Whole-Body Diffusion-weighted MR Imaging of Iron Deposits in Hodgkin, Follicular, and Diffuse Large B-Cell Lymphoma
Purpose To analyze the frequency and distribution of low-signal-intensity regions (LSIRs) in lymphoma lesions and to compare these to fluorodeoxyglucose (FDG) uptake and biologic markers of inflammation. Materials and Methods The authors analyzed 61 untreated patients with a bulky lymphoma (at least...
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creator | Cottereau, Anne-Ségolène Mulé, Sébastien Lin, Chieh Belhadj, Karim Vignaud, Alexandre Copie-Bergman, Christiane Boyez, Alice Zerbib, Pierre Tacher, Vania Scherman, Elodie Haioun, Corinne Luciani, Alain Itti, Emmanuel Rahmouni, Alain |
description | Purpose To analyze the frequency and distribution of low-signal-intensity regions (LSIRs) in lymphoma lesions and to compare these to fluorodeoxyglucose (FDG) uptake and biologic markers of inflammation. Materials and Methods The authors analyzed 61 untreated patients with a bulky lymphoma (at least one tumor mass ≥7 cm in diameter). When a LSIR within tumor lesions was detected on diffusion-weighted images obtained with a b value of 50 sec/mm
, a T2-weighted gradient-echo (GRE) sequence was performed and calcifications were searched for with computed tomography (CT). In two patients, Perls staining was performed on tissue samples from the LSIR. LSIRs were compared with biologic inflammatory parameters and baseline FDG positon emission tomography (PET)/CT parameters (maximum standardized uptake value [SUV
], total metabolic tumor volume [TMTV]). Results LSIRs were detected in 22 patients and corresponded to signal void on GRE images; one LSIR was due to calcifications, and three LSIRS were due to a recent biopsy. In 18 patients, LSIRs appeared to be related to focal iron deposits; this was proven with Perls staining in two patients. The LSIRs presumed to be due to iron deposits were found mostly in patients with aggressive lymphoma (nine of 26 patients with Hodgkin lymphoma and eight of 20 patients with diffuse large B-cell lymphoma vs one of 15 patients with follicular lymphoma; P = .047) and with advanced stage disease (15 of 18 patients). LSIRS were observed in spleen (n = 14), liver (n = 3), and nodal (n = 8) lesions and corresponded to foci FDG uptake, with mean SUV
of 9.8, 6.7, and 16.2, respectively. These patients had significantly higher serum levels of C-reactive protein, α
-globulin, and α
-globulin and more frequently had microcytic anemia than those without such deposits (P = .0072, P = .003, P = .0068, and P < .0001, respectively). They also had a significantly higher TMTV (P = .0055) and higher levels of spleen involvement (P < .0001). Conclusion LSIRs due to focal iron deposits are detected in lymphoma lesions and are associated with a more pronounced biologic inflammatory syndrome.
RSNA, 2017 Online supplemental material is available for this article. |
doi_str_mv | 10.1148/radiol.2017170599 |
