Johannes Wessling MD, Presenter: Nothing to Disclose

Michael Puesken MD, Abstract Co-Author: Nothing to Disclose

Christoph Schuelke, Abstract Co-Author: Nothing to Disclose

Anna Knauer, Abstract Co-Author: Nothing to Disclose

Walter Leonhard Heindel MD, Abstract Co-Author: Nothing to Disclose

Boris Buerke MD, Abstract Co-Author: Nothing to Disclose

Evaluation of semi-automated volumetry in comparison to metric measurements on therapy response classification in CT follow-up examinations of malignant lymphoma.

MSCT scans of 62 patients with malignant lymphoma prior (baseline) and after 2 cycles of chemotherapy (follow-up) were included. A total of 300 target lymph nodes (56 cervical, 121 thoracic and 123 abdominal) were evaluated by two radiologists independently. Long axis diameter (LAD), short axis diameter (SAD), WHO-square and volume were determined manually and using semi-automated segmentation software. Time for manual and semi-automated segmentation was evaluated. Therapy response was calculated for each parameter based on „IWC“ lymphoma-guidelines and „RECIST“-adapted guidelines. Mean  metric and volumetric measurements served as the reference standard. Statistical analysis was performed using intraclass correlation coefficients (ICC), t- and McNemar-test.

Over all regions mean lymph node size in baseline/follow-up was 23.4±10.2 mm/17.1±9.3 mm for LAD and 7.4±13.7 ml/3.5±9.7 ml for volume. Mean evaluation time for semi-automated segmentation without need for correction was shorter (16.8±11.9 sec) than for manual measurements (29.2±14.6 sec). In 65% of all lymph nodes correction was necessary and evaluation time increased to 39.7±26.7 sec. Regarding therapy response, semi-automated volumetry obtained significantly more accurate classifications than semi-automated and manual LAD and SAD (e.g. volume 87.6% vs. semi-automated LAD 83.9%, manual SAD 78.7%, all p<0.05).

Semi-automated lymph node volumetry is more accurate for therapy response classification in patients with malignant lymphoma as compared to established linear measurements (e. g. SAD).

Improved therapy response evaluation by volumetry of lymph nodes in malignant lymphoma could have significant impact on  chemotherapy regime optimization.

Wessling, J, Puesken, M, Schuelke, C, Knauer, A, Heindel, W, Buerke, B, MSCT Follow-up in Patients with Malignant Lymphoma: Does Semiautomated Volumetry Improve Therapy Response Classification Compared to Manual Linear Measurements?.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11034244.html