Tests for lymphoma having an MRI scan

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Leon Jacobs
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1 Produced Due for revision Tests for lymphoma having an MRI scan The tests that your consultant will organise will depend on your symptoms, what kind of lymphoma you have and where it is, what treatment you are on and how you are followed up. You might have to have magnetic resonance imaging (usually shortened to MRI) to investigate your lymphoma. In this article we will explain: what MRI is why you might have an MRI scan what it is like to have an MRI scan whether MRI scans are safe. What is MRI? MRI scans use large, strong magnets and radio waves. These forms of energy make the atoms in the cells vibrate at different speeds. An MRI scanner picks up these different vibration speeds and maps them out to produce highly detailed cross-sectional images of the inside of the body on a computer screen. MRI does not use the type of radiation that is used in ordinary X-rays or computed tomography (CT) scans. What is MRI used for? MRI is particularly useful for taking pictures of soft tissues, such as bone marrow, cartilage, the brain, the eye and the spinal cord. It is usually better than CT scanning for investigating these tissues. In people with lymphoma, MRI is mainly used to look at the brain and spinal cord because it is particularly good at lighting up the fatty linings of the nerves. It is therefore used to help diagnose and stage lymphomas of the central nervous system. It is sometimes used in children with lymphoma in preference to investigations that use higher-energy types of radiation and it is also sometimes used to assess whether the bone marrow is affected by lymphoma. 1

What is it like to have an MRI scan? MRI scanners are not available in every NHS hospital and you might have to travel to a larger centre to have this done.

2 What is it like to have an MRI scan? MRI scanners are not available in every NHS hospital and you might have to travel to a larger centre to have this done. The MRI scanner consists of a large cylinder or tube (it looks a bit like a doughnut) that contains a series of magnets. As in a CT scan, you have to lie on a narrow padded examination table that moves you through the cylinder. Preparing for the scan Because the cylinder uses a magnet you will have to take off any metal jewellery or watches before the scan. You should let the staff know if you have any other metal implants, such as a replacement hip or heart pacemaker. You should also mention if you have any metal staples (sometimes used instead of stitches) still in place after a biopsy or an operation. You will be advised in advance if there are any other special instructions about preparing for your scan. For some MRI scans you will first be given an injection of a special dye or contrast agent into a vein to show up certain parts of the body more clearly. For MRI scans of the brain, for example, you might be given an agent called gadolinium. This is considered to be a safe substance but you should let the radiographer know if you have any allergies, kidney problems or problems with blood clotting, so that special precautions can be taken. With some contrast agents you can feel a slight sting or warmth while it is being injected. Having an MRI scan (Science Photo Library / M ) 2

3 Having the scan itself You will have to lie on a special table that moves into the centre of the magnet cylinder. The MRI scanner can feel hot and is very noisy and you will hear some hammering noises while the scanner is preparing for scanning and taking the pictures. Before going into the cylinder you will probably be offered disposable earplugs to reduce the noise (or you might be able to listen to music on a CD). You might also feel some vibration and some slight movement of the table during the examination. It is important not to move during the scan as this would blur the pictures. Because the MRI scanner is quite an enclosed space you might feel a bit claustrophobic, but you will have a buzzer to hold to let the staff know if you are becoming distressed. There will also be a two-way speaker in the machine so that you can hear and speak to the medical staff. If you feel claustrophobia is going to be a serious problem, you could ask whether you could have a sedative before the scan. MRI scans take anything from 15 minutes to over an hour to complete and you can go straight home afterwards. Getting the results It is not possible to say exactly how long it will take to get the results of your MRI scan, but usually the consultant who has ordered the investigation will receive the report from the radiologist within a few days. You will not be told the results by the staff while you are having the scan or just afterwards. Is MRI safe? MRI does not involve exposing the body to any of the type of radiation that is used in X-rays and CT scans. Lots of research has been done into whether the magnetic field and the radio waves that are used in MRI pose a risk to the human body, but MRI has been found to be a very safe medical procedure for patients. The main problem people sometimes have with MRI scans is being allergic to the contrast agent, which is why you will be asked about any allergies or bad reactions you have had in the past. Acknowledgement We would like to thank Professor Peter Hoskin, consultant clinical oncologist at Mount Vernon Hospital, Northwood, Middlesex and Professor of Clinical Oncology at University College London Hospitals, London, for reviewing this article. 3

4 More information The Lymphoma Association produces a wide range of booklets and information sheets on all aspects of lymphoma and its treatment. Visit our website at or telephone our freephone helpline ( ) if you would like to receive any of this information or if you would like to talk to someone about your lymphoma. If you have any particular concerns about your health or treatment, you should discuss these first with your doctor or key worker. The Lymphoma Association cannot provide information about individual diagnosis or treatment and the information we provide is not a substitute for advice from your health professionals. Useful organisations Macmillan Cancer Support 89 Albert Embankment, London SE1 7UQ Free helpline: Macmillan Cancer Support produces a number of helpful leaflets on tests for cancer. Cancer Research UK Patient UK References Punwani S. Pediatric and adolescent lymphoma: comparison of whole-body STIR half- Fourier RARE MR imaging with an enhanced PET/CT reference for initial staging. Radiology, : Hartwig V, et al. Biological effects and safety in magnetic resonance imaging: a review. International Journal of Environmental Research and Public Health, : Kwee TC, et al. Whole-body MRI, including diffusion-weighted imaging, for the initial staging of malignant lymphoma: comparison to computed tomography. Investigative Radiology, :

5 Kwee TC, et al. Magnetic resonance imaging for the detection of bone marrow involvement in malignant lymphoma. British Journal of Haematology, : Batchelor T, Loeffler JS. Primary CNS lymphoma. Journal of Clinical Oncology, : About our publications: The Lymphoma Association is committed to the provision of high quality information for people with lymphoma, their families and friends. We produce our information in accordance with nationally recognised guidelines. These include the DISCERN tool for information about treatments, the NHS Toolkit for producing patient information, and the Campaign for Plain English guidelines. Our publications are written by experienced medical writers, in close collaboration with medical advisers with expertise in the appropriate field. Textbooks and professional journals are consulted to ensure that information is as up to date as possible. References are provided where they have been used. Some publications are written by professionals themselves, acting on guidance provided by the Lymphoma Association. Our publications are reviewed every two years and updated as necessary. Our publications are reviewed by a panel of volunteers with experience of lymphoma. Publications are also reviewed by members of the Lymphoma Association helpline team, who have many years collective experience of supporting those with lymphoma. In some instances, our publications are funded by educational grants from pharmaceutical companies. These sponsors do not have any involvement in the content of a publication. They are not invited to see the content and have no editorial input. Lymphoma Association Views expressed in this publication are those of the contributors. The Lymphoma Association does not necessarily agree with or endorse the comments included here. 5

Who can have an MRI scan?

i MRI Scan Contents What is an MRI scan? 1 Why am I having an MRI scan? 1 Who can have an MRI scan? 1 What preparation will I need? 2 What happens when I come for the scan? 2 Who will I see when I have