| Article ID | Journal | Published Year | Pages | File Type |
|---|---|---|---|---|
| 4225048 | European Journal of Radiology | 2016 | 7 Pages |
•The optimal strategy for relapse detection after curative treatment of large-cell B lymphoma is still controversial.•Our findings suggest that the relapse is most commonly suspected by the patient or the clinician and it is rarely detected only by imaging.•The risk of surveillance are not fully justified as it probably implies exposure to unnecessary radiation, which has been linked to cancer development.•59% of our patients had cumulative effective dose greater than 100 mSv due to surveillance CT, the threshold often considered for significant risk.
IntroductionTo evaluate the role of surveillance computed tomography (CT) in detection of tumor relapse after complete remission for large-cell lymphoma and to estimate the cancer risk related to those examinations.Materials and methodsWe retrospectively identified the cases of large-cell lymphoma diagnosed at our institution during a fifteen years period. We extracted from charts the information needed. Agreement between clinical and radiological evaluation for relapse detection was determined with index kappa and McNemar tests. We analysed the surveillance CT examinations performed to the patients in complete remission with no recurrence during the follow-up period and we estimated the life attributable risk (LAR) of radiation-induced cancer above base line using the approach of the Biological Effects of Ionizing Radiation (BEIR) VII.Results184 patients with biopsy confirmed large-cell lymphoma were included. Complete remission was attained in 125 patients. After a median follow-up of 93.73 months, 97 of them remain in remission. Relapse was confirmed in 28 patients; only 3 of them were asymptomatic. Kappa and McNemar analyses revealed good agreement for diagnosis of recurrence and significant difference for exclusion of relapse. Patients in remission received a median of 6 surveillance CT examinations. Fifty-seven patients had total cumulative doses greater than 100 mSv. The mean increase in estimated radiation-induced cancer risk was 0.5%.ConclusionOur results suggest that periodic CT examinations have a limited role in detecting relapse in large-cell lymphoma as the clinical surveillance dictates the patient management.