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fullrecord | <record><control><sourceid>proquest_hal_p</sourceid><recordid>TN_cdi_hal_primary_oai_HAL_hal_04395846v1</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1948763106</sourcerecordid><originalsourceid>FETCH-LOGICAL-c335t-9fbeedd98a79443fe08c535b9cdbf170a512120b5a88bebf9555c0cca5e5c78a3</originalsourceid><addsrcrecordid>eNpFkV1P2zAUhi20CTrYD-AG-XJIBHziuLEvoYy1UiYktGmXluOP1JsTF7sB9d8vqB27OtLR8z46Ry9C50CuASp-k5TxMVyXBGqoCRPiCM2AlXUBFNgHNCOE0oJXIE7Qp5x_EwIV4_UxOim54Awom6H8ax2DLe6i2eF779yYfRyKV-u79dYa_P0Jr3rV-aHD0eFVigO-t5uY_TZjP-BlNN0fP1zhhxiC12NQ6QqrwRxUFjcqdRbfFQsbAm52_WYde3WGPjoVsv18mKfo58PXH4tl0Tx-Wy1um0JTyraFcK21xgiualFV1FnCNaOsFdq0bvpXMSihJC1TnLe2dYIxponWilmma67oKbrce9cqyE3yvUo7GZWXy9tGvu1IRQXj1fwFJvbLnt2k-DzavJW9z3q6Wg02jlmCqHg9p0DmEwp7VKeYc7Lu3Q1EvvUi973I_71MmYuDfmx7a94T_4qgfwHIRIms</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1948763106</pqid></control><display><type>article</type><title>Whole-Body Diffusion-weighted MR Imaging of Iron Deposits in Hodgkin, Follicular, and Diffuse Large B-Cell Lymphoma</title><source>MEDLINE</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><creator>Cottereau, Anne-Ségolène ; Mulé, Sébastien ; Lin, Chieh ; Belhadj, Karim ; Vignaud, Alexandre ; Copie-Bergman, Christiane ; Boyez, Alice ; Zerbib, Pierre ; Tacher, Vania ; Scherman, Elodie ; Haioun, Corinne ; Luciani, Alain ; Itti, Emmanuel ; Rahmouni, Alain</creator><creatorcontrib>Cottereau, Anne-Ségolène ; Mulé, Sébastien ; Lin, Chieh ; Belhadj, Karim ; Vignaud, Alexandre ; Copie-Bergman, Christiane ; Boyez, Alice ; Zerbib, Pierre ; Tacher, Vania ; Scherman, Elodie ; Haioun, Corinne ; Luciani, Alain ; Itti, Emmanuel ; Rahmouni, Alain</creatorcontrib><description>Purpose To analyze the frequency and distribution of low-signal-intensity regions (LSIRs) in lymphoma lesions and to compare these to fluorodeoxyglucose (FDG) uptake and biologic markers of inflammation. Materials and Methods The authors analyzed 61 untreated patients with a bulky lymphoma (at least one tumor mass ≥7 cm in diameter). When a LSIR within tumor lesions was detected on diffusion-weighted images obtained with a b value of 50 sec/mm
, a T2-weighted gradient-echo (GRE) sequence was performed and calcifications were searched for with computed tomography (CT). In two patients, Perls staining was performed on tissue samples from the LSIR. LSIRs were compared with biologic inflammatory parameters and baseline FDG positon emission tomography (PET)/CT parameters (maximum standardized uptake value [SUV
], total metabolic tumor volume [TMTV]). Results LSIRs were detected in 22 patients and corresponded to signal void on GRE images; one LSIR was due to calcifications, and three LSIRS were due to a recent biopsy. In 18 patients, LSIRs appeared to be related to focal iron deposits; this was proven with Perls staining in two patients. The LSIRs presumed to be due to iron deposits were found mostly in patients with aggressive lymphoma (nine of 26 patients with Hodgkin lymphoma and eight of 20 patients with diffuse large B-cell lymphoma vs one of 15 patients with follicular lymphoma; P = .047) and with advanced stage disease (15 of 18 patients). LSIRS were observed in spleen (n = 14), liver (n = 3), and nodal (n = 8) lesions and corresponded to foci FDG uptake, with mean SUV
of 9.8, 6.7, and 16.2, respectively. These patients had significantly higher serum levels of C-reactive protein, α
-globulin, and α
-globulin and more frequently had microcytic anemia than those without such deposits (P = .0072, P = .003, P = .0068, and P < .0001, respectively). They also had a significantly higher TMTV (P = .0055) and higher levels of spleen involvement (P < .0001). Conclusion LSIRs due to focal iron deposits are detected in lymphoma lesions and are associated with a more pronounced biologic inflammatory syndrome.
