ISSN: 1899-0967
Polish Journal of Radiology
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2018
vol. 83
 
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abstract:
Original paper

Application of the apparent diffusion coefficient in magnetic resonance imaging in an assessment of the early response to treatment in Hodgkin’s and non-Hodgkin’s lymphoma – pilot study

Mateusz Patyk, Jacek Kwiatkowski, Aleksander Pawluś, Daniel Hołownia, Kinga Szymańska, Rafał Mazur, Jurand Silicki, Roman Badowski, Dąbrówka Sokołowska-Dąbek, Małgorzata Kuliszkiewicz-Janus, Urszula Zaleska-Dorobisz

© Pol J Radiol 2018; 83: e210-e214
Online publish date: 2018/05/12
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Purpose
Lymphoproliferative neoplasms are the largest and most frequently diagnosed entities in the group of haema­tological malignancies. The aim of the study was to assess whether apparent diffusion coefficient (ADC) measured on the first day of the second cycle of chemotherapy could be a predictor of prognosis and of the final treatment’s outcome.

Material and methods
The study included 27 patients with diagnosed Hodgkin’s and non-Hodgkin’s lymphoma, who had magnetic resonance (MR) performed with diffusion weighted imaging/apparent diffusion coefficient (DWI/ADC) before and on the first day of the second cycle of chemotherapy. Imaging was performed using a 1.5 T MR scanner. ADC was measured in lymphoma infiltration in the area of the lowest signal in the ADC map and the highest signal on β 800 images in post-treatment study. After that, the corresponding area was determined in a pre-treatment study and an ADC value was measured.

Results
The difference between ADC values in pre-treatment (ADC = 720 mm2/s) and post-treatment (ADC = 1059 mm2/s) studies was statistically significant (p < 0.001). Cutoff values for estimating response to treatment were established at the level of ADC 1080 mm2/s, and ADC to muscle ratio at 0.82 in post-treatment study. Patients with ADC > 752 mm2/s before treatment manifested lower probability of progression than patients with ADC < 752 mm2/s.

Conclusions
ADC measurement’s before treatment and on the first day of the second cycle of chemotherapy can be used as a prognostic marker in lymphoma therapy. ADC values lower than 1080 mm2/s and an increase of the ratio after the treatment can be considered as a marker of disease progression.

keywords:

lymphoma, Hodgkin’s lymphoma, magnetic resonance imaging, diffusion MRI

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