Whole Body Magnetic Resonance Imaging for Staging Hodgkin Lymphoma in Adolescents

Abstract Background: Once a malignant lymphoma has been diag-nosed, the staging of the disease must be assessed, as this determines treatment planning and prognosis as well as monitoring the effect of therapy. Aim of Study: This study aimed at exploring the role of the whole body MRI (WB-MRI) as well as its drawbacks and limitations as an emerging whole body imaging modality and to compare between (WB-MRI) and 18F fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG-PET/CT), for staging adolescents' patients with patho-logically proven Hodgkin lymphoma. Material and Methods: This prospective study included 60 adolescents referred to the diagnostic radiology department with pathologically proven Hodgkin lymphoma. Their ages ranged from 12 to 18 years. Patients were seen at the radiology department from March 2017 to December 2020. History, clinical examination, conventional imaging (CT scan of the neck, chest, abdomen and pelvis) and bone marrow biopsy, which was considered the gold standard of the results were done. All patients underwent integrated 18F-FDG PET/CT then whole-body diffusion weighted imaging (DWI) within 2 days with no chemotherapy was given in-between the two examinations. Results: In our study, taking the biopsy results and/or combined clinical /radiological findings as a standard reference, a comparison between the overall results of 18F-FDG PET/CT and WB-MRI/DWIBS was performed. We found that PET-CT had significantly higher results in the assessment of Hodgkin Lymphoma patients with statistically higher sensi-tivity, specificity, accuracy, PPV & NPV (98.9%, 99.5%, 98.8%, 99.5% and 99.3%) compared to (84.6%, 92%, 88.8%, 92% and 91%) for DWIBS results, respectively. Conclusion: We concluded that 18F-FDG PET/CT remains a cornerstone in detecting Hodgkin lymphoma. WB-MRI/ DWIBS may provide a complementary tool for 18F-FDG PET CT especially for bone marrow evaluation rather than other infiltrates in Hodgkin lymphoma patients.