Use of Magnetic Resonance Imaging in the Evaluation of Mediastinal and Systemic Disease in Lymphoma. A Systematic Review

The aim of this study is to assess the diagnostic value of magnetic resonance imaging (MRI), alone or combined with positron emission tomography (PET), for evaluation of mediastinal disease in lymphoma in comparison with PET/computed tomography (CT). Eighteen prospective studies with sample size ranging between 17 and 140 patients were included in this analysis. MRI, regardless of the sequence obtained, where used for the evaluation of lymphoma. Histopathology results and clinical or imaging follow-up were used as the reference standard. Studies were excluded if the sample size was less than 15 cases or if less than 15 lymph nodes assessment were presented. Papers not reporting sufficient data were also excluded. As compared to PET/CT, MRI proved to be an alternative to use in evaluation of mediastinal disease of lymphoma. MRI has high sensitivity and specificity for nodal and extranodal involvement in lymphoma and the agreement between MRI with the standard technique was high. The ALARA principle reinforces these findings because it is a radiation-free technique and its use is preferred in young population at risk of being subjected to several studies. MRI seems to be a promising and free-radiation alternative due to its high sensitivity and specificity, as well as its high level of agreement with the standard reference. This suggests that MRI could play a significant role in lymphoma study. El objetivo de este estudio es evaluar el valor diagnóstico de la resonancia magnética (RM), sola o combinada con la tomografía por emisión de positrones (PET), para la valoración de la afectación mediastínica en el linfoma en comparación con la tomografía computarizada (TC)/PET. Se incluyeron en el análisis 18 estudios prospectivos con un tamaño de muestra que oscilaba entre los 17 y los 140 pacientes. Se utilizó la resonancia magnética, independientemente de la secuencia obtenida para la evaluación del linfoma. Los resultados de histopatología y el seguimiento clínico o de imagen se utilizaron como estándar de referencia. Se excluyeron los estudios si el tamaño de la muestra era inferior a 15 casos, o si se presentaron evaluaciones de menos de 15 ganglios linfáticos. Los artículos que no proporcionaban datos suficientes también fueron excluidos. En comparación con PET/TC, la RM demostró ser una alternativa útil en la evaluación de la afectación mediastínica del linfoma. La RM tiene una alta sensibilidad y especificidad para detectar afectación nodal y extranodal en