Computed Tomography Texture Analysis for Monitoring Treatment Response in Childhood Lymphomas: A Preliminary Study

Objective: This preliminary study aims to evaluate the effectiveness of computed tomography (CT) texture analysis parameters in monitoring treatment response in childhood lymphomas. Methods: A retrospective study was conducted on 28 pediatric patients (15 with Hodgkin lymphoma and 13 with non-Hodgkin lymphoma), aged 3-16 years. CT images were acquired using a 64-detector spiral CT scanner and analyzed with OLEA research software (Olea Medical, La Ciotat, France). Regions of interest were placed on non-necrotic tumor areas in venous phase sequences. Results: No significant age distribution difference was found between the genders, in both lymphoma groups (p=0.6). For Hodgkin lymphoma, significant texture parameters included median and gray-level non-uniformity in gray-level run-length matrix, gray-level size-zone matrix, and gray-level dependence matrix. For non-Hodgkin lymphoma, significant parameters were joint energy and sum entropy in gray-level co-occurrence matrices, zone entropy in gray-level size zone matrices, and dependence entropy in gray-level dependence matrices. Receiver operating characteristic analysis for Hodgkin lymphoma showed p-values of 0.0002-0.04, area under the curve (AUC) values of 65-78, sensitivity rates of 56-75%, and specificity rates of 58-75%. For non-Hodgkin lymphoma, significant parameters had p-values of 0.006-0.027, AUC values of 0.71-0.73, sensitivity of 47-87%, and specificity of 60-87%. Conclusion: The study highlights the value of CT texture analysis in differentiating between Hodgkin and non-Hodgkin lymphoma in pediatric patients. By identifying significant texture parameters, this analysis method can improve diagnostic accuracy and treatment planning in childhood lymphomas.