Defining MRI-based follow-up protocol for primary central nervous system lymphoma

Area of Science:

• Neuro-oncology
• Radiology
• Clinical Follow-up Protocols

Background:

• Optimal follow-up protocols for primary central nervous system lymphoma (PCNSL) remain undefined.
• This study is the first to assess the impact of structured follow-up imaging on the timing of PCNSL relapse detection.

Purpose of the Study:

• To evaluate the benefit of structured follow-up imaging (sMRI) versus additional imaging (aMRI) for detecting relapse in PCNSL.
• To analyze the impact of relapse detection method on overall survival after relapse (OS2).

Main Methods:

• Retrospective analysis of 198 PCNSL patients diagnosed between 2003 and 2020 from 8 Finnish hospitals.
• Data collection included structured MRI (sMRI), additional MRI (aMRI) based on symptoms, and outpatient/emergency visits.
• Comparison of relapse detection methods and evaluation of overall survival (OS) post-relapse.

Main Results:

• Relapse occurred in 35.9% of patients, primarily within the first two years.
• In the first year, sMRI detected 48.3% of relapses, while aMRI detected 51.7%.
• Overall survival after relapse (OS2) was 4.0 months for sMRI-detected relapses versus 3.0 months for aMRI-detected relapses (P=0.203).

Conclusions:

• Structured imaging (sMRI) proved beneficial for detecting PCNSL relapses within the first year post-diagnosis.
• A trend towards improved survival was noted for patients whose relapses were identified through structured imaging.