DOI: https://doi.org/10.22263/2312-4156.2017.1.59
Kharuzhyk S.A.
Can whole body magnetic resonance imaging replace X-ray computed tomography, bone scan and biopsy in the diagnosis of bone marrow involvement in patients with lymphoma? Comparison of their diagnostic and economic effectiveness
N.N. Alexandrov National Cancer Centre of Belarus, Minsk, Republic of Belarus
Vestnik VGMU. 2017;16(1):59-70.
Abstract.
Objectives. To evaluate the effectiveness of whole body magnetic resonance imaging (MRI) in the diagnosis of bone marrow (BM) involvement in patients with lymphoma compared with X-ray computed tomography (CT), bone scan (BS) and BM biopsy as well as to determine whether whole body MRI can replace these studies as a sole method of BM involvement diagnosis.
Material and methods. The study prospectively included 85 patients with lymphoma. All patients underwent pretreatment CT and MRI of the neck, thorax, abdomen and pelvis, BM biopsy with cytological and histological examination. In some patients BS was performed. The effectiveness of these methods in the diagnosis of BM involvement was compared. Economic effectiveness of the whole body MRI as compared to the complex of methods including CT, BS and BM biopsy was evaluated.
Results. Hodgkin’s lymphoma (HL) occurred in 38 patients, non-Hodgkin’s lymphomas (NHL) – in 47. The frequency of BM involvement in HL was 21%, in NHL – 38%. The sensitivity of CT in the diagnosis of BM involvement made up 19%, specificity – 98%, accuracy – 74%, that of BM biopsy – 58%, 100% and 87%, that of MRI – 85%, 97% and 93%, that of the complex of methods including CT, BS and BM biopsy – 73%, 97% and 89%, respectively. The sensitivity of MRI in HL was 100%, that of biopsy – 0%, that of the complex of methods – 38%, in NHL – 78%, 83% and 89%, respectively. The cost of the whole body MRI was lower compared to the cost of the complex of methods.
Conclusions. The whole body MRI can replace CT, BS and BM biopsy in the diagnosis of BM involvement in patients with HL. In patients with NHL, in order to increase the diagnostic effectiveness of MRI, it is necessary to explore the possibilities of new scanning techniques, diffusion-weighed imaging included.
Key words: lymphoma, bone marrow, magnetic resonance imaging, computed tomography, bone scan, biopsy, economic effectiveness.
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Information about authors:
Kharuzhyk S.A. – Candidate of Medical Sciences, associate professor, MRI physician of the radiology department, N.N. Alexandrov National Cancer Centre of Belarus.
Correspondence address: Republic of Belarus, 223040, Minsk district, agrogorodok Lesnoy, N.N. Alexandrov National Cancer Centre of Belarus, radiology department. E-mail: Этот адрес электронной почты защищён от спам-ботов. У вас должен быть включен JavaScript для просмотра. – Siarhei A. Kharuzhyk.
