rentradВестник рентгенологии и радиологииJournal of radiology and nuclear medicine0042-46762619-0478Limited Liability Company "LUCHEVAYA DIAGNOSTIKA", Russian Association of Radiologists10.20862/0042-4676-2014-0-6-18-28rentrad-54Research ArticleСтатьиОПТИМИЗАЦИЯ ПРОТОКОЛА МАГНИТНО-РЕЗОНАНСНОЙ ТОМОГРАФИИ ВСЕГО ТЕЛА ДЛЯ СТАДИРОВАНИЯ ЛИМФОМЫ ХОДЖКИНАOPTIMIZATION OF A WHOLE-BODY MAGNETIC RESONANCE IMAGING PROTOCOL FOR HODGKIN LYMPHOMA STAGINGМихайловА. И.MikhaylovA. I.

аспирант

ул. Баррикадная, 2/1, Москва, 123995

Postgraduate

ul. Barrikadnaya, 2/1, Moscow, 123995

azatmihailov@gmail.comПановВ. О.PanovV. O.

к. м. н., доцент кафедры лучевой диагностики, лучевой терапии и медицинской физики

ул. Баррикадная, 2/1, Москва, 123995

MD, PhD, Associate Professor of Department of Radiation Diagnosis, Radiotherapy and Medical Physics

ul. Barrikadnaya, 2/1, Moscow, 123995

ТюринИ. Е.TyurinI. E.

д. м. н., профессор, заведующий кафедрой лучевой диагностики, лучевой терапии и медицинской физики 

ул. Баррикадная, 2/1, Москва, 123995

MD, PhD, DSc, Professor, Head of Department of Radiation Diagnosis, Radiotherapy and Medical Physics 

ul. Barrikadnaya, 2/1, Moscow, 123995

ГБОУ ДПО «Российская медицинская академия последипломного образования» Министерства здравоохранения РФРоссияRussian Medical Academy of Postgraduate Education, Ministry of Health of the RFRussian Federation201401032016061828Copyright © Михайлов А.И., Панов В.О., Тюрин И.Е., 20162016Михайлов А.И., Панов В.О., Тюрин И.Е.Mikhaylov A.I., Panov V.O., Tyurin I.E.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.russianradiology.ru/jour/article/view/54

Цель исследования – оптимизация протокола проведения магнитно-резонансной томографии всего тела (МРТ-ВТ), включающего диффузионно-взвешенные изображения (DWI), для использования в диагностическом комплексе при лимфоме Ходжкина (ЛХ).

Материал и методы

Материал и методы. Отработка протокола МРТ-ВТ, адаптированного для стадирования и мониторинга ЛХ, проходила на 1.5 T и 3.0 T МР-томографах. В исследование были включены 128 пациентов с ЛХ, верифицированной на основании результатов комплексного клинико-лабораторного и инструментального обследований, включая компьютерную томографию (КТ), позитронную эмиссионную томографию (ПЭТ), ПЭТ/КТ, сцинтиграфию и рентгенографию костей скелета, ультразвуковое исследование, лабораторные анализы и данные биопсии, а также 27 здоровых лиц. Диагностическая ценность созданного протокола была определена путем сравнения с «золотым стандартом» диагностики лимфомы Ходжкина – позитронной эмиссионной томографией с 18F-фтордезоксиглюкозой у 63 пациентов с ЛХ.

Результаты

Результаты. МРТ всего тела показала высокую чувствительность – 99,2% (ДИ 97,6–100%) и специфичность – 99,6% (ДИ 99,05–100%) в определении очагов поражения при ЛХ.

Заключение

Заключение. Высокая чувствительность и специфичность МРТ-ВТ, сопоставимые с таковыми ПЭТ, позволяют предложить этот метод для оценки первичной распространенности опухолевого процесса при ЛХ. Разработанный протокол МРТ- ВТ без контрастного усиления для 1,5 Т и 3,0 Т томографов дает возможность получать в рамках одного исследования анатомические (Т2-ВИ) и функциональные (DWI с оценкой измеряемого коэффициента диффузии) МР-изображения нодальных и экстранодальных поражений при ЛХ без увеличения временных затрат, модернизации оборудования и программного обеспечения. Применение предложенного протокола повышает качество лучевой диагностики ЛХ при одновременном снижении лучевой нагрузки на пациента. 

Objective

Objective: to optimize a whole-body magnetic resonance imaging (WBMRI) protocol including diffusion-weighted imaging (DWI) used as a diagnostic complex for Hodgkin lymphoma (HL).

Material and methods

Material and methods. The WBMRI protocol adapted for HL staging and monitoring was tried out on 1.5 T and 3.0 T MRI scanners. The investigation included 128 patients with HL verified by complex clinical, laboratory, and instrumental studies (including computed tomography (CT), positron emission tomography (PET), PET/CT, scintigraphy and radiology of the skeleton, ultrasonography, laboratory tests, and biopsy) and 27 healthy individuals. The diagnostic value of the elaborated protocol was determined comparing with that of 18F-fluorodeoxyglucose PET, the gold standard for diagnosing HL in 63 patients with this condition.

Results

Results. WBMRI showed high sensitivity (99.2%) (97.6–100% confidence interval (CI)) and specificity (99.6%) (99.05–100% CI) in determining the foci of lesion in HL.

Conclusion

Conclusion. The high sensitivity and specificity of WBMRI, which are similar to those of PET, may suggest that this method should be used to estimate the extent of the primary tumor in HL. Within one study, the proposed non-contrast-enhanced WBMRI protocol for 1.5 T and 3.0 T MRI scanners can yield anatomic (T2- WI) and functional (DWI estimating the measured diffusion coefficient) MR images of nodal and extranodal lesions in HL, without increasing time and modernizing equipment and software. The proposed protocol improves the quality of HL radiodiagnosis, by concurrently reducing a patient’s radiation exposure.

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The authors declare that there are no conflicts of interest present.