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Cellular density evaluation for malignant lymphoma using equivalent cross-relaxation rate imaging - initial experience.

Nishiofuku H, Matsushima S, Inaba Y, Yamaura H, Sato Y, Morishima Y, Kichikawa K - Korean J Radiol (2010)

Bottom Line: Institutional Review Board approval was obtained and all patients provided informed consent.All patients underwent ECR imaging and the offset frequency was set at 7 ppm.The correlation coefficient between the ECR values and cellular density in ML was 0.88 (p = 0.001).

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Nara Medical University, Kashihara, Nara, Japan. nishiofukuhideyuki@yahoo.co.jp

ABSTRACT

Objective: Equivalent cross-relaxation rate (ECR) imaging is an MRI technique used to evaluate quantitatively a change in the protein-water interaction. We aimed to evaluate retrospectively the usefulness of ECR imaging for the histologic classification of malignant lymphoma (ML).

Materials and methods: Institutional Review Board approval was obtained and all patients provided informed consent. The study subjects included 15 patients with untreated ML who were histologically diagnosed with follicular lymphoma (FL; n = 8) or diffuse large B-cell lymphoma (DLBCL; n = 7). All patients underwent ECR imaging and the offset frequency was set at 7 ppm.

Results: The median ECR values were 71% (range; 60.7 to 75.5) in FL and 54% (50.8 to 59.4) in DLBCL (p = 0.001). The median cellular density was 1.5 +/- 0.17 x 10(6) / mm(2) in FL and 1.0 +/- 0.70 x 10(6) / mm(2) in DLBCL (p = 0.001). The correlation coefficient between the ECR values and cellular density in ML was 0.88 (p = 0.001). In FL and DLBCL, assuming ECR value cut-off points of 60%, both sensitivity and specificity were 100%.

Conclusion: A strong correlation between ECR and cellular density in ML is demonstrated and the ECR may be a useful technique to differentiate between FL and DLBCL.

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Equivalent cross-relaxation rate imaging at frequency offset of 7 ppm. For equivalent cross-relaxation rate imaging, color scale range was set from black to red (0-150).A. Lymph node swelling was seen in paraaortic region, measuring approximately 3×4 cm (white arrow). On equivalent cross-relaxation rate imaging, lymph nodes in follicular lymphoma are yellowish-green.B. Diffusion maximum intensity projection image in follicular lymphoma: enlarged lymph nodes showed high signal intensity.C. Fusion image of equivalent cross-relaxation rate imaging in follicular lymphoma. This area was measured as equivalent cross-relaxation rate value.D. Lymph node swelling is seen in paraaortic region, measuring approximately 4×6 cm (white arrow). Equivalent cross-relaxation rate imaging indicated that lymph nodes in diffuse large B-cell lymphoma are blue.E. Diffusion maximum intensity projection image for diffuse large B-cell lymphoma: enlarged lymph nodes showed high signal intensity.F. Fusion image of equivalent cross-relaxation rate imaging in diffuse large B-cell lymphoma. This area was measured as equivalent cross-relaxation rate value.
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Figure 1: Equivalent cross-relaxation rate imaging at frequency offset of 7 ppm. For equivalent cross-relaxation rate imaging, color scale range was set from black to red (0-150).A. Lymph node swelling was seen in paraaortic region, measuring approximately 3×4 cm (white arrow). On equivalent cross-relaxation rate imaging, lymph nodes in follicular lymphoma are yellowish-green.B. Diffusion maximum intensity projection image in follicular lymphoma: enlarged lymph nodes showed high signal intensity.C. Fusion image of equivalent cross-relaxation rate imaging in follicular lymphoma. This area was measured as equivalent cross-relaxation rate value.D. Lymph node swelling is seen in paraaortic region, measuring approximately 4×6 cm (white arrow). Equivalent cross-relaxation rate imaging indicated that lymph nodes in diffuse large B-cell lymphoma are blue.E. Diffusion maximum intensity projection image for diffuse large B-cell lymphoma: enlarged lymph nodes showed high signal intensity.F. Fusion image of equivalent cross-relaxation rate imaging in diffuse large B-cell lymphoma. This area was measured as equivalent cross-relaxation rate value.

Mentions: All tumor masses were detected on FST2WI, diffusion-weighted imaging and ECRI. A fusion image with FST2WI and ECRI was used to calculate the ECR value. The enlarged lymph node in FL was yellowish-green, whereas for DLBCL, it was blue. Therefore, the ECRI intensity in FL was higher than that in DLBCL (Fig. 1). Box plots of ECR data for FL and DLBCL indicate that the median ECR values were 71% (range; 60.7 to 75.5) in FL and 54% (50.8 to 59.4) in DLBCL (Fig. 2). A statistically significant difference was observed between FL and DLBCL (p = 0.001).


