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What Is the Best Method for Assessing Splenic Volume in Patients With CLL?

By: Kayci Reyer
Posted: Thursday, October 6, 2022

According to research presented in Academic Radiology, three-dimensional measurements of splenic size appear to provide the most accurate dimensions versus one- and two-dimensional assessments in patients with chronic lymphocytic leukemia (CLL). Spleen size has been correlated with disease activity in patients with hematologic disease.

“Not achieving normalization of spleen size in CLL patients on treatment can be a common reason for not meeting the complete response criteria. Therefore, the appropriate evaluation method of the size of the spleen before, during, and after treatment is useful to make proper therapeutic decisions throughout the course of the disease,” noted Li-Yueh Hsu, DSc, of the National Institutes of Health, Bethesda, Maryland, and colleagues.

The study evaluated abdominal CT images from 48 patients with CLL enrolled in a phase II clinical trial. Images were analyzed prior to and following treatment, which consisted of 2 months of continuous acalabrutinib therapy. Measurements were taken three ways: one-dimensionally along multiple planes and two- and three-dimensionally using formulae based on the linear measurements. Actual spleen volume was measured using manual segmentation.

Three-dimensional measurements, including the splenic index and a volume formula, were most strongly correlated with actual splenic volume. Sagittal long axis diameter, coronal long axis diameter, and cephalocaudal length had the closest correlation among unidimensional measurements. Less-reliable correlations were identified between actual splenic volume and the sum of the long and short axis diameters, a two-dimensional index.

“Choosing an accurate and reproducible method of assessment of the splenic size is valuable while evaluating patients at every stage of CLL management,” stated the authors.

Disclosure: For full disclosures of the study authors, visit academicradiology.org.


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