Parametric Imaging of Contrast-Enhanced Ultrasound (CEUS) for the Evaluation of Acute Gastrointestinal Graft-Versus-Host Disease
Abstract
:1. Introduction
2. Materials and Methods
2.1. Patients
2.2. Ultrasound Examination
2.3. Strain Elastography
2.4. CEUS
2.5. Parametric Analysis
2.6. Ultrasound Image Analysis
2.7. Histopathological Analysis for Acute GvHD of Intestinal Biopsies
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Patient Characteristcs | Value |
---|---|
Patients | 24 |
Female, n (%) | 7 (29) |
Male, n (%) | 17 (71) |
Age, median (range) | 58y (21–68) |
Diagnosis | |
Acute myeloid leukemia, n (%) | 15 (63) |
Acute lymphoblastic leukemia, n (%) | 1 (4) |
Myelodysplastic syndrome, n (%) | 2 (8) |
Myeloproliferative neoplasms, n (%) | 1 (4) |
Others, n (%) | 5 (20) |
Conditioning regimen | |
Reduced intensity conditioning, n (%) | 2 (8) |
Standard, n (%) | 22 (92) |
Donor type | |
Unrelated | 14 (58) |
Sibling | 10 (42) |
Stem cell source | |
Peripheral blood stem cells, n (%) | 20 (83) |
Bone marrow, n (%) | 4 (17) |
GvHD prophylaxis | |
Cyclophosphamide, tacrolimus, mycophenolate mofetil | 10 (42) |
Ciclosporine A, methotrexate, antithymocyte globuline | 9 (38) |
Ciclosporine A, mycophenolate mofetil, antithymocyte globuline | 2 (8) |
Others | 3 (12) |
Acute GI GvHD grading | |
Stages I, n (%) | 12 (50) |
Stages II–IV, n (%) | 12 (50) |
Patient # | Days after Allo-HSCT | Overall GvHD Grade | GI GvHD Stage | GvHD Histology | B-Mode | Elastography | CEUS | PI | HD Steroids | Additional IS | Improvement in Follow-Up PI | Outcome |
---|---|---|---|---|---|---|---|---|---|---|---|---|
1 | 20 | 3 | 3 | 3 | 2 | 2 | y | y | y | Eta | y | a&w |
2 | 55 | 3 | 3 | 0 | 2 | 3 | y | y | y | Eta | y | a&w |
3 | 194 | 4 | 4 | 4 | 2 | 3 | y | y | y | Eta | - | TRM (GvHD) |
4 | 11 | 1 | 1 | 1 | 1 | 2 | y | y | y | - | - | a&w |
5 | 24 | 2 | 1 | 1 | 2 | 3 | y | y | y | - | - | a&w |
6 | 20 | 2 | 2 | 1 | 2 | 3 | y | y | y | - | - | a&w |
7 | 195 | 4 | 4 | 3 | 2 | 2 | y | y | y | Eta, Eve | - | TRM |
8 | 19 | 2 | 1 | 1 | 1 | 1 | y | y | y | - | y | a&w |
9 | 17 | 0 | 0 | 0 | 2 | 2 | n | n | y | - | - | a&w |
10 | 17 | 3 | 3 | 2 | 1 | 2 | y | y | y | - | - | a&w |
11 | 20 | 3 | 2 | 2 | 2 | 3 | y | y | y | - | - | a&w |
12 | 20 | 1 | 1 | 0 | 2 | 3 | y | y | y | - | - | a&w |
13 | 18 | 4 | 4 | 2 | 2 | 2 | n | y | y | Eta, ATG | - | TRM (GvHD) |
14 | 42 | 1 | 1 | 1 | 2 | 2 | y | y | y | Rux | - | a&w |
15 | 37 | 3 | 3 | 0 | 3 | 3 | y | y | y | Eta, Rux | - | a&w |
16 | 413 | 4 | 4 | 3 | 2 | 2 | y | y | y | AAT | a&w | |
17 | 20 | 3 | 2 | 2 | 2 | 3 | y | y | y | Eta | - | a&w |
18 | 12 | 0 | 0 | 0 | 2 | 3 | n | n | y | - | - | a&w |
19 | 20 | 2 | 1 | 1 | 2 | 2 | y | n | y | - | - | a&w |
20 | 24 | 1 | 0 | 1 | 2 | 3 | y | y | n | - | - | a&w |
21 | 89 | 1 | 1 | 2 | 2 | 2 | y | y | y | Eta, Rux | y | a&w |
22 | 19 | 3 | 3 | 2 | 1 | 2 | y | y | y | Eta | - | a&w |
23 | 17 | 2 | 1 | 1 | 1 | 1 | y | n | y | Eta | - | a&w |
24 | 148 | 3 | 2 | 2 | 2 | 2 | y | y | y | Eta, CsA | - | a&w |
Median | 61 |
GI GvHD Histology Result. | US + CEUS GI GvHD Suspicion | Parametric Imaging GI GvHD Suspicion | Treatment Initiation before Histology Result | |||
---|---|---|---|---|---|---|
Yes (any grade) | 19 | Yes | 18 (95%) | Yes | 17 (89%) | 18 |
No | 1 (5%) | No | 2 (11%) | (95%) | ||
No | 5 | Yes | 3 (60%) | Yes | 3 (60%) | 1 |
No | 2 (40%) | No | 2 (40%) | (20%) |
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Pausch, A.-M.; Kammerer, S.; Weber, F.; Herr, W.; Stroszczynski, C.; Holler, E.; Edinger, M.; Wolff, D.; Weber, D.; Jung, E.-M.; et al. Parametric Imaging of Contrast-Enhanced Ultrasound (CEUS) for the Evaluation of Acute Gastrointestinal Graft-Versus-Host Disease. Cells 2021, 10, 1092. https://doi.org/10.3390/cells10051092
Pausch A-M, Kammerer S, Weber F, Herr W, Stroszczynski C, Holler E, Edinger M, Wolff D, Weber D, Jung E-M, et al. Parametric Imaging of Contrast-Enhanced Ultrasound (CEUS) for the Evaluation of Acute Gastrointestinal Graft-Versus-Host Disease. Cells. 2021; 10(5):1092. https://doi.org/10.3390/cells10051092
Chicago/Turabian StylePausch, Antonia-Maria, Sylvia Kammerer, Florian Weber, Wolfgang Herr, Christian Stroszczynski, Ernst Holler, Matthias Edinger, Daniel Wolff, Daniela Weber, Ernst-Michael Jung, and et al. 2021. "Parametric Imaging of Contrast-Enhanced Ultrasound (CEUS) for the Evaluation of Acute Gastrointestinal Graft-Versus-Host Disease" Cells 10, no. 5: 1092. https://doi.org/10.3390/cells10051092
APA StylePausch, A. -M., Kammerer, S., Weber, F., Herr, W., Stroszczynski, C., Holler, E., Edinger, M., Wolff, D., Weber, D., Jung, E. -M., & Wertheimer, T. (2021). Parametric Imaging of Contrast-Enhanced Ultrasound (CEUS) for the Evaluation of Acute Gastrointestinal Graft-Versus-Host Disease. Cells, 10(5), 1092. https://doi.org/10.3390/cells10051092