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Chen J, Lin F, Dai Z, Chen Y, Fan Y, Li A, Zhao C. Survival prediction in diffuse large B-cell lymphoma patients: multimodal PET/CT deep features radiomic model utilizing automated machine learning. J Cancer Res Clin Oncol 2024; 150:452. [PMID: 39382750 DOI: 10.1007/s00432-024-05905-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2024] [Accepted: 07/21/2024] [Indexed: 10/10/2024]
Abstract
PURPOSE We sought to develop an effective combined model for predicting the survival of patients with diffuse large B-cell lymphoma (DLBCL) based on the multimodal PET-CT deep features radiomics signature (DFR-signature). METHODS 369 DLBCL patients from two medical centers were included in this study. Their PET and CT images were fused to construct the multimodal PET-CT images using a deep learning fusion network. Then the deep features were extracted from those fused PET-CT images, and the DFR-signature was constructed through an Automated machine learning (AutoML) model. Combined with clinical indexes from the Cox regression analysis, we constructed a combined model to predict the progression-free survival (PFS) and the overall survival (OS) of patients. In addition, the combined model was evaluated in the concordance index (C-index) and the time-dependent area under the ROC curve (tdAUC). RESULTS A total of 1000 deep features were extracted to build a DFR-signature. Besides the DFR-signature, the combined model integrating metabolic and clinical factors performed best in terms of PFS and OS. For PFS, the C-indices are 0.784 and 0.739 in the training cohort and internal validation cohort, respectively. For OS, the C-indices are 0.831 and 0.782 in the training cohort and internal validation cohort. CONCLUSIONS DFR-signature constructed from multimodal images improved the classification accuracy of prognosis for DLBCL patients. Moreover, the constructed DFR-signature combined with NCCN-IPI exhibited excellent potential for risk stratification of DLBCL patients.
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Affiliation(s)
- Jianxin Chen
- The Key Laboratory of Broadband Wireless Communication and Sensor Network Technology (Ministry of Education), Nanjing University of Posts and Telecommunications, Nanjing, China.
| | - Fengyi Lin
- The Key Laboratory of Broadband Wireless Communication and Sensor Network Technology (Ministry of Education), Nanjing University of Posts and Telecommunications, Nanjing, China
| | - Zhaoyan Dai
- The Key Laboratory of Broadband Wireless Communication and Sensor Network Technology (Ministry of Education), Nanjing University of Posts and Telecommunications, Nanjing, China
| | - Yu Chen
- The Key Laboratory of Broadband Wireless Communication and Sensor Network Technology (Ministry of Education), Nanjing University of Posts and Telecommunications, Nanjing, China
| | - Yawen Fan
- The Key Laboratory of Broadband Wireless Communication and Sensor Network Technology (Ministry of Education), Nanjing University of Posts and Telecommunications, Nanjing, China
| | - Ang Li
- The Key Laboratory of Broadband Wireless Communication and Sensor Network Technology (Ministry of Education), Nanjing University of Posts and Telecommunications, Nanjing, China
| | - Chenyu Zhao
- The Key Laboratory of Broadband Wireless Communication and Sensor Network Technology (Ministry of Education), Nanjing University of Posts and Telecommunications, Nanjing, China
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2
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Kishida M, Fujisawa M, Steidl C. Molecular biomarkers in classic Hodgkin lymphoma. Semin Hematol 2024:S0037-1963(24)00069-6. [PMID: 38969539 DOI: 10.1053/j.seminhematol.2024.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Accepted: 05/27/2024] [Indexed: 07/07/2024]
Abstract
Classic Hodgkin lymphoma is a unique B-cell derived malignancy featuring rare malignant Hodgkin and Reed Sternberg (HRS) cells that are embedded in a quantitively dominant tumor microenvironment (TME). Treatment of classic Hodgkin lymphoma has significantly evolved in the past decade with improving treatment outcomes for newly diagnosed patients and the minority of patients suffering from disease progression. However, the burden of toxicity and treatment-related long-term sequelae remains high in a typically young patient population. This highlights the need for better molecular biomarkers aiding in risk-adapted treatment strategies and predicting response to an increasing number of available treatments that now prominently involve multiple immunotherapy options. Here, we review modern molecular biomarker approaches that reflect both the biology of the malignant HRS cells and cellular components in the TME, while holding the promise to improve diagnostic frameworks for clinical decision-making and be feasible in clinical trials and routine practice. In particular, technical advances in sequencing and analytic pipelines using liquid biopsies, as well as deep phenotypic characterization of tissue architecture at single-cell resolution, have emerged as the new frontier of biomarker development awaiting further validation and implementation in routine diagnostic procedures.
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Affiliation(s)
- Makoto Kishida
- Centre for Lymphoid Cancer department, BC Cancer, Vancouver, British Columbia, Canada
| | - Manabu Fujisawa
- Centre for Lymphoid Cancer department, BC Cancer, Vancouver, British Columbia, Canada; Institute of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Christian Steidl
- Centre for Lymphoid Cancer department, BC Cancer, Vancouver, British Columbia, Canada; Institute of Medicine, University of Tsukuba, Ibaraki, Japan; Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
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3
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Parihar AS, Pant N, Subramaniam RM. Quarter-Century PET/CT Transformation of Oncology: Lymphoma. PET Clin 2024; 19:281-290. [PMID: 38403384 DOI: 10.1016/j.cpet.2023.12.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2024]
Abstract
The clinical landscape of lymphomas has changed dramatically over the last 2 decades, including significant progress made in the understanding and utilization of imaging modalities and the available treatment options for both indolent and aggressive lymphomas. Since the introduction of hybrid PET/CT scanners in 2001, the indications of 18F-fluorodeoxyglucose (FDG) PET/CT in the management of lymphomas have grown rapidly. In today's clinical practice, FDG PET/CT is used in successful management of the vast majority patients with lymphomas.
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Affiliation(s)
- Ashwin Singh Parihar
- Mallinckrodt Institute of Radiology; Siteman Cancer Center, Washington University School of Medicine, St Louis, MO, USA.
| | | | - Rathan M Subramaniam
- Faculty of Medicine, Nursing, Midwifery & Health Sciences, The University of Notre Dame Australia, Sydney, Australia; Department of Radiology, Duke University, Durham, NC, USA; Department of Medicine, University of Otago Medical School, Dunedin, New Zealand
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4
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Development and validation of a [18F]FDG PET/CT-based radiomics nomogram to predict the prognostic risk of pretreatment diffuse large B cell lymphoma patients. Eur Radiol 2022; 33:3354-3365. [PMID: 36547676 PMCID: PMC10121518 DOI: 10.1007/s00330-022-09301-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 09/03/2022] [Accepted: 11/13/2022] [Indexed: 12/24/2022]
Abstract
Abstract
Objective
In this study, based on PET/CT radiomics features, we developed and validated a nomogram to predict progression-free survival (PFS) for cases with diffuse large B cell lymphoma (DLBCL) treated with immunochemotherapy.
