Whole-body MRI in paediatric Hodgkin lymphoma

Abstract

Lymphomas (lymph node cancer) are the third most common form of cancer in children. About a third of the lymphomas are Hodgkin lymphomas. Medical imaging plays an important role in determining disease progression (staging), assessment of response to therapy, and follow-up of children with Hodgkin lymphoma.

Over the past few years, the use of imaging studies in Hodgkin lymphoma has shifted from Computed Tomography (CT) to the addition of Positron Emission Tomography (PET) and most recently, whole-body Magnetic Resonance Imaging (MRI).

This thesis focuses on determining the diagnostic accuracy of whole-body MRI for staging, early assessment of response to therapy and assessment of remission at the end of therapy in children with Hodgkin lymphoma. In addition, normal values of lymph nodes in children are investigated.

In summary, the studies show that data on the normal size of the lymph nodes by age is very important for a correct diagnosis of pathological lymph nodes. This is especially relevant in children. In addition, the studies presented in this thesis show that it is still challenging to determine the optimal role of whole-body MRI in imaging protocols for paediatric Hodgkin lymphoma. The results indicate that whole-body MRI is a very suitable radiation-free alternative to anatomical imaging by CT. In addition, this thesis shows that whole-body MRI can be a good alternative to FDG-PET/CT for the staging of Hodgkin lymphoma in children. Whole-body MRI (including visual assessment of DWI), however, did not correlate sufficiently with FDG-PET/CT for (early) response assessment.