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Dynamic contrast-enhanced MRI improves accuracy for detecting focal splenic involvement in children and adolescents with Hodgkin disease

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Abstract

Background

Accurate assessment of splenic disease is important for staging Hodgkin lymphoma.

Objective

The purpose of this study was to assess T2-weighted imaging with and without dynamic contrast-enhanced (DCE) MRI for evaluation of splenic Hodgkin disease.

Materials and methods

Thirty-one children with Hodgkin lymphoma underwent whole-body T2-weighted MRI with supplementary DCE splenic imaging, and whole-body PET-CT before and following chemotherapy. Two experienced nuclear medicine physicians derived a PET-CT reference standard for splenic disease, augmented by follow-up imaging. Unaware of the PET-CT, two experienced radiologists independently evaluated MRI exercising a locked sequential read paradigm (T2-weighted then DCE review) and recorded the presence/absence of splenic disease at each stage. Performance of each radiologist was determined prior to and following review of DCE-MRI. Incorrect MRI findings were ascribed to reader (lesion present on MRI but missed by reader) or technical (lesion not present on MRI) error.

Results

Seven children had splenic disease. Sensitivity/specificity of both radiologists for the detection of splenic involvement using T2-weighted images alone was 57%/100% and increased to 100%/100% with DCE-MRI. There were three instances of technical error on T2-weighted imaging; all lesions were visible on DCE-MRI.

Conclusions

T2-weighted imaging when complemented by DCE-MRI imaging may improve evaluation of Hodgkin disease splenic involvement.

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Acknowledgments

This work was undertaken at the Comprehensive Biomedical Centre, University College Hospital London, which received a proportion of the funding from the National Institute for Health Research. The views expressed in this publication are those of the authors and not necessarily those of the UK Department of Health. The authors are grateful to the Royal College of Radiologists and the Radiological Research Trust for grants in support of this work.

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Authors and Affiliations

  1. Centre for Medical Imaging, University College London, 3rd Floor East Wing, 250 Euston Road, London, UK, NW1 2PG

    Shonit Punwani, King Kenneth Cheung, Nicholas Skipper, Stuart A. Taylor & Steve Halligan

  2. Department of Radiology, University College London Hospital, 235 Euston Road, London, UK, NW1 2BU

    Shonit Punwani, Nichola Bell, Stuart A. Taylor, Steve Halligan & Paul D. Humphries

  3. Department of Paediatrics, University College London Hospital, 235 Euston Road, London, UK, NW1 2BU

    Ananth Shankar & Stephen Daw

  4. Department of Medical Physics and Bioengineering, University College London, London, WC1E 6BT, UK

    Alan Bainbridge

  5. Institute of Nuclear Medicine, University College Hospital, 235 Euston Road, London, UK, NW1 2BU

    Ashley M. Groves, Sharon F. Hain & Simona Ben-Haim

Authors
  1. Shonit Punwani
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  2. King Kenneth Cheung
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  3. Nicholas Skipper
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  4. Nichola Bell
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  5. Alan Bainbridge
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  6. Stuart A. Taylor
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  7. Ashley M. Groves
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  8. Sharon F. Hain
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  9. Simona Ben-Haim
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  10. Ananth Shankar
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  11. Stephen Daw
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  12. Steve Halligan
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  13. Paul D. Humphries
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Corresponding author

Correspondence to Shonit Punwani.

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Punwani, S., Cheung, K.K., Skipper, N. et al. Dynamic contrast-enhanced MRI improves accuracy for detecting focal splenic involvement in children and adolescents with Hodgkin disease. Pediatr Radiol 43, 941–949 (2013). https://doi.org/10.1007/s00247-012-2616-7

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  • DOI: https://doi.org/10.1007/s00247-012-2616-7

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