Methods
This study retrospectively recruited 129 cases with DLBCL. Among them, PET/CT scans were conducted and baseline images were collected for radiomics features along with their clinicopathological features. Radiomics features related to recurrence were screened for survival analysis using univariate Cox regression analysis with p < 0.05. Next, a weighted Radiomics-score (Rad-score) was generated and independent risk factors were obtained from univariate and multivariate Cox regressions to build the nomogram. Furthermore, the nomogram was tested for their ability to predict PFS using time-dependent receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis (DCA).
Results
Blood platelet, Rad-score, and gender were included in the nomogram as independent DLBCL risk factors for PFS. We found that the training cohort areas under the curve (AUCs) were 0.79, 0.84, and 0.88, and validation cohort AUCs were 0.67, 0.83, and 0.72, respectively. Further, the DCA and calibration curves confirmed the predictive nomogram’s clinical relevance.
Conclusion
Using Rad-score, blood platelet, and gender of the DLBCL patients, a PET/CT radiomics-based nomogram was developed to guide cases’ recurrence risk assessment prior to treatment. The developed nomogram can help provide more appropriate treatment plans to the cases.
Key Points
• DLBCL cases can be classified into low- and high-risk groups using PET/CT radiomics based Rad-score.
• When combined with other clinical characteristics (gender and blood platelet count), Rad-score can be used to predict the outcome of the pretreatment of DLBCL cases with a certain degree of accuracy.
• A prognostic nomogram was established in this study in order to aid in assessing prognostic risk and providing more accurate treatment plans for DLBCL cases.
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5
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Din F, Mellor F, Millard T, Pace E, Khan N, Attygalle AD, Cunningham D, Zafar S, Sharma B. Radiology of Castleman disease: the pivotal role of imaging in diagnosis, staging, and response assessment of this rare entity. Clin Radiol 2022; 77:399-408. [PMID: 35177229 DOI: 10.1016/j.crad.2022.01.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 01/12/2022] [Indexed: 11/16/2022]
Abstract
Castleman Disease (CD) is a rare entity that typically presents as an enhancing nodal mass in the mediastinum or head and neck region on computed tomography (CT). It may manifest as unicentric or multicentric regions of lymph node enlargement. A key clinical issue in the context of CD is delayed diagnosis, which contributes adversely to patient outcome, given that accurate diagnosis facilitates earlier treatment of this curable disease. This article will address relevant imaging aspects, with reference to typical and atypical imaging features of CD, illustrated using examples from our specialist centre; the imaging journey for patients with CD; and will provide practical pointers to radiologists in differentiating CD from other benign and malignant causes of enhancing lymphadenopathy, including lymphoma and neoplastic adenopathy. We will also review current classification tools and staging challenges with reference to World Health Organization guidelines, International Working Group guidelines as well as the Lugano classification. Finally, we will discuss the potential role of additional imaging techniques in CD, highlighting novel imaging methods and expanded utilities from our specialist centre.
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Affiliation(s)
- F Din
- Department of Radiology, The Royal Marsden NHS Trust, London, UK
| | - F Mellor
- Department of Radiology, The Royal Marsden NHS Trust, London, UK
| | - T Millard
- Department of Radiology, The Royal Marsden NHS Trust, London, UK
| | - E Pace
- Department of Radiology, The Royal Marsden NHS Trust, London, UK
| | - N Khan
- Department of Radiology, The Royal Marsden NHS Trust, London, UK
| | - A D Attygalle
- The Lymphoma Unit, The Royal Marsden NHS Trust, London, UK
| | - D Cunningham
- The Lymphoma Unit, The Royal Marsden NHS Trust, London, UK
| | - S Zafar
- Department of Radiology, The Royal Marsden NHS Trust, London, UK
| | - B Sharma
- Department of Radiology, The Royal Marsden NHS Trust, London, UK.
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6
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Can pre-transplant 18F-choline positron emission tomography predict relapse following autologous stem cell transplantation in primary central nervous system lymphoma? Bone Marrow Transplant 2022; 57:113-115. [PMID: 34611292 DOI: 10.1038/s41409-021-01484-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 09/15/2021] [Accepted: 09/24/2021] [Indexed: 02/08/2023]
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7
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Cost and clinical benefit of imaging surveillance after treatment for breast implant-associated anaplastic large cell lymphoma (BIA-ALCL). EUROPEAN JOURNAL OF SURGICAL ONCOLOGY 2021; 48:748-751. [PMID: 34974948 DOI: 10.1016/j.ejso.2021.12.463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 12/09/2021] [Accepted: 12/23/2021] [Indexed: 11/22/2022]
Abstract
Recent UK guidelines recommend that surveillance imaging should not be offered to patients who have undergone treatment for breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) unless clinically indicated. The aim of this study was to explore the evolving practice at a tertiary referral unit and quantify the direct economic costs (DEC) associated with post-treatment BIA-ALCL routine radiological surveillance prior to adoption of the guidelines. Eleven patients were treated for BIA-ALCL between 2015 and 2020. At a median follow-up of 38 months (IQR 12-47) there were no local or distant relapses. Two patients did not have any radiological surveillance and 1 had follow-up elsewhere. The remaining 8 patients had a combination of positron emission tomography/computed tomography (PET/CT) (n = 10), CT (n = 2), breast ultrasound (n = 6), mammogram (n = 4) and breast magnetic resonance imaging (MRI) (n = 1) as routine imaging follow-up not guided by clinical concerns. Total cost of imaging was £10,396 (€12,257) with a median cost of £1953 (€2304) per patient [IQR £526-2029 (€621-2394)]. This cost could have been saved based on current guidelines recommending no routine surveillance for asymptomatic patients.