Cellular density evaluation for malignant lymphoma using equivalent cross-relaxation rate imaging - initial experience.

Nishiofuku H, Matsushima S, Inaba Y, Yamaura H, Sato Y, Morishima Y, Kichikawa K - Korean J Radiol (2010)

Equivalent cross-relaxation rate imaging at frequency offset of 7 ppm. For equivalent cross-relaxation rate imaging, color scale range was set from black to red (0-150).A. Lymph node swelling was seen in paraaortic region, measuring approximately 3×4 cm (white arrow). On equivalent cross-relaxation rate imaging, lymph nodes in follicular lymphoma are yellowish-green.B. Diffusion maximum intensity projection image in follicular lymphoma: enlarged lymph nodes showed high signal intensity.C. Fusion image of equivalent cross-relaxation rate imaging in follicular lymphoma. This area was measured as equivalent cross-relaxation rate value.D. Lymph node swelling is seen in paraaortic region, measuring approximately 4×6 cm (white arrow). Equivalent cross-relaxation rate imaging indicated that lymph nodes in diffuse large B-cell lymphoma are blue.E. Diffusion maximum intensity projection image for diffuse large B-cell lymphoma: enlarged lymph nodes showed high signal intensity.F. Fusion image of equivalent cross-relaxation rate imaging in diffuse large B-cell lymphoma. This area was measured as equivalent cross-relaxation rate value.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2864860&req=5

Figure 1: Equivalent cross-relaxation rate imaging at frequency offset of 7 ppm. For equivalent cross-relaxation rate imaging, color scale range was set from black to red (0-150).A. Lymph node swelling was seen in paraaortic region, measuring approximately 3×4 cm (white arrow). On equivalent cross-relaxation rate imaging, lymph nodes in follicular lymphoma are yellowish-green.B. Diffusion maximum intensity projection image in follicular lymphoma: enlarged lymph nodes showed high signal intensity.C. Fusion image of equivalent cross-relaxation rate imaging in follicular lymphoma. This area was measured as equivalent cross-relaxation rate value.D. Lymph node swelling is seen in paraaortic region, measuring approximately 4×6 cm (white arrow). Equivalent cross-relaxation rate imaging indicated that lymph nodes in diffuse large B-cell lymphoma are blue.E. Diffusion maximum intensity projection image for diffuse large B-cell lymphoma: enlarged lymph nodes showed high signal intensity.F. Fusion image of equivalent cross-relaxation rate imaging in diffuse large B-cell lymphoma. This area was measured as equivalent cross-relaxation rate value.
Mentions: All tumor masses were detected on FST2WI, diffusion-weighted imaging and ECRI. A fusion image with FST2WI and ECRI was used to calculate the ECR value. The enlarged lymph node in FL was yellowish-green, whereas for DLBCL, it was blue. Therefore, the ECRI intensity in FL was higher than that in DLBCL (Fig. 1). Box plots of ECR data for FL and DLBCL indicate that the median ECR values were 71% (range; 60.7 to 75.5) in FL and 54% (50.8 to 59.4) in DLBCL (Fig. 2). A statistically significant difference was observed between FL and DLBCL (p = 0.001).

Bottom Line: Institutional Review Board approval was obtained and all patients provided informed consent.All patients underwent ECR imaging and the offset frequency was set at 7 ppm.The correlation coefficient between the ECR values and cellular density in ML was 0.88 (p = 0.001).

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Nara Medical University, Kashihara, Nara, Japan. nishiofukuhideyuki@yahoo.co.jp

ABSTRACT

Objective: Equivalent cross-relaxation rate (ECR) imaging is an MRI technique used to evaluate quantitatively a change in the protein-water interaction. We aimed to evaluate retrospectively the usefulness of ECR imaging for the histologic classification of malignant lymphoma (ML).

Materials and methods: Institutional Review Board approval was obtained and all patients provided informed consent. The study subjects included 15 patients with untreated ML who were histologically diagnosed with follicular lymphoma (FL; n = 8) or diffuse large B-cell lymphoma (DLBCL; n = 7). All patients underwent ECR imaging and the offset frequency was set at 7 ppm.

Results: The median ECR values were 71% (range; 60.7 to 75.5) in FL and 54% (50.8 to 59.4) in DLBCL (p = 0.001). The median cellular density was 1.5 +/- 0.17 x 10(6) / mm(2) in FL and 1.0 +/- 0.70 x 10(6) / mm(2) in DLBCL (p = 0.001). The correlation coefficient between the ECR values and cellular density in ML was 0.88 (p = 0.001). In FL and DLBCL, assuming ECR value cut-off points of 60%, both sensitivity and specificity were 100%.

Conclusion: A strong correlation between ECR and cellular density in ML is demonstrated and the ECR may be a useful technique to differentiate between FL and DLBCL.

Show MeSH
Related in: MedlinePlus