Whole-body diffusion-weighted MR imaging of iron deposits in hodgkin, follicular, and diffuse large b-cell lymphoma

Anne Ségolène Cottereau, Sébastien Mulé, Chieh Lin, Karim Belhadj, Alexandre Vignaud, Christiane Copie-Bergman, Alice Boyez, Pierre Zerbib, Vania Tacher, Elodie Scherman, Corinne Haioun, Alain Luciani, Emmanuel Itti, Alain Rahmouni*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

2 Scopus citations

Abstract

Purpose: To analyze the frequency and distribution of low-signalintensity 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/ mm2, 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 max], 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 SUVmax of 9.8, 6.7, and 16.2, respectively. These patients had significantly higher serum levels of C-reactive protein, a1-globulin, and a2-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.

Original languageEnglish
Pages (from-to)560-567
Number of pages8
JournalRadiology
Volume286
Issue number2
DOIs
StatePublished - 02 2018
Externally publishedYes

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