Trastulli, Fabio (2022) UTILIZZO DELLA CONTRAST-ENHANCED ULTRASOUND (CEUS) CON ESAFLUORURO DI ZOLFO NELL’IDENTIFICAZIONE DELL’INVASIONE SPLENICA DA LINFOMA. STUDIO MONOCENTRICO DI 260 NODULI. [Tesi di dottorato]
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| Tipologia del documento: | Tesi di dottorato |
|---|---|
| Lingua: | Italiano |
| Titolo: | UTILIZZO DELLA CONTRAST-ENHANCED ULTRASOUND (CEUS) CON ESAFLUORURO DI ZOLFO NELL’IDENTIFICAZIONE DELL’INVASIONE SPLENICA DA LINFOMA. STUDIO MONOCENTRICO DI 260 NODULI |
| Autori: | Autore Email Trastulli, Fabio f.trastulli@gmail.com |
| Data: | 12 Dicembre 2022 |
| Numero di pagine: | 27 |
| Istituzione: | Università degli Studi di Napoli Federico II |
| Dipartimento: | Medicina Clinica e Chirurgia |
| Dottorato: | Terapie avanzate biomediche e chirurgiche |
| Ciclo di dottorato: | 35 |
| Coordinatore del Corso di dottorato: | nome email Pane, Fabrizio fabrizio.pane@unina.it |
| Tutor: | nome email Picardi, Marco [non definito] |
| Data: | 12 Dicembre 2022 |
| Numero di pagine: | 27 |
| Parole chiave: | CEUS LINFOMA NON HOGKIN LINFOMA DI HODGKIN INTERESSAMENTO SPLENICO |
| Settori scientifico-disciplinari del MIUR: | Area 06 - Scienze mediche > MED/15 - Malattie del sangue |
| Depositato il: | 06 Mar 2023 07:50 |
| Ultima modifica: | 09 Apr 2025 14:11 |
| URI: | http://www.fedoa.unina.it/id/eprint/14675 |
Abstract
Contrast-enhanced ultrasonography (CEUS) use for detecting lymphoma in the spleen was questioned because of the risk of its inadequate diagnostic accuracy. The aim of the present study was to validate CEUS exam for the identification of spleen involvement by lymphoma in patients at risk. A total of 260 nodules from the spleens of 77 patients with lymph node biopsy-proven non-Hodgkin lymphoma (NHL; n = 44) or Hodgkin lymphoma (HL; n = 33) at staging (n = 56) or follow-up (n = 21) were collected in a hematology Italian center and retrospectively analyzed. Nodules were classified as malignant lymphoma if ≥0.5 cm (long axis) with arterial phase isoen-hancement and early (onset <60 s after contrast agent injection) wash-out of marked (≤120 s after contrast agent injection) degree. Other perfusional combinations at CEUS scans qualified lesions as benign or inconclusive. Diagnostic reference standard was clinical laboratory imaging monitoring for 230 nodules, and/or histology for 30 nodules. The median nodule size was 1.5 cm (range 0.5-7 cm). According to the reference standard, 204 (78%) nodules were lymphomas (aggressive-NHL (a-NHL), 122; classic-HL (c-HL), 65; indolent (i)-NHL, 17) and 56 (22%) were benign (inflammation, infection, and/or mesenchymal) lesions. Sensitivity, specificity, positive predictive value, negative predictive value, and overall diagnostic accuracy of CEUS for detecting lymphoma in the spleen were 95%, 100%, 100%, 85%, and 96%, respectively. Marked wash-out range of 55-90 s (median, 74 s), 92-120 s (median, 100 s), and 101-120 s (median, 114.5 s) was 100%, 96.6%, and 77% predictive of a-NHL, c-HL, and i-NHL splenic nodular infiltration, respectively. The CEUS perfusional pattern of arterial phase isoenhancement with early wash-out of marked degree was highly accurate for the detection of lymphomatous invasion of spleen in patients at risk, enabling its use for a confident non-invasive diagnosis.
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