[Optimalisation of lymph node assessment in patients undergoing therapy for lymphoma using a multi-row CT]

Aim of the study was evaluation the accuracy of routinely performed helical computed tomography (CT) compared to modern multidetector row CT (MDCT) in staging and assessing response to treatment of patients with lymphoma, especially in cranio-caudal dimention.

60 patients with known Hodgkin's disease localised in chest were evaluated by the means of two methods: axial reconstruction of 5-6 mm thick slices--typical set for helical CT and 2-mm thin slices with coronal and sagital reconstruction--typical set for MSCT. Each of 120 obtained examinations (240 images reconstructions) were evaluated by 2 blinded readers.

Accuracy of measurements was greater at MSCT in all dimentions of evaluated lymph nodes (p<<0.0001). MSCT revealed in 15% of patients presence of lymph nodes enlarged only in craniocaudal length. Such nodes in conventional CT could be interpreted as "normal". Application of third dimention in lymph nodes assessment caused the change in clinical classification in 15% of patients in the study. Only in 40% of cases grade of response to treatment was the same in both CT ant MSCT techniques.

MSCT improves the detection rate of enlarge lymph nodes, especially in cranio-caudal dimention and shoud replece conventional spiral CT in assessment patients with lymphoma. In the time of new imaging technics we propose to modify the clinical staging of limphoma.