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.