NEW ALGORITHM FOR LYMPHOMA STAGING BASED ON WHOLE BODY DIFFUSION-WEIGHTED MAGNETIC RESONANCE IMAGING

Abstract

A prospective comparative study of the diagnostic efficiency of X-ray computed tomography (CT), ultrasound (US), bone marrow biopsy, osteoscintigraphy and a new safe diagnostic method – whole body diffusion-weighted magnetic resonance imaging (MRI-DWI) in staging lymphoma was conducted. We examined 158 adults including 68 with Hodgkin lymphoma and 90 with non-Hodgkin lymphoma. MRI-DWI demonstrated the highest diagnostic efficiency of lymphoid and bone marrow lesions. For the first time, indications for bone marrow biopsy in patients with lymphoma who underwent whole body MRI-DWI were determined. A new highly effective and safe lymphoma staging algorithm has been developed, including whole body MRI-DWI, US of the spleen, bone marrow biopsy (by indications). The developed algorithm increases a lymphoma staging accuracy with respect to CT without intravenous contrast by 23 %, with respect to CT with intravenous contrast by 17 %. The staging accuracy was 98 %. At the same time, X-ray and radioisotope radiation is not used, intravenous administration of contrast agents and radioactive isotopes is not required, the number of bone marrow biopsies is reduced by 72 %, and a cost of patient examination is reduced.