Evaluation of Whole Body Diffusion Weighted Imaging in the Staging and Treatment Response of Lymphoma Compared With Fluoride-Oxyglucose (FDG) PET/CT as a Reference Standard

Tiffany Hennedige, David Chee Eng Ng, Miriam Tao, Richard Hong Hui Quek, Soon Thye Lim and Jin Wei Kwek

Evaluation of Whole Body Diffusion Weighted Imaging in the Staging and Treatment Response of Lymphoma Compared With Fluoride-Oxyglucose (FDG) PET/CT as a Reference Standard.

Positron emission tomography/computed tomography following administration of radiotracer 18F fluorodeoxyglucose is currently considered standard of practice for the management of lymphoma. The diagnostic sensitivity and specificity of PET/CT in the initial staging of intermediate or high grade non-Hodgkin
lymphoma has been found to approach 100%.

It provides metabolic information by way of a semiquantitative index, the standardized uptake value which
has been shown to be useful for determining disease prognosis and treatment response.

However, PET/CT is expensive, time-consuming, requires exposure to ionizing radiation and is not widely available
as it involves the use of a cyclotron. In addition, FDG is not entirely cancer-specific; brown fat, muscle tissue and other factors such as infection, inflammation and granulomatous disease can also demonstrate increased FDG uptake.

On the other hand, magnetic resonance imaging although expensive, does not involve exposure to ionizing radiation, is more widely available and provides excellent soft tissue contrast.

In addition, with rapidly progressive MRI techniques such as echo planar imaging
and parallel imaging techniques, whole body MRI examinations can be performed within an
acceptable time frame. However, large nodes may be reactive and small nodes can still harbor foci of disease.

Radiol Open J. 2017; 2(1): 17-25. doi: 10.17140/ROJ-2-114

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