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8
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Sabri YY, Ewis NM, Zawam HEH, Khairy MA. Role of diffusion MRI in diagnosis of mediastinal lymphoma: initial assessment and response to therapy. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2021. [DOI: 10.1186/s43055-021-00597-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Abstract
Background
Malignant lymphoma accounts for nearly 20% of all mediastinal neoplasms in adults and 50% in children. Hodgkin’s disease is the most common primary mediastinal lymphoma. In non-Hodgkin’s lymphoma, the two most common forms of primary mediastinal lymphoma are lymphoblastic lymphoma and diffuse large B-cell lymphoma. The aim of this study is to implement diffusion MRI in the algorithm of diagnosis of mediastinal lymphoma, differentiating Hodgkin's from non-Hodgkin's lymphoma and assessment of post therapeutic response.
Results
Using Diffusion weighted magnetic resonance imaging DWI-MRI, there were statistic significant difference between ADC values in lymph nodes and mediastinal masses in Hodgkin and non-Hodgkin lymphomas. ADC range in non-treated Hodgkin lymphoma cases was 0.774 to 1.4, while ADC range in in non-treated non-Hodgkin lymphoma was 0.476 to 0.668. In this study, there was statistically significant difference of ADC values in lymphoma cases presented by mediastinal masses with and without chemotherapy.
Conclusions
Diffusion weighted magnetic resonance imaging DWI-MRI is a promising functional technique in diagnosis of Hodgkin's and non-Hodgkin's lymphoma and assessment of response to treatment with no need for special preparation, contrast injection or radiation exposure.
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9
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Valduga SG, Forte GC, Paganin RP, Abreu DG, Medeiros TM, Irion K, Hochhegger B, Mattiello R. Whole-body magnetic resonance imaging for the diagnosis of metastasis in children and adolescents: a systematic review and meta-analysis. Radiol Bras 2021; 54:329-335. [PMID: 34602669 PMCID: PMC8475173 DOI: 10.1590/0100-3984.2020.0183] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 01/15/2021] [Indexed: 11/21/2022] Open
Abstract
Whole-body magnetic resonance imaging (WB-MRI) is a noninvasive imaging method that can be used to diagnose and stage tumors, as well as to assess therapeutic responses in oncology. The objective of this meta-analysis was to evaluate the accuracy of WB-MRI for the diagnosis of metastases in pediatric patients. The following electronic databases were searched: Medline, Embase, Cochrane Central Register of Controlled Trials, Scientific Electronic Library Online, Latin-American and Caribbean Health Sciences Literature, Cumulative Index to Nursing and Allied Health Literature, Web of Science, and ClinicalTrials.gov. All of the selected studies included children and adolescents with histopathological confirmation of a primary tumor. Collectively, the studies included 118 patients ranging in age from 7 months to 19 years. The pooled sensitivity and specificity of WB-MRI were, respectively, 0.964 (95% CI: 0.944-0.978; I2 = 0%) and 0.902 (95% CI: 0.882-0.919; I2 = 98.4%), with an area under the curve (AUC) of 0.991. We found that WB-MRI had good accuracy for the diagnosis of metastases in pediatric patients and could therefore provide an alternative to complete the staging of tumors in such patients, being a safer option because it does not involve the use of ionizing radiation.
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Affiliation(s)
| | - Gabriele Carra Forte
- Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
| | | | - Diego Gomez Abreu
- Universidad Industrial de Santander (UIS), Bucaramanga, Santander, Colombia
| | | | - Klaus Irion
- Thoracic Imaging DIIRM, Manchester University and Manchester University NHS Foundation Trust Department of Radiology, Manchester, UK
| | - Bruno Hochhegger
- Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
| | - Rita Mattiello
- Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
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10
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Mehdi AS, Bitar G, Sharma RK, Iyengar S, El-Sharkawi D, Tasoulis MK, Attygalle AD, Cunningham D, Sharma B. Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL): a good practice guide, pictorial review, and new perspectives. Clin Radiol 2021; 77:79-87. [PMID: 34579859 DOI: 10.1016/j.crad.2021.09.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 09/02/2021] [Indexed: 11/03/2022]
Abstract
Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a rare but emerging T-cell non-Hodgkin lymphoma. It has two distinct subtypes, "effusion-only" or "mass-forming" disease, arising around implants in patients with in situ or previous history of textured-surface breast implants. The clinical, histopathological and imaging features are unique and nuanced as compared to primary breast malignancy and other lymphoma categories. Prompt recognition and diagnosis triggers referral to appropriate BIA-ALCL centres and initiation of treatment, with potential for excellent prognosis. Definitive management of both subtypes involves implant and capsule removal; systemic therapy is reserved for mass-forming disease and advanced-stage disease. There have been recent crucial advances in the diagnostic pathway, with publication of national and international guidelines: from the UK Medicines Healthcare products Regulatory Agency (MHRA) Plastic, Reconstructive and Aesthetic Surgery Expert Advisory Group (PRASEAG), and the United States National Comprehensive Cancer Network (NCCN). This review provides a practical guide to the clinical work-up of BIA-ALCL, enabling optimisation of the diagnostic imaging pathway, with representative cases.
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Affiliation(s)
- A S Mehdi
- Radiology Department, Imperial College Healthcare NHS Trust, London, UK
| | - G Bitar
- Lymphoma Unit, Royal Marsden NHS Foundation Trust, London, UK
| | - R K Sharma
- Medical School, College of Medicine and Health, University of Exeter, UK
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- Lymphoma Unit, Royal Marsden NHS Foundation Trust, London, UK; Lymphoma Unit, The Institute of Cancer Research, ICR, London, UK
| | - S Iyengar
- Lymphoma Unit, Royal Marsden NHS Foundation Trust, London, UK; Lymphoma Unit, The Institute of Cancer Research, ICR, London, UK
| | - D El-Sharkawi
- Lymphoma Unit, Royal Marsden NHS Foundation Trust, London, UK; Lymphoma Unit, The Institute of Cancer Research, ICR, London, UK
| | - M K Tasoulis
- Lymphoma Unit, Royal Marsden NHS Foundation Trust, London, UK
| | - A D Attygalle
- Lymphoma Unit, Royal Marsden NHS Foundation Trust, London, UK
| | - D Cunningham
- Lymphoma Unit, Royal Marsden NHS Foundation Trust, London, UK; Lymphoma Unit, The Institute of Cancer Research, ICR, London, UK
| | - B Sharma
- Lymphoma Unit, Royal Marsden NHS Foundation Trust, London, UK; Lymphoma Unit, The Institute of Cancer Research, ICR, London, UK.
