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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

Nicolas Rosbach
Nicolas Rosbach
, 
Sebastian Fischer
Sebastian Fischer
, 
Vitali Koch
Vitali Koch
, 
Thomas J. Vogl
Thomas J. Vogl
, 
Konrad Bochennek
Konrad Bochennek
, 
Thomas Lehrnbecher
Thomas Lehrnbecher
, 
Scherwin Mahmoudi
Scherwin Mahmoudi
, 
Leon Grünewald
Leon Grünewald
, 
Frank Grünwald
Frank Grünwald
 und 
Simon Bernatz
Simon Bernatz
   | 21. Juni 2023
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Article Category: Research Article
Online veröffentlicht: 21. Juni 2023
Seitenbereich: 150 - 157
Eingereicht: 02. Feb. 2023
Akzeptiert: 27. März 2023
DOI: https://doi.org/10.2478/raon-2023-0021
Schlüsselwörter
© 2023 Nicolas Rosbach et al., published by Sciendo
This work is licensed under the Creative Commons Attribution 4.0 International License.

FIGURE 1.

Flowchart for recruitment of study subjects according to the Standards for Reporting of Diagnostic Accuracy (STARD) studies.
Flowchart for recruitment of study subjects according to the Standards for Reporting of Diagnostic Accuracy (STARD) studies.

FIGURE 2.

MRI and FDG-PET/CT imaging of two Hodgkin lymphoma (HL) patients. Left side (A, B): 12yo patient with newly diagnosed HL, (A) MRI examination with thoracal apparent diffusion coefficient (ADC) map. (B) correlating FDG-PET/CT examination with a HL lesion and calculated SUVmax. right side (C, D): 9yo patient with newly diagnosed HL, (C) MRI examination with neck ADC map. (D) correlating FDG-PET/CT examination with a HL lesion and calculated SUVmax.
MRI and FDG-PET/CT imaging of two Hodgkin lymphoma (HL) patients. Left side (A, B): 12yo patient with newly diagnosed HL, (A) MRI examination with thoracal apparent diffusion coefficient (ADC) map. (B) correlating FDG-PET/CT examination with a HL lesion and calculated SUVmax. right side (C, D): 9yo patient with newly diagnosed HL, (C) MRI examination with neck ADC map. (D) correlating FDG-PET/CT examination with a HL lesion and calculated SUVmax.

FIGURE 3.

Correlation of SUVmax and mean apparent diffusion coefficient (ADC). The calculated meanADC of the MRI examinations show a strong inverse correlation with the correlating SUVmax of the FDG-PET/CT examinations.
Correlation of SUVmax and mean apparent diffusion coefficient (ADC). The calculated meanADC of the MRI examinations show a strong inverse correlation with the correlating SUVmax of the FDG-PET/CT examinations.

FIGURE 4.

Neck imaging: correlation of SUVmax and mean apparent diffusion coefficient (ADC). The calculated meanADC of the MRI examinations show a strong inverse correlation with the correlating SUVmax of the FDG-PET/CT examinations.
Neck imaging: correlation of SUVmax and mean apparent diffusion coefficient (ADC). The calculated meanADC of the MRI examinations show a strong inverse correlation with the correlating SUVmax of the FDG-PET/CT examinations.

FIGURE 5.

Thoracal imaging: correlation of SUVmax and mean apparent diffusion coefficient (ADC). The calculated meanADC of the MRI examinations show a strong inverse correlation with the correlating SUVmax of the FDG-PET/CT examinations.
Thoracal imaging: correlation of SUVmax and mean apparent diffusion coefficient (ADC). The calculated meanADC of the MRI examinations show a strong inverse correlation with the correlating SUVmax of the FDG-PET/CT examinations.

FIGURE 6.

Abdominal imaging: correlation of SUVmax and meanADC. The calculated meanADC of the MRI examinations show a fair inverse correlation with the correlating SUVmax of the FDG-PET/CT examinations.
Abdominal imaging: correlation of SUVmax and meanADC. The calculated meanADC of the MRI examinations show a fair inverse correlation with the correlating SUVmax of the FDG-PET/CT examinations.

Magnetic resonance imaging sequences

Sequence Orientation Body part
T2w-TIRM in transversal orientation transversal neck
T1w-TSE (fat suppressed, +/− contrast media) transversal neck
T1w-TSE (no fat suppression, with substraction, +/− contrast media) coronal neck
DWI (b-values: 50, 200, 800) transversal neck, body
T2w-HASTE coronal, sagittal and transversal body
T1w-VIBE (with fat suppression) without breath-hold-imaging +/− contrast media transversal body

Patient characteristics and classifications

Variable Retrospective cohort of patients diagnosed with Hodgkin lymphoma; baseline features
No. of patients 17
Median age (SD), years 15.8 (2.2)
Sex
  Male 11 (65%)
  Female 6 (35%)
Lugano classification
  1 3 (18%)
  2 6 (35%)
  3 4 (23%)
  4 4 (23%)
Hodgkin lymphoma subtypes (WHO classification)
  Nodular sclerosis 9 (52%)
  Mixed cellularity 5 (29%)
  Lymphocyte rich 2 (12%)
  Lymphocyte depleted 1 (6%)

Radiation exposure and examination time

Modality CTDI [mGy] DLP [mGy*cm] Examination time [min]
Mean (SD) Range Mean (SD) Range Mean (SD) Range
FDG-PET/CT 2.2 (0.8) 1.2–4.1 215.1 (92.1) 93.9–410.2 28 (8:26)1 20–49
MRI
  Neck 19:45 (3:41) 17:21–24:47
  Thorax 09:23 (2:12) 08:01–10:29
  Abdomen 09:23 (2:59) 07:32–12:21
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