<abstract xmlns="http://www.w3.org/1999/xhtml">

<sec><h3>Background</h3>
<p>The objective was to analyse if magnetic resonance imaging (MRI) can act as a non-radiation exposure surrogate for (18)F-Fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) in children with histologically confirmed Hodgkin lymphoma (HL) before treatment. This was done by analysing a potential correlation between apparent diffusion coefficient (ADC) in MRI and the maximum standardized uptake value (SUVmax) in FDG-PET/CT.</p>
</sec>
<sec><h3>Patients and methods</h3>
<p>Seventeen patients (six female, eleven male, median age: 16 years, range: 12–20 years) with histologically confirmed HL were retrospectively analysed. The patients underwent both MRI and (18)F-FDG PET/CT before the start of treatment. (18)F-FDG PET/CT data and correlating ADC maps in MRI were collected. For each HL-lesion two readers independently evaluated the SUVmax and correlating meanADC.</p>
</sec>
<sec><h3>Results</h3>
<p>The seventeen patients had a total of 72 evaluable lesions of HL and there was no significant difference in the number of lesions between male and female patients (median male: 15, range: 12–19 years, median female: 17 range: 12–18 years, p = 0.021). The mean duration between MRI and PET/CT was 5.9 ± 5.3 days. The inter-reader agreement as assessed by the intraclass correlation coefficient (ICC) was excellent (ICC = 0.98, 95% CI: 0.97–0.99). The correlated SUVmax and meanADC of all 17 patients (ROIs n = 72) showed a strong negative correlation of −0.75 (95% CI: −0.84, – −0.63, p = 0.001). Analysis revealed a difference in the correlations of the examination fields. The correlated SUVmax and meanADC showed a strong correlation at neck and thoracal examinations (neck: −0.83, 95% CI: −0.93, – −0.63, p &lt; 0.0001, thoracal: −0.82, 95% CI: −0.91, – −0.64, p &lt; 0.0001) and a fair correlation at abdominal examinations of −0.62 (95% CI: −0.83, – −0.28, p = 0.001).</p>
</sec>
<sec><h3>Conclusions</h3>
<p>SUVmax and meanADC showed a strong negative correlation in paediatric HL lesions. The assessment seemed robust according to inter-reader agreements. Our results suggest that ADC maps and meanADC have the potential to replace PET/CT in the analysis of disease activity in paediatric Hodgkin lymphoma patients. This may help reduce the number of PET/CT examinations and decrease radiation exposure to children.</p>
</sec>
</abstract>

Background
The objective was to analyse if magnetic resonance imaging (MRI) can act as a non-radiation exposure surrogate for (18)F-Fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) in children with histologically confirmed Hodgkin lymphoma (HL) before treatment. This was done by analysing a potential correlation between apparent diffusion coefficient (ADC) in MRI and the maximum standardized uptake value (SUVmax) in FDG-PET/CT.

Patients and methods
Seventeen patients (six female, eleven male, median age: 16 years, range: 12–20 years) with histologically confirmed HL were retrospectively analysed. The patients underwent both MRI and (18)F-FDG PET/CT before the start of treatment. (18)F-FDG PET/CT data and correlating ADC maps in MRI were collected. For each HL-lesion two readers independently evaluated the SUVmax and correlating meanADC.

Results
The seventeen patients had a total of 72 evaluable lesions of HL and there was no significant difference in the number of lesions between male and female patients (median male: 15, range: 12–19 years, median female: 17 range: 12–18 years, p = 0.021). The mean duration between MRI and PET/CT was 5.9 ± 5.3 days. The inter-reader agreement as assessed by the intraclass correlation coefficient (ICC) was excellent (ICC = 0.98, 95% CI: 0.97–0.99). The correlated SUVmax and meanADC of all 17 patients (ROIs n = 72) showed a strong negative correlation of −0.75 (95% CI: −0.84, – −0.63, p = 0.001). Analysis revealed a difference in the correlations of the examination fields. The correlated SUVmax and meanADC showed a strong correlation at neck and thoracal examinations (neck: −0.83, 95% CI: −0.93, – −0.63, p < 0.0001, thoracal: −0.82, 95% CI: −0.91, – −0.64, p < 0.0001) and a fair correlation at abdominal examinations of −0.62 (95% CI: −0.83, – −0.28, p = 0.001).

Conclusions
SUVmax and meanADC showed a strong negative correlation in paediatric HL lesions. The assessment seemed robust according to inter-reader agreements. Our results suggest that ADC maps and meanADC have the potential to replace PET/CT in the analysis of disease activity in paediatric Hodgkin lymphoma patients. This may help reduce the number of PET/CT examinations and decrease radiation exposure to children.

Correlation of mean apparent diffusion coefficient (ADC) and maximal standard uptake value (SUVmax) evaluated by diffusion-weighted MRI and 18F-FDG-PET/CT in children with Hodgkin lymphoma: a feasibility study

Department of Diagnostic and Interventional Radiology

University Hospital Frankfurt, Goethe University

Division of Paediatric Haematology and Oncology, Hospital for Children and Adolescents

Radiology and Oncology

This work is licensed under the Creative Commons Attribution 4.0 International License.

Background
The objective was to analyse if magnetic resonance imaging (MRI) can act as a non-radiation exposure surrogate for (18)F-Fluorodeoxyglucose (FDG)...

Correlation of mean apparent diffusion coefficient (ADC) and maximal standard uptake value (SUVmax) evaluated by diffusion-weighted MRI and 18F-FDG-PET/CT in children with Hodgkin lymphoma: a feasibility study

Article Category: Research Article

Published Online: Jun 21, 2023

Page range: 150 - 157

Received: Feb 02, 2023

Accepted: Mar 27, 2023

DOI: https://doi.org/10.2478/raon-2023-0021

Keywords
Hodgkin lymphoma, diffusion weighted imaging, apparent diffusion coefficient, MRI, PET/CT

© 2023 Nicolas Rosbach et al., published by Sciendo

This work is licensed under the Creative Commons Attribution 4.0 International License.

Correlation of mean apparent diffusion coefficient (ADC) and maximal standard uptake value (SUVmax) evaluated by diffusion-weighted MRI and 18F-FDG-PET/CT in children with Hodgkin lymphoma: a feasibility study

Article Category: Research Article

Published Online: Jun 21, 2023

Page range: 150 - 157

Received: Feb 02, 2023

Accepted: Mar 27, 2023

DOI: https://doi.org/10.2478/raon-2023-0021

KeywordsHodgkin lymphoma, diffusion weighted imaging, apparent diffusion coefficient, MRI, PET/CT

© 2023 Nicolas Rosbach et al., published by Sciendo

This work is licensed under the Creative Commons Attribution 4.0 International License.

Keywords
Hodgkin lymphoma, diffusion weighted imaging, apparent diffusion coefficient, MRI, PET/CT