Detection and Characterization of Residual Masses in Lymphomas
Condition: Hodgkin Lymphoma; B-Cell Lymphoma
MeSH terms: Lymphoma
Study type: Observational

Summary: 
      The present study aims to further optimize a whole-body Diffusion-Weighted Magnetic Resonance
      Imagery (DW-MRI or DWI) protocol on 3 Tesla MR and/or new system combining 3Tesla MR and
      Positron Emission Tomography (PET), to develop and validate an automated whole-body
      parametric image analysis algorithm, and to determine the added value of whole-body DWI to
      Fluorodeoxyglucose-PET for the management of lymphoma patients.
    

Detailed description: 
      Imaging biomarkers are important tools for the detection and characterization of cancers as
      well as for monitoring the response to therapy. "Whole-body" molecular imaging, in particular
      using 18-Fluorodeoxyglucose-PET, has been proven useful in the evaluation and management of
      lymphoma patients. FDG-PET has evolved as a valuable biomarker in aggressive lymphomas, which
      is the current state-of-the-art imaging technique for response assessment at the end of
      treatment. Additionally, the prognostic value of "interim" (during treatment) or early PET
      has been well established in Hodgkin lymphoma and diffuse large B-cell lymphoma, which
      together account for more than 50% of all lymphomas. Worldwide clinical trials are ongoing to
      evaluate risk-adapted individualized treatment strategy based on interim PET results.
      Therefore, uniform and evidence-based guidelines for the interpretation are warranted.
      International Workshop on Interim PET in Lymphoma recently proposed a 5-point score method
      and so far the results of validation studies are promising.

      However, one could speculate that the risk of false-positive studies due to a non-specific
      inflammatory effect will be greater when patients receiving more toxic regimens and the
      usefulness of imaging biomarkers would vary for different lymphoma subtypes. Meanwhile,
      thanks to rapid technical development, whole-body functional magnetic resonance imaging (MRI)
      in particular diffusion-weighted MRI (DWI) reflecting cell density is now feasible in the
      clinical setting. Quantitative parameters derived from DWI reflecting cell density may
      provide complementary information to current state-of-the-art FDG-PET imaging reflecting
      quantitatively glucose metabolism and prove to be helpful in patient management.

      Pilot studies have shown the potential of whole-body DWI in lymphomas for staging and
      response assessment on 1.5 Tesla MR system but larger-scaled prospective studies are required
      before this new imaging-based biomarker can ever be validated for routine clinical use.
      Besides, technical challenges remain especially when encountering higher-field clinical MR
      systems. Finally, a vast amount of information generated from whole-body parametric imaging
      data will require development of automated image analysis software, which may help in
      establishing a multi-parametric approach in characterizing residual lymphoma masses.

      Therefore, the present study aims to further optimize a whole-body DWI protocol on 3 Tesla MR
      and/or new system combining 3Tesla MR and PET, to develop and validate an automated
      whole-body parametric image analysis algorithm, and to determine the added value of
      whole-body DWI to FDG-PET for the management of lymphoma patients.
    

Observational model: Other
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        Newly diagnosed HL, DLBCL or FL At least 18 years of age Initial presentation of bulky
        disease