Purpose Investigate spleen diameter (d) and volume (v) relationship in patients with hematologic malignancies (HM) by determining volumetric thresholds that best correlate to established diameter thresholds for assessing response to treatment. Exploratorily, interrogate the impact of volumetric measurements in response categories and as a predictor of response. Methods Secondary analysis of prospectively collected clinical trial data of 382 patients with HM. Spleen diameters were computed following Lugano criteria and volumes using deep learning segmentation. d and v relationship was estimated using power regression model, volumetric thresholds (<InlineEquation ID="IEq1"> <InlineMediaObject> <ImageObject Color="BlackWhite" FileRef="261_2025_5030_Article_IEq1.gif" Format="GIF" Height="12" Rendition="HTML" Resolution="72" Type="Linedraw" Width="61" /> </InlineMediaObject> <EquationSource Format="TEX">\(\:{v}_{threshold}\)</EquationSource> </InlineEquation>) for treatment response estimated; threshold search to determine percentual change (<InlineEquation ID="IEq3"> <InlineMediaObject> <ImageObject Color="BlackWhite" FileRef="261_2025_5030_Article_IEq3.gif" Format="GIF" Height="19" Rendition="HTML" Resolution="72" Type="Linedraw" Width="31" /> </InlineMediaObject> <EquationSource Format="TEX">\(\:{v}_{\%}),\)</EquationSource> </InlineEquation> and minimum volumetric increase (<InlineEquation ID="IEq4"> <InlineMediaObject> <ImageObject Color="BlackWhite" FileRef="261_2025_5030_Article_IEq4.gif" Format="GIF" Height="12" Rendition="HTML" Resolution="72" Type="Linedraw" Width="55" /> </InlineMediaObject> <EquationSource Format="TEX">\(\:{v}_{increase}\)</EquationSource> </InlineEquation>) that maximize agreement with Lugano criteria performed. Spleen diameter and volume predictive performance for clinical response investigated using random forest model. Results <InlineEquation ID="IEq5"> <InlineMediaObject> <ImageObject Color="BlackWhite" FileRef="261_2025_5030_Article_IEq5.gif" Format="GIF" Height="17" Rendition="HTML" Resolution="72" Type="Linedraw" Width="115" /> </InlineMediaObject> <EquationSource Format="TEX">\(\:v=2.24\times\:{d}^{2.14}\)</EquationSource> </InlineEquation> describes the relationship between spleen diameter and volume. <InlineEquation ID="IEq6"> <InlineMediaObject> <ImageObject Color="BlackWhite" FileRef="261_2025_5030_Article_IEq1.gif" Format="GIF" Height="12" Rendition="HTML" Resolution="72" Type="Linedraw" Width="61" /> </InlineMediaObject> <EquationSource Format="TEX">\(\:{v}_{threshold}\)</EquationSource> </InlineEquation> for splenomegaly was 546 cm³. <InlineEquation ID="IEq7"> <InlineMediaObject> <ImageObject Color="BlackWhite" FileRef="261_2025_5030_Article_IEq1.gif" Format="GIF" Height="12" Rendition="HTML" Resolution="72" Type="Linedraw" Width="61" /> </InlineMediaObject> <EquationSource Format="TEX">\(\:{v}_{threshold}\)</EquationSource> </InlineEquation>, <InlineEquation ID="IEq8"> <InlineMediaObject> <ImageObject Color="BlackWhite" FileRef="261_2025_5030_Article_IEq8.gif" Format="GIF" Height="13" Rendition="HTML" Resolution="72" Type="Linedraw" Width="19" /> </InlineMediaObject> <EquationSource Format="TEX">\(\:{v}_{\%}\)</EquationSource> </InlineEquation>, and <InlineEquation ID="IEq9"> <InlineMediaObject> <ImageObject Color="BlackWhite" FileRef="261_2025_5030_Article_IEq4.gif" Format="GIF" Height="12" Rendition="HTML" Resolution="72" Type="Linedraw" Width="55" /> </InlineMediaObject> <EquationSource Format="TEX">\(\:{v}_{increase}\)</EquationSource> </InlineEquation> for assessing response resulting in highest agreement with Lugano criteria were 570 cm3, 73%, and 170 cm3, respectively. Predictive performance for response between diameter and volume were not significantly different (P=0.78). Conclusion This study provides empirical spleen volume threshold and percentual changes that best correlate with diameter thresholds, i.e., Lugano criteria, for assessment of response to treatment in patients with HM. In our dataset use of spleen volumetric thresholds versus diameter thresholds resulted in similar response assessment categories and did not signal differences in predictive values for response.

Relationship between spleen volume and diameter for assessment of response to treatment on CT in patients with hematologic malignancies enrolled in clinical trials

期刊论文
发表日期：

2025年5月31日

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Kyle A. Hasenstab,
Jie Lu,
Lambert T. Leong,
Emily Bossard,
Evye Pylarinou-Sinclair,
Karthika Devi,
Guilherme M. Cunha

摘要

Purpose

Investigate spleen diameter (d) and volume (v) relationship in patients with hematologic malignancies (HM) by determining volumetric thresholds that best correlate to established diameter thresholds for assessing response to treatment. Exploratorily, interrogate the impact of volumetric measurements in response categories and as a predictor of response.

Methods

Secondary analysis of prospectively collected clinical trial data of 382 patients with HM. Spleen diameters were computed following Lugano criteria and volumes using deep learning segmentation. d and v relationship was estimated using power regression model, volumetric thresholds ( \(\:{v}_{threshold}\) ) for treatment response estimated; threshold search to determine percentual change ( \(\:{v}_{\%}),\) and minimum volumetric increase ( \(\:{v}_{increase}\) ) that maximize agreement with Lugano criteria performed. Spleen diameter and volume predictive performance for clinical response investigated using random forest model.

Results

\(\:v=2.24\times\:{d}^{2.14}\) describes the relationship between spleen diameter and volume. \(\:{v}_{threshold}\) for splenomegaly was 546 cm³. \(\:{v}_{threshold}\) , \(\:{v}_{\%}\) , and \(\:{v}_{increase}\) for assessing response resulting in highest agreement with Lugano criteria were 570 cm³, 73%, and 170 cm³, respectively. Predictive performance for response between diameter and volume were not significantly different (P=0.78).

Conclusion

This study provides empirical spleen volume threshold and percentual changes that best correlate with diameter thresholds, i.e., Lugano criteria, for assessment of response to treatment in patients with HM. In our dataset use of spleen volumetric thresholds versus diameter thresholds resulted in similar response assessment categories and did not signal differences in predictive values for response.