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11
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Musanhu E, Sharma RK, Attygalle A, Wotherspoon A, Chau I, Cunningham D, Dearden C, El-Sharkawi D, Iyengar S, Sharma B. Chronic lymphocytic leukaemia and Richter's transformation: multimodal review and new imaging paradigms. Clin Radiol 2021; 76:789-800. [PMID: 34217434 DOI: 10.1016/j.crad.2021.06.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 06/01/2021] [Indexed: 12/15/2022]
Abstract
Chronic lymphocytic leukaemia (CLL) is the most common leukaemia in adults. It is a malignancy of CD5 B-cells characterised by small, mature-appearing lymphocytes accumulating in the blood, bone marrow, and lymphoid tissues. Richer transformation (RT) is an important adverse complication. Detection of RT is critical to allow initiation of appropriate therapy. CLL staging and response evaluation is complicated and nuanced. From our extensive tertiary centre experience of several hundred CLL cases over the last decade, we detail key computed tomography (CT) and positron-emission tomography (PET) imaging features of the natural history of CLL. The authors present an original imaging-based patient-management paradigm for the investigation of potential RT, which will inform global practice. Potential applications of whole-body diffusion weighted imaging, novel PET radiotracers, minimal residual disease, and ct-DNA are addressed.
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Affiliation(s)
- E Musanhu
- Radiology Department, Royal Marsden Hospital, London, UK
| | - R K Sharma
- University of Exeter Medical School, Exeter, UK
| | - A Attygalle
- Pathology Department, Royal Marsden Hospital, UK
| | - A Wotherspoon
- Clinical Oncology Department, Royal Marsden Hospital, UK
| | - I Chau
- Clinical Oncology Department, Royal Marsden Hospital, UK
| | - D Cunningham
- Clinical Oncology Department, Royal Marsden Hospital, UK
| | - C Dearden
- Clinical Oncology Department, Royal Marsden Hospital, UK
| | - D El-Sharkawi
- Clinical Oncology Department, Royal Marsden Hospital, UK
| | - S Iyengar
- The Institute of Cancer Research, London, UK
| | - B Sharma
- Radiology Department, Royal Marsden Hospital, London, UK.
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12
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Kowa JY, Millard T, Goldman A, Sharma RK, Attygalle A, Mahalingam P, Marshall K, Welsh L, Li S, Mackinnon A, Rich P, Nicholson E, Iyengar S, El-Sharkawi D, Chau I, Cunningham D, Sharma B. Are treatment response assessment maps (TRAMs) and 18 F-choline positron emission tomography the future of central nervous system lymphoma imaging? Br J Haematol 2021; 195:e116-e119. [PMID: 34109610 DOI: 10.1111/bjh.17632] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
| | | | | | - Rajaei K Sharma
- College of Medicine and Health, University of Exeter, Exeter, UK
| | | | | | | | - Liam Welsh
- The Royal Marsden NHS Foundation Trust, London, UK
| | - Su Li
- The Royal Marsden NHS Foundation Trust, London, UK
| | | | - Philip Rich
- The Royal Marsden NHS Foundation Trust, London, UK
| | | | - Sunil Iyengar
- The Royal Marsden NHS Foundation Trust, London, UK.,The Institute of Cancer Research, London, UK
| | | | - Ian Chau
- The Royal Marsden NHS Foundation Trust, London, UK
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13
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Zafar S, Sharma RK, Cunningham J, Mahalingam P, Attygalle AD, Khan N, Cunningham D, El-Sharkawi D, Iyengar S, Sharma B. Current and future best practice in imaging, staging, and response assessment for Non-Hodgkin's lymphomas: the Specialist Integrated Haematological Malignancy Imaging Reporting (SIHMIR) paradigm shift. Clin Radiol 2021; 76:391.e1-391.e18. [PMID: 33579517 DOI: 10.1016/j.crad.2020.12.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 12/24/2020] [Indexed: 12/12/2022]
Abstract
Non-Hodgkin's lymphoma (NHL) encompasses over 40 different haematological malignancies, including low and high-grade neoplasms, such as follicular lymphoma (FL) and diffuse large B-cell lymphoma (DLBCL) respectively. A key clinical issue in the context of NHL is delayed and inaccurate diagnosis, which contributes adversely to patient morbidity and mortality. This article will address relevant imaging aspects, with particular reference to advancements in NHL imaging, including computed tomography (CT), integrated positron-emission tomography (PET)-CT, and magnetic resonance imaging (MRI). We provide multiparametric (anato-functional) imaging display items, including histological correlation. We will also introduce our original concept of "Specialist Integrated Haematological Malignancy Imaging Reporting" (SIHMIR), a paradigm shift in lymphoma radiology.
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Affiliation(s)
- S Zafar
- Department of Radiology, The Royal Marsden NHS Trust, London, UK.
| | - R K Sharma
- College of Medicine and Health, University of Exeter, UK
| | - J Cunningham
- The Lymphoma Unit, The Royal Marsden NHS Trust, London, UK
| | - P Mahalingam
- The Lymphoma Unit, The Royal Marsden NHS Trust, London, UK
| | - A D Attygalle
- The Lymphoma Unit, The Royal Marsden NHS Trust, London, UK
| | - N Khan
- Department of Radiology, The Royal Marsden NHS Trust, London, UK
| | - D Cunningham
- The Lymphoma Unit, The Royal Marsden NHS Trust, London, UK
| | - D El-Sharkawi
- The Lymphoma Unit, The Royal Marsden NHS Trust, London, UK
| | - S Iyengar
- The Lymphoma Unit, The Royal Marsden NHS Trust, London, UK; The Institute of Cancer Research, London, UK
| | - B Sharma
- Department of Radiology, The Royal Marsden NHS Trust, London, UK; The Lymphoma Unit, The Royal Marsden NHS Trust, London, UK
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14
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Liquid biopsy based on small extracellular vesicles predicts chemotherapy response of canine multicentric lymphomas. Sci Rep 2020; 10:20371. [PMID: 33230132 PMCID: PMC7683601 DOI: 10.1038/s41598-020-77366-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 11/04/2020] [Indexed: 12/11/2022] Open
Abstract
Lymphoma is the most common type of canine hematological malignancy where the multicentric (cMCL) form accounts for 75% of all cases. The standard treatment is the CHOP chemotherapy protocols that include cyclophosphamide, doxorubicin, vincristine and prednisone, where the majority of dogs achieve complete/partial response; however, it is very important to predict non-responsive cases to improve treatment and to develop new targeted therapies. Here we evaluate a liquid biopsy approach based on serum Small Extracellular Vesicles enriched for exosomes (SEVs) to predict cMCL chemotherapy response. Nineteen dogs at the end of the 19-week chemotherapy protocol (8 Complete Response and 11 Progressive Disease) were evaluated for serum SEVs size, concentration and screened for 95 oncomirs. PD patients had higher SEVs concentration at the diagnosis than CR patients (P = 0.034). The ROC curve was significant for SEVs concentration to predict the response to CHOP (AUC = 0.8011, P = 0.0287). A potential molecular signature based on oncomirs from SEVs (caf-miR-205, caf-miR-222, caf-mir-20a and caf-miR-93) is proposed. To the best of our knowledge, this is the first study demonstrating the potential of a liquid biopsy based on SEVs and their miRNAs content to predict the outcome of chemotherapy for canine multicentric lymphomas.
