Whole-body FSE STIR MR imaging of lymphoma

PurposeTo evaluate the role of FSE STIR whole body MRI in diagnosis and initial staging of malignant lymphoma, and can FSE STIR whole body MRI replace conventional staging procedures including computed tomography and bone marrow biopsy in initial staging of lymphoma.Materials and methodsTwenty one newly diagnosed histologically proven lymphoma patients underwent whole body MR imaging and conventional staging procedures including computed tomography and bone marrow biopsy for initial staging of lymphoma using Modified Ann Arbor staging system. Both methods evaluated positive involvement by lymphoma to the nodal and extra-nodal sites including parenchymal organs, serosal cavities and bone marrow. The numbers of involved nodal and extra-nodal sites detected by both methods were compared, then agreement and disagreement between whole-body MRI and conventional procedures regarding lesions detection and staging according to the Ann Arbor staging system were calculated, along with binomial exact 95% confidence intervals (CIs).ResultsTwenty one patients had a total of 145 abnormalities. One hundred and twenty four were correctly diagnosed by conventional staging procedures, however, FSE STIR whole body MRI correctly diagnosed all the 144 abnormalities with 1 false negative and 3 false positive abnormalities with a total of detected abnormalities of 147 lesions. FSE STIR whole body MRI was significantly more accurate than conventional staging procedures in the diagnosis of positive lymphoma lesions [(99.3%; 95% CI: 95.6–100.0%) versus (85.5%; 95% CI: 78.5–90.6%)]. FSE STIR whole body MRI correctly staged 20 out of 21 patients, Kappa test 0.93 (P < 0.001) while conventional staging procedures correctly staged 17 and incorrectly staged 4 cases, Kappa test 0.74 (P < 0.001).ConclusionWhole body MR imaging can replace conventional staging procedures in the diagnosis and initial staging of malignant lymphoma as it offers a whole body overview of the lymphoma infiltration through the lymph node stations, parenchymal organs, serosal cavities and bone marrow.