Selective contrast-enhanced computed tomography is appropriate in diffuse large B-cell lymphoma therapy response...

Area of Science:

• Radiology
• Oncology

Background:

• Contrast-enhanced CT scans of the neck, thorax, and abdomen/pelvis are standard for diagnosing and assessing response in diffuse large B-cell lymphoma (DLBCL).
• Progression of disease (PD) during first-line treatment for DLBCL is infrequent, raising questions about the necessity of extensive imaging for response evaluation.

Purpose of the Study:

• To investigate whether imaging only initially involved regions is sufficient for assessing therapy response in DLBCL patients.
• To evaluate the pattern of disease involvement during and after first-line treatment for DLBCL.

Main Methods:

• Retrospective analysis of 167 DLBCL patients who underwent extensive contrast-enhanced CT at initial diagnosis.
• Majority of patients (77%) received R-CHOP chemotherapy.
• Therapy response was assessed using contrast-enhanced CT at interim and end-of-treatment staging.

Main Results:

• Overall response rate at end of treatment was 94%.
• No patients showed involvement of new sites at interim staging.
• Crucially, no patients developed involvement in sites not initially affected by DLBCL; progression or relapse involved only previously affected areas.

Conclusions:

• Selective imaging of initially involved DLBCL sites is supported by this retrospective analysis for therapy response assessment.
• This finding suggests a potential for more focused and efficient follow-up imaging strategies in DLBCL management.