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15
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Direct comparison of diagnostic accuracies of F-18 FDG PET and MRI for detection of bone marrow involvement in lymphoma patients; A meta-analysis. Leuk Res 2020; 99:106475. [PMID: 33189988 DOI: 10.1016/j.leukres.2020.106475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 10/26/2020] [Accepted: 11/01/2020] [Indexed: 11/23/2022]
Abstract
BACKGROUND The purpose of the current study was to compare the diagnostic accuracies of F-18 FDG PET or PET/CT and MRI for detection of bone marrow involvement (BMI) in lymphoma patients through a systematic review and meta-analysis. METHODS AND MATERIALS The PubMed, Cochrane database, and EMBASE database, from the earliest available date of indexing through July 31, 2020, were searched for studies evaluating direct comparison of diagnostic performance of F-18 FDG PET or PET/CT and MRI for BMI in lymphoma patients. We determined the sensitivities and specificities across studies, calculated positive and negative likelihood ratios (LR + and LR-), and constructed summary receiver operating characteristic curves. RESULTS Across 5 studies (212 patients), the pooled sensitivity of F-18 FDG PET or PET/CT was 0.65 (95 % CI; 0.42-0.82) a pooled specificity of 0.90 (95 % CI; 0.85-0.94). Likelihood ratio (LR) syntheses gave an overall positive likelihood ratio (LR+) of 6.4 (95 % CI; 3.3-12.4) and negative likelihood ratio (LR-) of 0.39 (95 % CI; 0.21-0.73). The pooled DOR was 16 (95 % CI; 5-56). The pooled sensitivity of MRI was 0.78 (95 % CI; 0.55-0.91) and a pooled specificity of 0.86 (95 % CI; 0.67-0.95). Likelihood ratio (LR) syntheses gave an overall positive likelihood ratio (LR+) of 5.6 (95 % CI; 1.8-17.0) and negative likelihood ratio (LR-) of 0.26 (95 % CI; 0.1-0.65). The pooled DOR was 22 (95 % CI; 3-149). In meta-regression analysis, no variable was the source of the study heterogeneity. CONCLUSION F-18 FDG PET or PET/CT and MRI showed similar diagnostic performances for the detection of BMI in lymphoma patients. Further large multicenter studies would be necessary to substantiate the diagnostic accuracy of F-18 FDG PET or PET/CT and MRI for the diagnosis of BMI in lymphoma patients.
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Kumar R, Hujairi N, Mohammed K, Attygalle A, Alexander E, Chau I, Cunningham D, Iyengar S, El-Sharkawi D, Sharma B. Early interval and serial positron emission tomography-computed tomography (PET-CT) after an indeterminate response defined by a PET scored 4 on the Deauville scale in lymphoma. Br J Haematol 2020; 190:e357-e362. [PMID: 32643153 DOI: 10.1111/bjh.16919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Raekha Kumar
- Radiology, Northwick Park Hospital and Royal Marsden Hospital NHS Trust, Middlesex, UK
| | - Nabil Hujairi
- Radiology, Royal Marsden Hospital NHS Trust, London, UK
| | - Kabir Mohammed
- Haematology, Royal Marsden Hospital NHS Trust, Sutton, UK
| | - Ayoma Attygalle
- Histopathology, Royal Marsden Hospital NHS Trust, Surrey, UK
| | - Emma Alexander
- Clinical Oncology, Royal Marsden Hospital NHS Trust, London, UK
| | - Ian Chau
- Department of Medicine, Royal Marsden Hospital NHS Trust, Sutton, UK
| | | | - Sunil Iyengar
- Haematology, Royal Marsden Hospital NHS Trust, Sutton, UK
| | - Dima El-Sharkawi
- NIHR UCLH Clinical Research Facility, Royal Marsden NHS Foundation Trust, Haematology and University College London Hospitals NHS Foundation Trust, Sutton, UK
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Lee ATJ, Attygale AD, Sharma RK, Iyengar S, El‐Sharkawi D, Chau I, Vroobel KM, Fotiadis N, Khan N, Butterfield N, Wotherspoon A, Cunningham D, Sharma B. LyRIC indeterminate response and Immune‐mediated pseudoprogression of diffuse large B‐cell lymphoma following polatuzumab‐based salvage therapy. Br J Haematol 2020; 189:e248-e251. [DOI: 10.1111/bjh.16679] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
| | | | | | | | | | - Ian Chau
- The Royal Marsden NHS Foundation Trust LondonUK
| | | | | | - Nasir Khan
- The Royal Marsden NHS Foundation Trust LondonUK
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Sharma B, Jurgensen-Rauch A, Pace E, Attygalle AD, Sharma R, Bommier C, Wotherspoon AC, Sharma S, Iyengar S, El-Sharkawi D. Breast Implant-associated Anaplastic Large Cell Lymphoma: Review and Multiparametric Imaging Paradigms. Radiographics 2020; 40:609-628. [PMID: 32302264 DOI: 10.1148/rg.2020190198] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a new provisional category in the 2016 World Health Organization (WHO) classification of lymphoid neoplasms, and its incidence is rising owing to increasing recognition of this complication of breast implant insertion. At a median of 10 years after implant insertion, the typical presenting features are sudden-onset breast swelling secondary to peri-implant effusion and less frequently mass-forming disease. Histologic features comprise pleomorphic cells expressing CD30 and negative anaplastic lymphoma kinase (ALK) receptor, similar to systemic and cutaneous ALK-negative anaplastic large cell lymphoma (ALCL). The effusion-only subtype is generally indolent and curable with surgery, unlike the more aggressive mass-forming disease, for which systemic therapy is advocated. High clinical suspicion and pertinent use of radiologic and pathology modalities are essential for timely and accurate diagnosis of BIA-ALCL. Contemporary imaging techniques including US, mammography, breast MRI, CT, and PET/CT are routinely used in breast disease and lymphomas; however, the unique behavior of BIA-ALCL presents significant diagnostic and radiologic interpretative challenges, with numerous nuanced imaging features being pertinent, and current lymphoma staging and response guidelines are not easily applicable to BIA-ALCL. The authors evaluate available evidence in this evolving field; detail key indications, strengths, and limitations of the panoply of radiologic techniques for BIA-ALCL; and propose multiparametric imaging paradigms for management of the peri-implant effusion and mass-forming or advanced disease subtypes, with the goal of accurate optimal patient care. The authors also predict a future model of multimodal assessment using novel imaging and molecular techniques and define key research directions. ©RSNA, 2020.