RSNA, 2017 Online supplemental material is available for this article.</description><identifier>ISSN: 0033-8419</identifier><identifier>EISSN: 1527-1315</identifier><identifier>DOI: 10.1148/radiol.2017170599</identifier><identifier>PMID: 28985135</identifier><language>eng</language><publisher>United States: Radiological Society of North America</publisher><subject>Adolescent ; Adult ; Aged ; Biomarkers - metabolism ; Diffusion Magnetic Resonance Imaging ; Female ; Fluorodeoxyglucose F18 - pharmacokinetics ; Hodgkin Disease - pathology ; Humans ; Inflammation - metabolism ; Inflammation - pathology ; Iron - metabolism ; Life Sciences ; Lymph Nodes - metabolism ; Lymphoma, Follicular - pathology ; Lymphoma, Large B-Cell, Diffuse - pathology ; Male ; Middle Aged ; Multimodal Imaging ; Positron Emission Tomography Computed Tomography ; Prospective Studies ; Radiopharmaceuticals - pharmacokinetics ; Young Adult</subject><ispartof>Radiology, 2018-02, Vol.286 (2), p.560-567</ispartof><rights>Distributed under a Creative Commons Attribution 4.0 International License</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c335t-9fbeedd98a79443fe08c535b9cdbf170a512120b5a88bebf9555c0cca5e5c78a3</citedby><cites>FETCH-LOGICAL-c335t-9fbeedd98a79443fe08c535b9cdbf170a512120b5a88bebf9555c0cca5e5c78a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28985135$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://hal.u-pec.fr/hal-04395846$$DView record in HAL$$Hfree_for_read</backlink></links><search><creatorcontrib>Cottereau, Anne-Ségolène</creatorcontrib><creatorcontrib>Mulé, Sébastien</creatorcontrib><creatorcontrib>Lin, Chieh</creatorcontrib><creatorcontrib>Belhadj, Karim</creatorcontrib><creatorcontrib>Vignaud, Alexandre</creatorcontrib><creatorcontrib>Copie-Bergman, Christiane</creatorcontrib><creatorcontrib>Boyez, Alice</creatorcontrib><creatorcontrib>Zerbib, Pierre</creatorcontrib><creatorcontrib>Tacher, Vania</creatorcontrib><creatorcontrib>Scherman, Elodie</creatorcontrib><creatorcontrib>Haioun, Corinne</creatorcontrib><creatorcontrib>Luciani, Alain</creatorcontrib><creatorcontrib>Itti, Emmanuel</creatorcontrib><creatorcontrib>Rahmouni, Alain</creatorcontrib><title>Whole-Body Diffusion-weighted MR Imaging of Iron Deposits in Hodgkin, Follicular, and Diffuse Large B-Cell Lymphoma</title><title>Radiology</title><addtitle>Radiology</addtitle><description>Purpose To analyze the frequency and distribution of low-signal-intensity regions (LSIRs) in lymphoma lesions and to compare these to fluorodeoxyglucose (FDG) uptake and biologic markers of inflammation. Materials and Methods The authors analyzed 61 untreated patients with a bulky lymphoma (at least one tumor mass ≥7 cm in diameter). When a LSIR within tumor lesions was detected on diffusion-weighted images obtained with a b value of 50 sec/mm
, a T2-weighted gradient-echo (GRE) sequence was performed and calcifications were searched for with computed tomography (CT). In two patients, Perls staining was performed on tissue samples from the LSIR. LSIRs were compared with biologic inflammatory parameters and baseline FDG positon emission tomography (PET)/CT parameters (maximum standardized uptake value [SUV
], total metabolic tumor volume [TMTV]). Results LSIRs were detected in 22 patients and corresponded to signal void on GRE images; one LSIR was due to calcifications, and three LSIRS were due to a recent biopsy. In 18 patients, LSIRs appeared to be related to focal iron deposits; this was proven with Perls staining in two patients. The LSIRs presumed to be due to iron deposits were found mostly in patients with aggressive lymphoma (nine of 26 patients with Hodgkin lymphoma and eight of 20 patients with diffuse large B-cell lymphoma vs one of 15 patients with follicular lymphoma; P = .047) and with advanced stage disease (15 of 18 patients). LSIRS were observed in spleen (n = 14), liver (n = 3), and nodal (n = 8) lesions and corresponded to foci FDG uptake, with mean SUV
of 9.8, 6.7, and 16.2, respectively. These patients had significantly higher serum levels of C-reactive protein, α
-globulin, and α
-globulin and more frequently had microcytic anemia than those without such deposits (P = .0072, P = .003, P = .0068, and P < .0001, respectively). They also had a significantly higher TMTV (P = .0055) and higher levels of spleen involvement (P < .0001). Conclusion LSIRs due to focal iron deposits are detected in lymphoma lesions and are associated with a more pronounced biologic inflammatory syndrome.
