Figure 2 New functional imaging techniques in lymphoma

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Presentation transcript:

Figure 2 New functional imaging techniques in lymphoma Figure 2 | New functional imaging techniques in lymphoma. a–h | Synchronous axial diffusion-weighted images of a patient with CD15+/CD30+/CD20+ unclassifiable B-cell lymphoma (with features intermediate between DLBCL and classical HL). i–p | Synchronous images of a patient with classical HL of the nodular sclerosis subtype. a,b,i,j | Post-chemotherapy axial CT images showing the presence of a residual anterior mediastinal mass, with a complete metabolic response defined using PET imaging (baseline bulky disease, not shown). c,d,k,l | Follow-up imaging showed possible relapse on both CT and PET scans. e–h | MRI-axial-fused T2 Haste/b1050 diffusion-weighted imaging (DWI), T2 Haste, apparent diffusion coefficient (ADC) and opposite-phase T1-weighted sequences, respectively, demonstrate that the anterior mediastinal tissue contains minimal amounts of fat and a large volume of non-impeded water with a mean ADC of 1,804 × 10−3 mm2/cm (range 1,517–2,172 × 10−3 mm2/s), which is above the threshold for residual disease169. The presence of such features indicates low levels of cellularity (white arrow), suggesting the presence of thymic hyperplasia rather than active lymphoma. m–p | Axial T2 Haste, water fraction map, ADC and fat fraction map images demonstrate the presence of minimal amounts of fat and a large amount of non-impeded water with a mean ADC of 1,907 × 10−3 mm2/cm (range 1,602–2,316 × 10−3 mm2/s) in keeping with low cellularity (white arrow) and the presence of thymic hyperplasia and not lymphoma (proven on follow-up investigations, images not shown). The water/fraction maps were calculated using controlled aliasing in parallel imaging results in higher acceleration (CAIPIRINHA) sequences. Cunningham, J. et al. (2017) Evolution of lymphoma staging and response evaluation: current limitations and future directions Nat. Rev. Clin. Oncol. doi:10.1038/nrclinonc.2017.78