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Affiliation(s)
- Bhupinder Sharma
- From the Departments of Radiology (B.S., E.P.), Hematopathology (A.D.A., A.C.W.), Oncology (C.B.), and Hematology (S.S., S.I., D.E.S.), Royal Marsden Hospital, Fulham Road, London SW3 6JJ, England; Department of Medical Oncology, Royal Marsden Hospital Chelsea, London, England (A.J.R.); and University of Exeter Medical School, Exeter, England (R.S.)
| | - Amanda Jurgensen-Rauch
- From the Departments of Radiology (B.S., E.P.), Hematopathology (A.D.A., A.C.W.), Oncology (C.B.), and Hematology (S.S., S.I., D.E.S.), Royal Marsden Hospital, Fulham Road, London SW3 6JJ, England; Department of Medical Oncology, Royal Marsden Hospital Chelsea, London, England (A.J.R.); and University of Exeter Medical School, Exeter, England (R.S.)
| | - Erika Pace
- From the Departments of Radiology (B.S., E.P.), Hematopathology (A.D.A., A.C.W.), Oncology (C.B.), and Hematology (S.S., S.I., D.E.S.), Royal Marsden Hospital, Fulham Road, London SW3 6JJ, England; Department of Medical Oncology, Royal Marsden Hospital Chelsea, London, England (A.J.R.); and University of Exeter Medical School, Exeter, England (R.S.)
| | - Ayoma D Attygalle
- From the Departments of Radiology (B.S., E.P.), Hematopathology (A.D.A., A.C.W.), Oncology (C.B.), and Hematology (S.S., S.I., D.E.S.), Royal Marsden Hospital, Fulham Road, London SW3 6JJ, England; Department of Medical Oncology, Royal Marsden Hospital Chelsea, London, England (A.J.R.); and University of Exeter Medical School, Exeter, England (R.S.)
| | - Rajaei Sharma
- From the Departments of Radiology (B.S., E.P.), Hematopathology (A.D.A., A.C.W.), Oncology (C.B.), and Hematology (S.S., S.I., D.E.S.), Royal Marsden Hospital, Fulham Road, London SW3 6JJ, England; Department of Medical Oncology, Royal Marsden Hospital Chelsea, London, England (A.J.R.); and University of Exeter Medical School, Exeter, England (R.S.)
| | - Côme Bommier
- From the Departments of Radiology (B.S., E.P.), Hematopathology (A.D.A., A.C.W.), Oncology (C.B.), and Hematology (S.S., S.I., D.E.S.), Royal Marsden Hospital, Fulham Road, London SW3 6JJ, England; Department of Medical Oncology, Royal Marsden Hospital Chelsea, London, England (A.J.R.); and University of Exeter Medical School, Exeter, England (R.S.)
| | - Andrew C Wotherspoon
- From the Departments of Radiology (B.S., E.P.), Hematopathology (A.D.A., A.C.W.), Oncology (C.B.), and Hematology (S.S., S.I., D.E.S.), Royal Marsden Hospital, Fulham Road, London SW3 6JJ, England; Department of Medical Oncology, Royal Marsden Hospital Chelsea, London, England (A.J.R.); and University of Exeter Medical School, Exeter, England (R.S.)
| | - Sarkhara Sharma
- From the Departments of Radiology (B.S., E.P.), Hematopathology (A.D.A., A.C.W.), Oncology (C.B.), and Hematology (S.S., S.I., D.E.S.), Royal Marsden Hospital, Fulham Road, London SW3 6JJ, England; Department of Medical Oncology, Royal Marsden Hospital Chelsea, London, England (A.J.R.); and University of Exeter Medical School, Exeter, England (R.S.)
| | - Sunil Iyengar
- From the Departments of Radiology (B.S., E.P.), Hematopathology (A.D.A., A.C.W.), Oncology (C.B.), and Hematology (S.S., S.I., D.E.S.), Royal Marsden Hospital, Fulham Road, London SW3 6JJ, England; Department of Medical Oncology, Royal Marsden Hospital Chelsea, London, England (A.J.R.); and University of Exeter Medical School, Exeter, England (R.S.)
| | - Dima El-Sharkawi
- From the Departments of Radiology (B.S., E.P.), Hematopathology (A.D.A., A.C.W.), Oncology (C.B.), and Hematology (S.S., S.I., D.E.S.), Royal Marsden Hospital, Fulham Road, London SW3 6JJ, England; Department of Medical Oncology, Royal Marsden Hospital Chelsea, London, England (A.J.R.); and University of Exeter Medical School, Exeter, England (R.S.)
