Chen Yunbin MD, Presenter: Nothing to Disclose

Zhong Jing MS, Abstract Co-Author: Nothing to Disclose

To investigate WB-DWI's clinical application in the early assessment of chemotherapeutic effects of malignant lymphoma.

15 patients with pathologically diagnosed malignant lymphoma which received complete standard chemotherapy were given WB-DWI scans.Images were acquired on a 1.5 Tesla MRI system (GE Healthcare, HDMR EXCITE III, WI, USA).with b value0,800 s/mm2,using a short TI inversion-reversion recovery diffusion weighted echo-planar imaging (STIR-DW-EPI) sequence.The patients were placed in a feet first supine position, scanned across six stations continuously covering the entire body from the head to the feet, under normal breathing, using built in-body coil.All patients received WB-DWI scan during pre-treatment, early-treatment and post-treatment stages of chemotherapy. The largest diameters and ADC values of the lesions during the 3 stages were measured and analysed statistically.

43 nodal and extranodal lesions detected by conventional methods were visualized clearly on the map of WB-DWI. Using the RECIST criteria for clinical efficacy of solid tumor, all patients showed effective treatment (CR or PR) after complete 4 or 6 cycles of chemotherapy. In the early-treatment stage, the morphological changes were not obvious(the reconstructed 3D-MIP imaging). None of the reduce rates of the largest diameters according to the diagnostic criteria reached diagnosis standard (30%). Some lesions even had no morphologic changes at all at this stage, which waited until later chemotherapy cycles to show significant morphology changes(Fig.1~3). Average ADC values in pre-treatment, early-treatment and post-treatment scans were 0.8517 ± 0.4107 × 10-3 mm2 / s, 1.1496 ± 0.5119 × 10-3 mm2 / s and 1.5797 ± 0.5933 × 10-3 mm2 / s respectively, showing a incremental trend(Fig.4~9). Variance analysis of repeated measures design showed that there was significant difference in ADC values for each time point (P <0.001). Significant change in ADC values happened at a much earlier stages than morphological changes, providing early clues on the treatment effects of chemotherapy.

WB-DWI is a useful tool with promising clinical value in the assessment of the chemotherapy effects in lymphoma,especially in the early stage.

WB-DWI is a useful tool with promising clinical value in the early assessment of the chemotherapy effects in lymphoma.

Yunbin, C, Jing, Z, The Clinical Application of Magnetic Resonance Whole Body Diffusion Weighted Imaging in the Early Assessment of Chemotherapeutic Effect in Lymphoma.  Radiological Society of North America 2009 Scientific Assembly and Annual Meeting, November 29 - December 4, 2009 ,Chicago IL. http://archive.rsna.org/2009/8013696.html