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Author
Kitayama, Takahiro Department of Radiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University
Tanaka, Takashi Department of Radiology, Okayama City Hospital
Kanie, Yuichiro Department of Radiology, Okayama University Hospital
Marukawa, Yohei Department of Radiology, Okayama Saiseikai General Hospital
Kojima, Katsuhide Department of Radiology, Okayama University Hospital
Tanaka, Takehiro Department of Pathology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University ORCID Kaken ID publons
Takao, Soshi Department of Epidemiology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University ORCID Kaken ID publons researchmap
Hiraki, Takao Department of Radiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Kaken ID publons researchmap
Abstract
This retrospective study investigated whether necrotic lesions detected on a computed tomography (CT) scan are more regressive than non-necrotic lesions after methotrexate withdrawal in patients pathologically diagnosed with methotrexate-associated lymphoproliferative disorders (MTX-LPD). In total, 89 lesions extracted from 24 patients on CT scans were included in the analysis. All patients had been evaluated for the presence of necrosis within lesions via CT scan upon first suspicion of MTX-LPD (baseline CT scan). The percentage lesion size reduction between the baseline and initial follow-up CT scan was calculated. The association between necrosis within lesions and size changes was estimated via linear regression analyses using both crude and adjusted models. Necrosis was significantly more common in extranodal lesions (27 out of 30 lesions, 90%) than in nodal lesions (9 out of 59 lesions, 15%, p<0.001). In the crude model, the regression of necrotic lesions was 58.5% greater than that of non-necrotic lesions; the difference was statistically significant (p<0.001). Additionally, the longest diameter of necrotic lesions at the baseline CT scan was significantly greater than that of non-necrotic lesions (p<0.001). Based on the adjusted model, necrotic lesions showed 49.3% greater regression than non-necrotic lesions (p=0.017). Necrosis detected on a CT scan was found to be an independent predictor of regression after MTX withdrawal in patients with MTX-LPD.
Keywords
methotrexate
lymphoproliferative disorder
computed tomography
necrosis
Amo Type
Original Article
Publication Title
Acta Medica Okayama
Published Date
2024-02
Volume
volume78
Issue
issue1
Publisher
Okayama University Medical School
Start Page
29
End Page
36
ISSN
0386-300X
NCID
AA00508441
Content Type
Journal Article
language
English
Copyright Holders
Copyright Ⓒ 2024 by Okayama University Medical School
File Version
publisher
Refereed
True
PubMed ID
Web of Science KeyUT