RSNA, 2017 Online supplemental material is available for this article.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Biomarkers - metabolism</subject><subject>Diffusion Magnetic Resonance Imaging</subject><subject>Female</subject><subject>Fluorodeoxyglucose F18 - pharmacokinetics</subject><subject>Hodgkin Disease - pathology</subject><subject>Humans</subject><subject>Inflammation - metabolism</subject><subject>Inflammation - pathology</subject><subject>Iron - metabolism</subject><subject>Life Sciences</subject><subject>Lymph Nodes - metabolism</subject><subject>Lymphoma, Follicular - pathology</subject><subject>Lymphoma, Large B-Cell, Diffuse - pathology</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Multimodal Imaging</subject><subject>Positron Emission Tomography Computed Tomography</subject><subject>Prospective Studies</subject><subject>Radiopharmaceuticals - pharmacokinetics</subject><subject>Young Adult</subject><issn>0033-8419</issn><issn>1527-1315</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFkV1P2zAUhi20CTrYD-AG-XJIBHziuLEvoYy1UiYktGmXluOP1JsTF7sB9d8vqB27OtLR8z46Ry9C50CuASp-k5TxMVyXBGqoCRPiCM2AlXUBFNgHNCOE0oJXIE7Qp5x_EwIV4_UxOim54Awom6H8ax2DLe6i2eF779yYfRyKV-u79dYa_P0Jr3rV-aHD0eFVigO-t5uY_TZjP-BlNN0fP1zhhxiC12NQ6QqrwRxUFjcqdRbfFQsbAm52_WYde3WGPjoVsv18mKfo58PXH4tl0Tx-Wy1um0JTyraFcK21xgiualFV1FnCNaOsFdq0bvpXMSihJC1TnLe2dYIxponWilmma67oKbrce9cqyE3yvUo7GZWXy9tGvu1IRQXj1fwFJvbLnt2k-DzavJW9z3q6Wg02jlmCqHg9p0DmEwp7VKeYc7Lu3Q1EvvUi973I_71MmYuDfmx7a94T_4qgfwHIRIms</recordid><startdate>201802</startdate><enddate>201802</enddate><creator>Cottereau, Anne-Ségolène</creator><creator>Mulé, Sébastien</creator><creator>Lin, Chieh</creator><creator>Belhadj, Karim</creator><creator>Vignaud, Alexandre</creator><creator>Copie-Bergman, Christiane</creator><creator>Boyez, Alice</creator><creator>Zerbib, Pierre</creator><creator>Tacher, Vania</creator><creator>Scherman, Elodie</creator><creator>Haioun, Corinne</creator><creator>Luciani, Alain</creator><creator>Itti, Emmanuel</creator><creator>Rahmouni, Alain</creator><general>Radiological Society of North America</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>1XC</scope></search><sort><creationdate>201802</creationdate><title>Whole-Body Diffusion-weighted MR Imaging of Iron Deposits in Hodgkin, Follicular, and Diffuse Large B-Cell Lymphoma</title><author>Cottereau, Anne-Ségolène ; Mulé, Sébastien ; Lin, Chieh ; Belhadj, Karim ; Vignaud, Alexandre ; Copie-Bergman, Christiane ; Boyez, Alice ; Zerbib, Pierre ; Tacher, Vania ; Scherman, Elodie ; Haioun, Corinne ; Luciani, Alain ; Itti, Emmanuel ; Rahmouni, Alain</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c335t-9fbeedd98a79443fe08c535b9cdbf170a512120b5a88bebf9555c0cca5e5c78a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Biomarkers - metabolism</topic><topic>Diffusion Magnetic Resonance Imaging</topic><topic>Female</topic><topic>Fluorodeoxyglucose F18 - pharmacokinetics</topic><topic>Hodgkin Disease - pathology</topic><topic>Humans</topic><topic>Inflammation - metabolism</topic><topic>Inflammation - pathology</topic><topic>Iron - metabolism</topic><topic>Life Sciences</topic><topic>Lymph Nodes - metabolism</topic><topic>Lymphoma, Follicular - pathology</topic><topic>Lymphoma, Large B-Cell, Diffuse - pathology</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Multimodal Imaging</topic><topic>Positron Emission Tomography Computed Tomography</topic><topic>Prospective Studies</topic><topic>Radiopharmaceuticals - pharmacokinetics</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Cottereau, Anne-Ségolène</creatorcontrib><creatorcontrib>Mulé, Sébastien</creatorcontrib><creatorcontrib>Lin, Chieh</creatorcontrib><creatorcontrib>Belhadj, Karim</creatorcontrib><creatorcontrib>Vignaud, Alexandre</creatorcontrib><creatorcontrib>Copie-Bergman, Christiane</creatorcontrib><creatorcontrib>Boyez, Alice</creatorcontrib><creatorcontrib>Zerbib, Pierre</creatorcontrib><creatorcontrib>Tacher, Vania</creatorcontrib><creatorcontrib>Scherman, Elodie</creatorcontrib><creatorcontrib>Haioun, Corinne</creatorcontrib><creatorcontrib>Luciani, Alain</creatorcontrib><creatorcontrib>Itti, Emmanuel</creatorcontrib><creatorcontrib>Rahmouni, Alain</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>Hyper