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Mediastinal Lymphoma: Quantitative Changes in Gadolinium Enhancement at MR Imaging after Treatment¹

¹ From the Departments of Radiology (A.R., N.J., M.G., N.V.), Hematology (M.D., K.B., F.R.), Biostatistics (E.L.), and Pathology (P.G.), Centre Hospitalo–Universitaire Henri Mondor, 51 Avenue du Maréchal de Lattre de Tassigny, 94010 Créteil, France. Received April 7, 2000; revision requested June 1; final revision received November 1; accepted November 20. Supported by the Association pour la Recherche contre le Cancer. Address correspondence to A.R. (e-mail: alain.rahmouni@hmn.ap-hop-paris.fr).

PURPOSE: To compare changes in gadolinium enhancement at magnetic resonance (MR) imaging with outcome in mediastinal lymphoma after treatment.

MATERIALS AND METHODS: Thirty-one patients with bulky mediastinal lymphoma (17 with Hodgkin disease, 14 with non–Hodgkin lymphoma) underwent serial MR imaging before and up to 50 months after treatment, with routine follow-up (including computed tomography). Signal intensity ratios between masses and muscle were calculated on T1-weighted, T2-weighted, and contrast material–enhanced T1-weighted spin-echo MR images. The percentage enhancement and signal intensity ratios of mediastinal masses on T2-weighted MR images were calculated at diagnosis and during and after treatment.

RESULTS: Twenty-one patients with persistent complete remission had a mean percentage enhancement of residual masses (4%; range, -26% to 40%) that was significantly lower than that of initial masses (78%; range, 41%–124%). Although the mean signal intensity ratio of residual masses on T2-weighted images was significantly lower than that of initial masses, an increase in this ratio was observed in four patients after treatment. In seven patients with relapse, the percentage enhancement value of the residual mass was as high as that of the initial mass.

CONCLUSION: Gadolinium enhancement of lymphomatous masses of the mediastinum decreased markedly after treatment in patients in continuous complete remission but not in patients with relapse.

Index terms: Gadolinium • Hodgkin disease, MR, 67.121411, 67.12143, 67.342 • Lymphoma, MR, 67.121411, 67.12143, 67.343 • Magnetic resonance (MR), contrast enhancement, 67.12143 • Magnetic resonance (MR), tissue characterization, 67.121411 • Mediastinum, neoplasms, 67.342, 67.343

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