Whole-body diffusion-weighted magnetic resonance imaging (WB-DW-MRI) vs choline-positron emission tomography-computed tomography (choline-PET/CT) for selecting treatments in recurrent prostate cancer

2016 ◽  
Vol 19 (5) ◽  
pp. 553-561 ◽  
Author(s):  
A. J. Conde-Moreno ◽  
G. Herrando-Parreño ◽  
R. Muelas-Soria ◽  
J. Ferrer-Rebolleda ◽  
R. Broseta-Torres ◽  
...  
2020 ◽  
Vol 100 (6) ◽  
pp. 321-334
Author(s):  
S. A. Kharuzhyk ◽  
E. A. Zhavrid ◽  
A. V. Dzyuban ◽  
K. V. Poddubnyy ◽  
E. V. Sukolinskaya ◽  
...  

Objective – to compare the diagnostic efficiency of whole-body diffusion-weighted magnetic resonance imaging (DW-MRI) and positron emission tomography combined with computed tomography (PET/CT) in the staging of lymphomas.Material and methods. The prospective study enrolled 92 adult patients with Hodgkin's lymphoma or non-Hodgkin's lymphoma. Before treatment, all the patients underwent whole-body DW-MRI and PET/CT. The techniques were compared for their efficiency in diagnosing damage to lymph nodes (LNs) and organs and in determining the stage of lymphoma.Results. The sensitivity, specificity, and accuracy of DW-MRI in diagnosing a lesion in the enlarged LNs were 98.2%, 99.9%, and 99.3%, respectively; those of PET/CT were 99.4%, 100.0%, and 99.8%. ROC analysis showed that the efficiency of the techniques in diagnosing a lesion in the enlarged LNs did not differ (p>0.06). The sensitivity of DW-MRI and PET/CT in diagnosing a lesion in the unenlarged LNs was 77.8% and 88.1%, respectively (p<0.001). The sensitivity, specificity, and accuracy of DW-MRI in diagnosing lung damage were 73.3%, 98.7%, 94.6%; those of PET/CT were 86.7%, 98.7%, and 96.7%; those for the spleen were 54.8%, 98.3%, 83.3% and 100.0%, 100.0%, 100.0%; those for bone marrow (BM) were 87.1%, 96.4%, 93.0% and 64.5%, 87.3%, 79.1%,; those for all organs were 72.9%, 98.1%, 91.4% and 80.0%, 96.6%, 92.2%. The ROC analysis indicated that the efficiency of the techniques in diagnosing a lesion in the lung did not differ (p>0.3), that of PET/CT for the spleen was higher (p <0.0001); that of DW-MRI for BM was higher (p<0.0008); that for all organs did not differ (p>0.35). DW-MRI and PET/CT could determine the correct stage of lymphoma in the same number of patients (86%). The new lymphoma staging algorithm involving whole-body DW-MRI in all patients, PET/CT, and BM biopsies according to the established indications made it possible to determine the correct stage of lymphoma in 95% of patients.Conclusion. Whole-body DW-MRI has comparable efficiency to PET/CT in the staging of lymphoma. The new lymphoma staging algorithm based on whole-body DW-MRI is superior to PET/CT and PET/CT with BM biopsy.


2017 ◽  
Vol 35 (25) ◽  
pp. 2911-2918 ◽  
Author(s):  
Philippe Moreau ◽  
Michel Attal ◽  
Denis Caillot ◽  
Margaret Macro ◽  
Lionel Karlin ◽  
...  

Purpose Magnetic resonance imaging (MRI) and positron emission tomography–computed tomography (PET-CT) are important imaging techniques in multiple myeloma (MM). We conducted a prospective trial in patients with MM aimed at comparing MRI and PET-CT with respect to the detection of bone lesions at diagnosis and the prognostic value of the techniques. Patients and Methods One hundred thirty-four patients received a combination of lenalidomide, bortezomib, and dexamethasone (RVD) with or without autologous stem-cell transplantation, followed by lenalidomide maintenance. PET-CT and MRI were performed at diagnosis, after three cycles of RVD, and before maintenance therapy. The primary end point was the detection of bone lesions at diagnosis by MRI versus PET-CT. Secondary end points included the prognostic impact of MRI and PET-CT regarding progression-free (PFS) and overall survival (OS). Results At diagnosis, MRI results were positive in 127 of 134 patients (95%), and PET-CT results were positive in 122 of 134 patients (91%; P = .33). Normalization of MRI after three cycles of RVD and before maintenance was not predictive of PFS or OS. PET-CT became normal after three cycles of RVD in 32% of the patients with a positive evaluation at baseline, and PFS was improved in this group (30-month PFS, 78.7% v 56.8%, respectively). PET-CT normalization before maintenance was described in 62% of the patients who were positive at baseline. This was associated with better PFS and OS. Extramedullary disease at diagnosis was an independent prognostic factor for PFS and OS, whereas PET-CT normalization before maintenance was an independent prognostic factor for PFS. Conclusion There is no difference in the detection of bone lesions at diagnosis when comparing PET-CT and MRI. PET-CT is a powerful tool to evaluate the prognosis of de novo myeloma.


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