Article en Ligne (HAL)</collection><jtitle>Radiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Cottereau, Anne-Ségolène</au><au>Mulé, Sébastien</au><au>Lin, Chieh</au><au>Belhadj, Karim</au><au>Vignaud, Alexandre</au><au>Copie-Bergman, Christiane</au><au>Boyez, Alice</au><au>Zerbib, Pierre</au><au>Tacher, Vania</au><au>Scherman, Elodie</au><au>Haioun, Corinne</au><au>Luciani, Alain</au><au>Itti, Emmanuel</au><au>Rahmouni, Alain</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Whole-Body Diffusion-weighted MR Imaging of Iron Deposits in Hodgkin, Follicular, and Diffuse Large B-Cell Lymphoma</atitle><jtitle>Radiology</jtitle><addtitle>Radiology</addtitle><date>2018-02</date><risdate>2018</risdate><volume>286</volume><issue>2</issue><spage>560</spage><epage>567</epage><pages>560-567</pages><issn>0033-8419</issn><eissn>1527-1315</eissn><abstract>Purpose To analyze the frequency and distribution of low-signal-intensity regions (LSIRs) in lymphoma lesions and to compare these to fluorodeoxyglucose (FDG) uptake and biologic markers of inflammation. Materials and Methods The authors analyzed 61 untreated patients with a bulky lymphoma (at least one tumor mass ≥7 cm in diameter). When a LSIR within tumor lesions was detected on diffusion-weighted images obtained with a b value of 50 sec/mm
, a T2-weighted gradient-echo (GRE) sequence was performed and calcifications were searched for with computed tomography (CT). In two patients, Perls staining was performed on tissue samples from the LSIR. LSIRs were compared with biologic inflammatory parameters and baseline FDG positon emission tomography (PET)/CT parameters (maximum standardized uptake value [SUV
], total metabolic tumor volume [TMTV]). Results LSIRs were detected in 22 patients and corresponded to signal void on GRE images; one LSIR was due to calcifications, and three LSIRS were due to a recent biopsy. In 18 patients, LSIRs appeared to be related to focal iron deposits; this was proven with Perls staining in two patients. The LSIRs presumed to be due to iron deposits were found mostly in patients with aggressive lymphoma (nine of 26 patients with Hodgkin lymphoma and eight of 20 patients with diffuse large B-cell lymphoma vs one of 15 patients with follicular lymphoma; P = .047) and with advanced stage disease (15 of 18 patients). LSIRS were observed in spleen (n = 14), liver (n = 3), and nodal (n = 8) lesions and corresponded to foci FDG uptake, with mean SUV
of 9.8, 6.7, and 16.2, respectively. These patients had significantly higher serum levels of C-reactive protein, α
-globulin, and α
-globulin and more frequently had microcytic anemia than those without such deposits (P = .0072, P = .003, P = .0068, and P < .0001, respectively). They also had a significantly higher TMTV (P = .0055) and higher levels of spleen involvement (P < .0001). Conclusion LSIRs due to focal iron deposits are detected in lymphoma lesions and are associated with a more pronounced biologic inflammatory syndrome.
RSNA, 2017 Online supplemental material is available for this article.</abstract><cop>United States</cop><pub>Radiological Society of North America</pub><pmid>28985135</pmid><doi>10.1148/radiol.2017170599</doi><tpages>8</tpages></addata></record> |
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subjects | Adolescent Adult Aged Biomarkers - metabolism Diffusion Magnetic Resonance Imaging Female Fluorodeoxyglucose F18 - pharmacokinetics Hodgkin Disease - pathology Humans Inflammation - metabolism Inflammation - pathology Iron - metabolism Life Sciences Lymph Nodes - metabolism Lymphoma, Follicular - pathology Lymphoma, Large B-Cell, Diffuse - pathology Male Middle Aged Multimodal Imaging Positron Emission Tomography Computed Tomography Prospective Studies Radiopharmaceuticals - pharmacokinetics Young Adult |
title | Whole-Body Diffusion-weighted MR Imaging of Iron Deposits in Hodgkin, Follicular, and Diffuse Large B-Cell Lymphoma |
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