MR-IMAGING TO DETECT CHEST-WALL AND PLEURAL INVOLVEMENT IN PATIENTS WITH LYMPHOMA - EFFECT ON RADIATION-THERAPY PLANNING

OBJECTIVE. The purpose of this study was to determine the influence th at accurate MR detection of chest wall and pleural disease has on the type and extent of radiation therapy subsequently performed in patient s with thoracic lymphoma. MATERIALS AND METHODS. MR images and CT scan s of the chests of 57 patients who had biopsy-proved lymphoma were ret rospectively examined for evidence of involvement of the chest wall an d pleura. For patients with thoracic lymphoma, we compared radiation p ortals and dosage,designed by using information from MR images with po rtals and dosage designed by using information from chest radiographs and CT scans. RESULTS. Chest wall or pleural disease was detected in 2 2 of the 57 patients examined. Chest wall disease was identified on MR images in 20 patients (29 sites) and pleural disease in 14 patients ( 16 sites). Chest wall and pleural disease were identified on CT scans in seven and five patients, respectively. Of the 15 patients who recei ved radiation therapy, three (20%) had treatment planning altered, eit her by increasing the area exposed to radiation or by increasing the r adiation dose, because of findings noted only on MR images. CONCLUSION . Chest wall and pleural sites of disease that may be detected only on MR images can be important in designing appropriate radiation portals and dosage for patients who have chest lymphoma.