title: Current imaging follow-up of non-Hodgkin lymphoma exposes patients to significant radiation but does not detect asymptomatic relapses.
abstract: The standard approach to the follow-up of lymphoma includes computed tomography (CT) every 6-12 months for the first 2 years and, then, as clinically indicated. Recent evidence suggests that most relapses are detected clinically, outside scheduled CT which, on the other hand, increases risk of second malignancies and cost. In early-stage lymphomas, involved site CT instead of full body CT may be a reasonable alternative to reduce radiation dose. We analyzed whether regular CT surveillance detects asymptomatic relapses in a single-center Uruguayan early stage non-Hodgkin lymphoma (NHL) population. We evaluated utility of full body CT halfway and at the end-of-treatment evaluation and calculated the radiation exposure. In our study, CT surveillance added nothing to clinical follow-up. Moreover, 44% of our patients received a cumulative effective dose that doubles the risk of malignancies. Involved-site CT scan would be enough to monitor response during treatment in early stage NHL.
authors.affiliation: a Hospital de Clínicas, Hematology , Montevideo , Uruguay.
authors.forename: Eloisa
authors.initials: E
authors.lastname: Riva
authors.affiliation: a Hospital de Clínicas, Hematology , Montevideo , Uruguay.
authors.forename: Carolina
authors.initials: C
authors.lastname: Oliver
authors.affiliation: b Radiology Department, Hospital de Clínicas , Montevideo , Uruguay and.
authors.forename: Maria del Carmen
authors.initials: Mdel C
authors.lastname: Pérez
authors.affiliation: b Radiology Department, Hospital de Clínicas , Montevideo , Uruguay and.
authors.forename: Osmar
authors.initials: O
authors.lastname: Telis
authors.affiliation: a Hospital de Clínicas, Hematology , Montevideo , Uruguay.
authors.forename: Lilian
authors.initials: L
authors.lastname: Díaz
authors.affiliation: c Mayo Clinic Arizona, Division of Hematology-Oncology , Scottsdale , AZ , USA.
authors.forename: Joseph R
authors.initials: JR
authors.lastname: Mikhael
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D011829:Radiation Dosage; D011830:Radiation Effects; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000009:adverse effects / Q000592:standards; D055815:Young Adult
keywords: Lymphoma and Hodgkin disease; prognostication; radiation