The role of contrast-enhanced ultrasound (CEUS) in the early assessment of microvascularization in patients with aggressive B-cell lymphoma treated by rituximab-CHOP: A preliminary study
Affiliations: Department of Diagnostic and Therapeutic Ultrasonography, Tianjin Medical University Cancer Institute and Hospital, Key Laboratory of Cancer Prevention and Therapy, Tianjin, China | The Third Department of Breast Cancer, Tianjin Medical University Cancer Institute and Hospital, Key Laboratory of Cancer Prevention and Therapy, Tianjin, China | Department of Molecular Imaging and Nuclear Medicine, Tianjin Medical University Cancer Institute and Hospital, Key Laboratory of Cancer Prevention and Therapy, Tianjin, China | Department of Thyroid and Cervical Tumor, Tianjin Medical University Cancer Institute and Hospital, Key Laboratory of Cancer Prevention and Therapy, Tianjin, China
Note: [] These authors contributed equally to this work.
Note: [] These authors contributed equally to this work.
Note: [] These authors contributed equally to this work.
Note: [] Corresponding author: Ming Gao, M.D., Ph.D., Department of Thyroid and Cervical Tumor, Tianjin Medical University Cancer Institute and Hospital, Key Laboratory of Cancer Prevention and Therapy, Huan-hu-xi Road, Ti-Yuan-Bei, He xi District, Tianjin 300060, PR China. Tel.: +86 13820881516; Fax: +86 22 23355901; E-mail: weixi198204@126.com
Abstract: OBJECTIVE: To explore the role of contrast-enhanced ultrasound (CEUS) in the early evaluation of microvacularization in patients with aggressive B-cell lymphoma treated by R-CHOP. MATERIALS AND METHODS: Fifty-two patients with aggressive B-cell lymphoma underwent combined rituximab-CHOP treatment (CHOP: cyclophosphamide, hydroxydaunomycin, vincristine, prednisonetreatment). Before the treatment and after the first two cycles of R-CHOP, CEUS was performed to assess the microvascularization of tumors. In addition, PET/CT examination was also included in this study before and after the treatment. Ideal cut-off value of CEUS parameters was calculated using receiver-operating characteristic (ROC) curve analysis to predict the treatment outcome. The response to treatment, progression-free survival (PFS) and overall survival (OS) were then compared according to PET/CT and CEUS results. The correlation between CEUS parameters and PET/CT results was investigated based on these analyses. RESULTS: All patients were non-Hodgkin lymphomas (NHL) with CD20 positive. The variations of CEUS parameters (peak intensity and mean intensity) at the mid-term of R-CHOP treatment significantly associated with results of treatment response (P < 0.001), and were also positive correlation with PET/CT results (P = 0.001). The CEUS positive or negative results were determined by cut-off points of peak intensity and mean intensity (4.70 and 4.15dB). The median time of clinical follow-up was 35.4 months. Kaplan-Meier survival analysis demonstrated that PET/CT and CEUS were both good predictors for PFS and OS rate in these patients. CONCLUSION: As a microvascular imaging modality, CEUS could be a feasible tool to predict the survival rate of patients with aggressive B-cell lymphoma after R-CHOP treatment.
