of indolent lymphoma subtypes with variable FDG-avidity.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"193 ","pages":"Article 112423"},"PeriodicalIF":3.3000,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Journal of Radiology","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0720048X25005091","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose

To assess the clinical applicability of Diffusion Weighted Imaging (DWI) datasets as a radiation-free alternative to 18F-FDG PET for the evaluation of the vitality of lymphoma lesions.

Material and Methods

A total of 181 patients (mean age: 30.9 ± 19.1 years) with confirmed lymphoma underwent 258 whole-body 18F-FDG PET/MR examinations for primary staging (n = 98), as interim scan during treatment (n = 67), as a follow-up examination (n = 49) or in case of suspected recurrence (n = 44). In each examination, the metabolic activity using standardized uptake values (SUVs) of lymphoma manifestations was measured and disease activity was determined according to the Deauville five-point-scale. In addition, DWI-derived ADC-values as well as the size and volume of the lesions were determined. Correlations between the different quantitative parameters were assessed using Spearman‘s rank test to evaluate the applicability of DWI-data for the discrimination between vital and non-vital lymphoma lesions.

Results

A total of 745 lymphoma manifestations were analyzed, comprising 622 nodal and 123 extranodal lesions. Spearman’s rank correlation revealed a strong/good inverse correlation between the ADCmean (r = 0.83) or ADCmin (0.69) and the SUVs, whereas for the size (r = 0.41) and volume (r = 0.52) a poor/moderate association was found. Furthermore, lymphoma lesions with a Deauville score of 1–3 had significantly higher ADCmean and ADCmin values than lesions with a score of 4–5. ROC-Analysis revealed an area under the curve of 0.95 (ADCmean) or 0.91 (ADCmin) to discriminate lymphoma manifestations with a Deauville-score of 1–3 from lesions with a score of 4 or 5.

Conclusion

The present study demonstrates a strong association between metabolic activity and the cellularity of lymphomas. Furthermore, our results reveal a good performance of DWI-derived ADC values for the differentiation between vital and avital lymphoma lesions. Therefore, DWI-sequences should be considered as a promising radiation-free alternative to FDG-PET, especially for the assessment of indolent lymphoma subtypes with variable FDG-avidity.

查看原文本刊更多论文

评估淋巴瘤患者疾病活动性的弥散加权成像数据集。

目的：评估扩散加权成像（DWI）数据集作为无辐射替代18F-FDG PET评估淋巴瘤病变活力的临床适用性。材料与方法：共有181例确诊淋巴瘤患者（平均年龄：30.9±19.1岁）接受了258次全身18F-FDG PET/MR检查，用于原发性分期（n = 98）、治疗期间中期扫描（n = 67）、随访检查（n = 49）或疑似复发时检查（n = 44）。在每次检查中，使用标准化摄取值（suv）测量淋巴瘤表现的代谢活性，并根据多维尔五分制确定疾病活动性。此外，还测定了dwi衍生的adc值以及病变的大小和体积。使用Spearman秩检验评估不同定量参数之间的相关性，以评估dwi数据在区分重要和非重要淋巴瘤病变方面的适用性。结果：共分析了745例淋巴瘤的表现，其中淋巴结病变622例，结外病变123例。Spearman秩相关显示ADCmean （r = 0.83）或ADCmin（0.69）与suv呈强/良好的负相关，而尺寸（r = 0.41）和体积（r = 0.52）呈弱/中度相关。此外，多维尔评分为1-3分的淋巴瘤病变的ADCmean和ADCmin值明显高于4-5分的病变。roc分析显示曲线下面积为0.95 （ADCmean）或0.91 （ADCmin）区分多维尔评分为1-3的淋巴瘤表现与4分或5分的病变。结论：本研究表明代谢活性与淋巴瘤细胞结构之间存在密切联系。此外，我们的研究结果显示，dwi衍生的ADC值在区分重要和重要淋巴瘤病变方面表现良好。因此，dwi序列应被视为FDG-PET的一种有前途的无辐射替代方法，特别是用于评估具有可变fdg亲和力的惰性淋巴瘤亚型。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

European Journal of Radiology 医学-核医学

CiteScore

6.70

自引率

3.00%

发文量

398

审稿时长

42 days

期刊介绍： European Journal of Radiology is an international journal which aims to communicate to its readers, state-of-the-art information on imaging developments in the form of high quality original research articles and timely reviews on current developments in the field. Its audience includes clinicians at all levels of training including radiology trainees, newly qualified imaging specialists and the experienced radiologist. Its aim is to inform efficient, appropriate and evidence-based imaging practice to the benefit of patients worldwide.