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Lymphoma: monitoring tumor size and signal intensity with MR imaging
A Rahmouni1, C Tempany, R Jones
1Department of Radiology and Radiological Sciences, Johns Hopkins Hospital, Baltimore, MD 21287.
Abstract:
To assess the potential value of magnetic resonance (MR) imaging in monitoring disease status, 34 patients with residual masses underwent MR imaging at sequential intervals. Patterns of signal intensity suggestive of active and inactive residual disease were compared to changes in tumor size. The signal intensity pattern was suggestive of persistent disease in 18 patients, even though tumor size was stable or decreased. Three of these patterns, seen within 6 months of initiation of therapy, were due to necrosis or inflammation. The MR imaging assessment of inactive disease was confirmed in 15 of the remaining 16 patients. In no case was an increase in tumor size seen in conjunction with a decrease in signal intensity. Because tumor size and signal intensity changes are not parallel in many cases, MR imaging may have a role in monitoring masses in patients with lymphoma. Signal intensity patterns, however, reflect gross histologic characteristics and cannot be considered specific, especially in the first 6 months after initiation of therapy.
Insights
Magnetic resonance (MR) imaging shows promise in monitoring lymphoma patients with residual masses. Signal intensity patterns, not just tumor size, can indicate active disease, aiding treatment assessment.
Area of Science:
- Radiology
- Oncology
- Medical Imaging
Background:
- Residual masses after lymphoma treatment require accurate monitoring to assess disease status.
- Tumor size is a common metric, but may not always reflect disease activity.
- Magnetic resonance (MR) imaging offers detailed anatomical and tissue characterization.
Purpose of the Study:
- To evaluate the utility of MR imaging in monitoring disease status in patients with residual masses.
- To compare MR imaging signal intensity patterns with changes in tumor size.
- To determine if MR imaging can differentiate active from inactive residual disease.
Main Methods:
- 34 patients with residual masses underwent sequential MR imaging.
- MR imaging signal intensity patterns were analyzed.
- Patterns were correlated with changes in tumor size and confirmed with histology where possible.
Main Results:
- MR imaging signal intensity suggested persistent disease in 18 patients despite stable or decreased tumor size.
- Early signal intensity changes (within 6 months) were sometimes due to necrosis or inflammation.
- In most cases, MR imaging assessment of inactive disease was accurate.
- Increased tumor size was not observed with decreased signal intensity.
Conclusions:
- MR imaging, by analyzing signal intensity patterns, may be valuable for monitoring residual masses in lymphoma patients.
- Tumor size and signal intensity changes are not always parallel, highlighting MR imaging's potential role.
- Signal intensity patterns reflect gross histology and lack specificity, particularly in the initial 6 months post-therapy.