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Midtreatment Evaluation of Lymphoma Response to Chemotherapy by Volume Perfusion Computed Tomography

Spira, Daniel MD*; Grünwald, Leonard*; Vogel, Wichard MD; Sauter, Alexander MD*; Spira, Sven Michael MSc; Claussen, Claus Detlef MD*; Horger, Marius MD*

Journal of Computer Assisted Tomography: January/February 2014 - Volume 38 - Issue 1 - p 123–130
doi: 10.1097/RCT.0b013e3182a90ee7
Abdominal Imaging

Objective: The aim of this study was to search for chemotherapy-induced perfusion changes of diffuse large B-cell lymphoma, follicular lymphoma, and Hodgkin lymphoma at midtreatment versus baseline volume perfusion computed tomography (VPCT).

Methods: Forty-five consecutive patients with untreated diffuse large B-cell lymphoma, follicular lymphoma, and Hodgkin lymphoma received VPCT examinations of the tumor bulk at baseline and during chemotherapy (midtreatment). Blood flow (BF), blood volume (BV), and transit constant (K-trans) were determined. Treatment response was categorized according to the Cheson criteria into complete or partial remission and stable or relapsed/progressive disease.

Results: Midtreatment follow-up showed a reduction in BF, BV, and K-trans in all lymphoma subtypes compared with baseline. The reduction in BV was less pronounced in larger tumors. Notably, BF, BV, and K-trans decreased in the responders (complete remission/partial remission) when compared with the nonresponders (stable or relapsed/progressive disease). Less than 10% reduction in BF was shown to be the best VPCT criterion for the identification of nonresponse.

Conclusions: Chemotherapy-induced perfusion changes in responders are recognizable at midtreatment VPCT.

From the *Department of Diagnostic and Interventional Radiology, and †Department of Oncology and Hematology, Eberhard-Karls-University, Tübingen, Germany; and ‡Finance Department, HEC Paris, Jouy en Josas, France.

Received for publication April 9, 2013; accepted August 12, 2013.

Reprints: Daniel Spira, MD, Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University, Hoppe-Seyler-Str. 3, 72076 Tübingen, Germany (e-mail:

Claus Detlef Claussen received technical support supplied by Siemens Healthcare (Forchheim, Germany). Daniel Spira was supported by an intramural grant of the Eberhard-Karls-University Tuebingen (project number 263-0-0). The other authors declare no conflict of interest.

© 2014 by Lippincott Williams & Wilkins