Tumour inhomogeneities on magnetic resonance imaging, a new factor with prognostic information in non-Hodgkin's lymphomas

The prognostic importance of inhomogeneities on magnetic resonance imaging (MRI) in non-Hodgkin lymphomas (NHL) was evaluated. Forty-six consecutive patients with high-grade NHL were examined and, for comparison purposes, 13 patients with low-grade NHL. The degree of inhomogeneity was measured with a quantitative method (IH8) and a subjective evaluation was also performed. Patients with localized disease (stage I), who had all been treated with radiotherapy, had an excellent prognosis, which was independent of the degree of tumour inhomogeneity. In generalized NHL (stages II-IV) treated with chemotherapy, IH8 provided prognostic information in high-grade NHL. Patients with pronounced tumour inhomogeneity, in particular, had a very poor prognosis. The prognostic impact was also seen if the analyses were performed with high-grade and low-grade NHLs grouped together. The inhomogeneities may indicate a mechanism related to treatment failure after chemotherapy, but not after fractionated radiotherapy.