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Mir F, Wilding C, Mcaddy N, Butterfield N, Sena L, Thompson S, Mitra I, Mohammed K, Vroobel K, Attygalle A, Chau I, Cunningham D, Dearden C, El-Sharkawi D, Fotiadis N, Wotherspoon A, Sharma B, Iyengar S. Focal splenic lesions in indolent B-NHL: association with high grade transformation and safe percutaneous biopsy. Br J Haematol 2020; 189:e157-e160. [PMID: 32196643 DOI: 10.1111/bjh.16580] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 02/23/2020] [Accepted: 02/24/2020] [Indexed: 12/20/2022]
Affiliation(s)
- Farheen Mir
- The Royal Marsden Hospital, Sutton, Surrey, UK
| | | | | | | | | | | | - Indu Mitra
- The Royal Marsden Hospital, Sutton, Surrey, UK
| | | | | | | | - Ian Chau
- The Royal Marsden Hospital, Sutton, Surrey, UK
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Jiang Y, Wang L, Zhou W, Gu J, Tian Y, Dong Y, Fu L, Wu HB. 18F-FDG PET/CT imaging findings in anaplastic large cell lymphoma, a rare subtype of lymphoma. Cancer Imaging 2020; 20:4. [PMID: 31924270 PMCID: PMC6954597 DOI: 10.1186/s40644-019-0278-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 12/09/2019] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE To investigate the 18F-FDG PET/CT imaging manifestations for anaplastic large cell lymphoma (ALCL), a rare subtype of T/NK cell lymphoma. METHODS Fifty patients with ALCL, including 32 anaplastic lymphoma kinase (ALK)-positive patients and 18 ALK-negative patients, were enrolled. The positive detection, maximal standardized uptake value (SUVmax), and distribution of nodal and extranodal involvement were recorded and analysed. Fifty patients with diffuse large B cell lymphoma (DLBCL) were collected as a control group. RESULTS ALCL lesions were demonstrated to be 18F-FDG-avid tumours with a mean SUVmax of 19.4 ± 12.6. Most (76%) ALCL patients presented with stage III-IV disease, and nodal and extranodal involvement occurred in 74.0 and 72.0% of the patients, respectively. ALCL and DLBCL showed many similarities in tumour stage, 18F-FDG uptake and tumour involvement (P > 0.05), although the preferred extranodal organs of involvement (bone and the gastrointestinal tract, respectively) were different (P < 0.05). Compared to ALK-negative lesions, a higher uptake of 18F-FDG was found in the ALK-positive lesions (SUVmax: 22.1 ± 14.3 vs. 15.1 ± 6.6, t = 2.354, P = 0.023). ALK-positive ALCL was more likely to involve the lymph nodes than ALK-negative ALCL (84.3% vs. 55.5%, χ2 = 4.973, P = 0.043), while ALK-negative ALCL was more prone to involve the extranodal organs compared to ALK-positive ALCL (88.9% vs. 62.5%, χ2 = 3.979, P = 0.046). CONCLUSION The present study demonstrated that ALCL is a systemic 18F-FDG-avid lymphoma with many imaging manifestations similar to DLBCL on PET/CT. The present study also showed that ALK expression actually influenced tumour 18F-FDG uptake and lesion distribution. These findings may be useful to improve the understanding of the biological characteristics of ALCL.
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Affiliation(s)
- Yanping Jiang
- Nanfang PET Center, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Avenue North, Guangzhou, 510515, Guangdong Province, China
| | - Lijuan Wang
- Nanfang PET Center, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Avenue North, Guangzhou, 510515, Guangdong Province, China
| | - Wenlan Zhou
- Nanfang PET Center, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Avenue North, Guangzhou, 510515, Guangdong Province, China
| | - Jiamei Gu
- Nanfang PET Center, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Avenue North, Guangzhou, 510515, Guangdong Province, China
| | - Ying Tian
- Nanfang PET Center, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Avenue North, Guangzhou, 510515, Guangdong Province, China
| | - Ye Dong
- Nanfang PET Center, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Avenue North, Guangzhou, 510515, Guangdong Province, China
| | - Lilan Fu
- Nanfang PET Center, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Avenue North, Guangzhou, 510515, Guangdong Province, China
| | - Hu-Bing Wu
- Nanfang PET Center, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Avenue North, Guangzhou, 510515, Guangdong Province, China.
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21
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Kahle XU, Montes de Jesus FM, Kwee TC, van Meerten T, Diepstra A, Rosati S, Glaudemans AWJM, Noordzij W, Plattel WJ, Nijland M. Relationship between semiquantitative 18F-fluorodeoxyglucose positron emission tomography metrics and necrosis in classical Hodgkin lymphoma. Sci Rep 2019; 9:11073. [PMID: 31363153 PMCID: PMC6667466 DOI: 10.1038/s41598-019-47453-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2019] [Accepted: 07/16/2019] [Indexed: 11/08/2022] Open
Abstract
Semiquantitative 18F-fluoro-2-deoxy-D-glucose positron emission tomography (18F-FDG PET) parameters have been proposed as prognostic markers in classical Hodgkin lymphoma (cHL). In non-Hodgkin lymphoma necrosis as assessed by 18F-FDG PET or computed tomography (CT) (necrosisvisual) correlates with an adverse prognosis. We investigated whether semiquantitative 18F-FDG PET metrics correlate with necrosisvisual, determined the incidence of necrosisvisual and explored the prognostic impact of these factors in cHL. From 87 cHL cases treated with ABVD, (escalated) BEACOPP or CHOP chemotherapy between 2010 and 2017, 71 had both a NEDPAS/EARL accredited 18F-FDG PET and a contrast enhanced CT scan. Semiquantitative 18F-FDG PET parameters were determined using Hermes Hybrid 3D software. Necrosisvisual, defined by photopenic tumor areas on 18F-FDG PET and attenuation values between 10 and 30 Hounsfield units (HUs) on CT, was assessed blinded to outcome. Univariate Cox regression survival analyses of progression free survival (PFS) were performed. Necrosisvisual was observed in 18.3% of cHL patients. Bulky disease (tumor mass >10 cm in any direction) (P = 0.002) and TLG (P = 0.041) but no other semiquantitative parameters were significantly associated with necrosisvisual. In exploratory univariate survival analysis for PFS the covariates IPS, bulky disease, MTV and TLG were prognostic, while necrosisvisual was not.
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Affiliation(s)
- X U Kahle
- Department of Hematology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
| | - F M Montes de Jesus
- Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - T C Kwee
- Department of Radiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - T van Meerten
- Department of Hematology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - A Diepstra
- Department of Pathology and Medical Biology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - S Rosati
- Department of Pathology and Medical Biology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - A W J M Glaudemans
- Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - W Noordzij
- Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - W J Plattel
- Department of Hematology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - M Nijland
- Department of Hematology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Park HY, Hong YC, Lee K, Koh J. Vitamin D status and risk of non-Hodgkin lymphoma: An updated meta-analysis. PLoS One 2019; 14:e0216284. [PMID: 31034511 PMCID: PMC6488072 DOI: 10.1371/journal.pone.0216284] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Accepted: 04/17/2019] [Indexed: 01/11/2023] Open
Abstract
Purpose This meta-analysis aimed to extensively investigate the association between various measures of vitamin D status and non-Hodgkin lymphoma (NHL) and its subtypes. Methods We searched MEDLINE (PubMed), Embase, and the Cochrane Library in February 2018. Two authors independently reviewed and selected articles based on predetermined criteria. Results A total of 30 studies with 56,458 NHL cases were finally selected, with 24, 9, and 3 studies on sunlight/ultraviolet radiation (UVR) exposure, dietary intake, and serum/plasma 25-hydroxyvitamin D levels, respectively. Significant protective effects of overall sunlight/UVR exposure on NHL and subtypes were observed, with summary relative risks (RRs) ranging from 0.67–0.80 (RR for NHL = 0.80; 95% confidence interval [CI]: 0.71–0.90) among subjects with high exposure compared to those with low exposure. The results were consistent with various classifications of sunlight/UVR exposure. In contrast, when exposure measures of dietary vitamin D intake (RR for NHL = 1.03; 95% CI: 0.90–1.19) and serum/plasma 25-hydroxyvitamin D levels (RR for NHL = 0.97; 95% CI: 0.82–1.15) were used, risk estimates were inconsistent or non-significant for NHL and the subtypes. Conclusion While risk estimates varied by different measures of vitamin D status, a protective effect of sunlight/UVR exposure on NHL incidence was verified, across most of the tested subtypes as well as exposure categories.
