CT perfusion in evaluation of post therapy cervical lymphoma

Abstract

Objective: Compare CT perfusion between responders and non-responders in patients with residual cervical nodes after lymphoma treatment. Subjects and methods: Twenty-seven patients with treated pathologically proved lymphoma were included in this prospective study, divided into two groups: responders (n. 15) and non-responders to treatment (n. 12). Blood flow (BF), blood volume (BV), mean transit time (MTT) and permeability (PS) were determined using CT perfusion. Lymph nodes sizes were measured (short axis). Results: BF, BV and PS were significantly higher in non-responders group [93.3 (65.3–111) ml/min/100 g, 6.3 (5.2–8) ml/100 g and 18.9 (14.5–25.1) ml/min/100 g respectively] as compared to responders group [54 (43.8–77.5) ml/min/100 g, 4.1 (2.2–4.8) ml/100 g and 9.4 (7.5–14.5) ml/min/100 g respectively], [p 0.019, 0.004 and 0.004 respectively]. MTT had a trend to be low in non-responders group, but did not reach statistical significance (p 0.305). Cutoff value for BF, BV and PS was 59.5 ml/min/100 g, 3.6 ml/100 g and 11.1 ml/min/100 g respectively, 92% sensitivity for the three parameters and specificity 67%, 47% and 73% respectively. Lymph node sizes had no relation to the perfusion parameter values. Conclusion: CT perfusion is a functional imaging tool with promising results in differentiating between responders and non-responders in treated lymphoma patients, using BF, BV and PS.

Keywords

• CT perfusion
• Lymphoma
• Cervical lymphadenopathy