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Affiliation(s)
- Hye Yin Park
- Samsung Health Research Institute, Samsung Electronics Co. Ltd., Hwaseong-si, Gyeonggi-do, Korea
- Institute of Environmental Medicine, Seoul National University Medical Research Center, Seoul, Korea
- * E-mail:
| | - Yun-Chul Hong
- Institute of Environmental Medicine, Seoul National University Medical Research Center, Seoul, Korea
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
- Environment Health Center, Seoul National University, Seoul, Korea
| | - Kyoungho Lee
- Samsung Health Research Institute, Samsung Electronics Co. Ltd., Hwaseong-si, Gyeonggi-do, Korea
| | - Jaewoo Koh
- Samsung Health Research Institute, Samsung Electronics Co. Ltd., Hwaseong-si, Gyeonggi-do, Korea
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Fitzpatrick JJ, Ryan MA, Bruzzi JF. Diagnostic accuracy of diffusion-weighted imaging- magnetic resonance imaging compared to positron emission tomography/computed tomography in evaluating and assessing pathological response to treatment in adult patients with lymphoma: A systematic review. J Med Imaging Radiat Oncol 2018; 62:530-539. [PMID: 29577630 DOI: 10.1111/1754-9485.12723] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Accepted: 02/20/2018] [Indexed: 12/19/2022]
Abstract
The use of Positron emission tomography/computerised tomography (PET/CT) is well established in the staging and assessment of treatment response of lymphoma. Recent studies have suggested that whole body diffusion-weighted imaging -magnetic resonance imaging (WB-DW-MRI) may be an alternative to PET/CT in both staging and assessment of treatment response. A systematic review was performed to assess the ability of DW-MRI in the assessment of treatment response in lymphoma. Pubmed, Medline, Web of Science and Embase databases were queried for studies examining whole body DW-MRI compared to PET/CT in adult patients using a protocol of search terms. We carried out an extensive assessment of titles, abstracts and full texts of relevant paper as well as quality assessment with the Quality Assessment of Diagnostic Accuracy (QUADAS-2) tool. Eight studies were found to meet the criteria and were included in our review and analysis. Overall, the quality of studies was found to be moderate, with good inter-rater agreement (K = 0.74). Data analysis showed that lesion-based assessment in 5 studies with pooled results had a sensitivity and specificity of 94.7% and 99.3%. Assessment with Cohen's Kappa coefficient showed agreement to be excellent (K = 0.88). Three studies were included for qualitative analysis, two of which showed good equivalence between PET/CT and DW-MRI. WB-DWI-MRI can be considered a sensitive and specific method for assessing treatment response in Lymphoma without the use of ionising radiation or administration of F-18 Flurodeoxyglucose. Further studies are needed to evaluate the optimum b-values in assessing treatment response.
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Hartshorn CM, Bradbury MS, Lanza GM, Nel AE, Rao J, Wang AZ, Wiesner UB, Yang L, Grodzinski P. Nanotechnology Strategies To Advance Outcomes in Clinical Cancer Care. ACS NANO 2018; 12:24-43. [PMID: 29257865 PMCID: PMC6589353 DOI: 10.1021/acsnano.7b05108] [Citation(s) in RCA: 148] [Impact Index Per Article: 24.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Ongoing research into the application of nanotechnology for cancer treatment and diagnosis has demonstrated its advantages within contemporary oncology as well as its intrinsic limitations. The National Cancer Institute publishes the Cancer Nanotechnology Plan every 5 years since 2005. The most recent iteration helped codify the ongoing basic and translational efforts of the field and displayed its breadth with several evolving areas. From merely a technological perspective, this field has seen tremendous growth and success. However, an incomplete understanding of human cancer biology persists relative to the application of nanoscale materials within contemporary oncology. As such, this review presents several evolving areas in cancer nanotechnology in order to identify key clinical and biological challenges that need to be addressed to improve patient outcomes. From this clinical perspective, a sampling of the nano-enabled solutions attempting to overcome barriers faced by traditional therapeutics and diagnostics in the clinical setting are discussed. Finally, a strategic outlook of the future is discussed to highlight the need for next-generation cancer nanotechnology tools designed to address critical gaps in clinical cancer care.
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Affiliation(s)
- Christopher M Hartshorn
- National Cancer Institute, National Institutes of Health, Bethesda, Maryland 20892, United States
- Corresponding Author,
| | - Michelle S Bradbury
- Department of Radiology and Molecular Pharmacology Program, Sloan Kettering Institute for Cancer Research, New York, New York, 10065, United States
| | - Gregory M Lanza
- Department of Medicine, Washington University School of Medicine, Saint Louis, Missouri 63108, United States
| | - Andre E Nel
- Division of NanoMedicine, Department of Medicine, and California NanoSystems Institute, University of California, Los Angeles, California 90095, United States
| | - Jianghong Rao
- Department of Radiology and Molecular Imaging Program at Stanford (MIPS), Stanford School of Medicine, Stanford, California 94305, United States
| | - Andrew Z. Wang
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, United States
| | - Ulrich B Wiesner
- Department of Materials Science and Engineering, Cornell University, Ithaca, New York 14843, United States
| | - Lily Yang
- Department of Surgery, Emory University School of Medicine, Atlanta, Georgia 30322, United States
| | - Piotr Grodzinski
- National Cancer Institute, National Institutes of Health, Bethesda, Maryland 20892, United States
- Corresponding Author,
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