{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T04:59:56Z","timestamp":1772773196423,"version":"3.50.1"},"reference-count":31,"publisher":"Springer Science and Business Media LLC","issue":"12","license":[{"start":{"date-parts":[[2023,9,26]],"date-time":"2023-09-26T00:00:00Z","timestamp":1695686400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,9,26]],"date-time":"2023-09-26T00:00:00Z","timestamp":1695686400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universit\u00e0 della Svizzera italiana"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Radiol med"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Purpose<\/jats:title>\n                <jats:p>Primary purpose was to assess changes of bone mineral density (BMD) in diffuse large B cell lymphoma (DLBCL) patients treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone R-CHOP (like) chemotherapy regimen. Secondary purposes were to assess other body composition features changes and to assess the association of pre-therapy values and their changes over time with survival.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Material and methods<\/jats:title>\n                <jats:p>Patients selected underwent R-CHOP(like) regimen for DLBCL, and underwent PET-CT before and after treatment. Main clinical data collected included body mass index, date of last follow-up, date of progression, and date of death. From the low-dose CT images, BMD was assessed at the L1 level; the other body composition values, including muscle and fat distribution, were assessed at the L3 level by using a dedicated software. Descriptive statistics were reported as median and interquartile range, or frequencies and percentages. Statistical comparisons of body composition variables between pre- and post-treatment assessments were performed using the Wilcoxon matched pairs signed rank test. Non-normal distribution of variables was tested with the Shapiro\u2013Wilk test. For qualitative variables, the Fisher exact test was used. Log rank test was used to compare survival between different subgroups of the study population defined by specific body composition cutoffs. The significance level was set at <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Eighty-two patients were included. The mean follow-up was 37.5\u2009\u00b1\u200921.4\u00a0months. A significant difference was found in mean BMD before and after R-CHOP(like) treatment (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001). The same trend was observed for mean skeletal muscle area (SMA) (<jats:italic>p<\/jats:italic>\u2009=\u20090.004) and mean skeletal muscle index (SMI) (<jats:italic>p<\/jats:italic>\u2009=\u20090.006). No significant association was demonstrated between body composition variables, PFS and OS.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>R-CHOP(like) treatment in DLBCL patients was associated with significant reduction of BMD, SMA and SMI.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s11547-023-01723-5","type":"journal-article","created":{"date-parts":[[2023,9,26]],"date-time":"2023-09-26T21:01:23Z","timestamp":1695762083000},"page":"1497-1507","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["CT-based body composition in diffuse large B cell lymphoma patients: changes after treatment and association with survival"],"prefix":"10.1007","volume":"128","author":[{"given":"Maria Cristina","family":"Pirosa","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fabiana","family":"Esposito","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giorgio","family":"Raia","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vito","family":"Chianca","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Cozzi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lorenzo","family":"Ruinelli","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luca","family":"Ceriani","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emanuele","family":"Zucca","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Filippo","family":"Del Grande","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5151-0866","authenticated-orcid":false,"given":"Stefania","family":"Rizzo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2023,9,26]]},"reference":[{"key":"1723_CR1","doi-asserted-by":"publisher","first-page":"298","DOI":"10.1016\/S0140-6736(16)32407-2","volume":"390","author":"JO Armitage","year":"2017","unstructured":"Armitage JO, Gascoyne RD, Lunning MA, Cavalli F (2017) Non-hodgkin lymphoma. Lancet 390:298\u2013310","journal-title":"Lancet"},{"key":"1723_CR2","doi-asserted-by":"publisher","first-page":"235","DOI":"10.1056\/NEJMoa011795","volume":"346","author":"B Coiffier","year":"2002","unstructured":"Coiffier B, Lepage E, Briere J et al (2002) CHOP chemotherapy plus rituximab compared with CHOP alone in elderly patients with diffuse large-B-cell lymphoma. N Engl J Med 346:235\u2013242","journal-title":"N Engl J Med"},{"key":"1723_CR3","doi-asserted-by":"publisher","first-page":"1105","DOI":"10.1080\/10428194.2016.1233543","volume":"58","author":"P Svendsen","year":"2017","unstructured":"Svendsen P, Shekhrajka N, Nielsen KL et al (2017) R-CHOP(-like) treatment of diffuse large B-cell lymphoma significantly reduces CT-assessed vertebral bone density: a single center study of 111 patients. Leuk Lymphoma 58:1105\u20131113","journal-title":"Leuk Lymphoma"},{"key":"1723_CR4","doi-asserted-by":"publisher","first-page":"561","DOI":"10.1093\/annonc\/mds517","volume":"24","author":"M Ghielmini","year":"2013","unstructured":"Ghielmini M, Vitolo U, Kimby E et al (2013) ESMO Guidelines consensus conference on malignant lymphoma 2011 part 1: diffuse large B-cell lymphoma (DLBCL), follicular lymphoma (FL) and chronic lymphocytic leukemia (CLL). Ann Oncol 24:561\u2013576","journal-title":"Ann Oncol"},{"key":"1723_CR5","doi-asserted-by":"publisher","first-page":"1218","DOI":"10.6004\/jnccn.2021.0054","volume":"19","author":"AD Zelenetz","year":"2021","unstructured":"Zelenetz AD, Gordon LI, Chang JE et al (2021) NCCN Guidelines(r) insights: B-Cell lymphomas, version 5.2021. J Natl Compr Canc Netw 19:1218\u20131230","journal-title":"J Natl Compr Canc Netw"},{"key":"1723_CR6","doi-asserted-by":"publisher","first-page":"524","DOI":"10.1148\/rg.2021200056","volume":"41","author":"PJ Pickhardt","year":"2021","unstructured":"Pickhardt PJ, Graffy PM, Perez AA, Lubner MG, Elton DC, Summers RM (2021) opportunistic screening at abdominal CT: use of automated body composition biomarkers for added cardiometabolic value. Radiographics 41:524\u2013542","journal-title":"Radiographics"},{"key":"1723_CR7","doi-asserted-by":"publisher","first-page":"360","DOI":"10.1148\/radiol.2019181648","volume":"291","author":"S Jang","year":"2019","unstructured":"Jang S, Graffy PM, Ziemlewicz TJ, Lee SJ, Summers RM, Pickhardt PJ (2019) Opportunistic osteoporosis screening at routine abdominal and thoracic ct: normative l1 trabecular attenuation values in more than 20 000 adults. Radiology 291:360\u2013367","journal-title":"Radiology"},{"issue":"9","key":"1723_CR8","doi-asserted-by":"publisher","first-page":"2194","DOI":"10.1002\/jbmr.428","volume":"26","author":"PJ Pickhardt","year":"2011","unstructured":"Pickhardt PJ, Lee LJ, del Rio AM et al (2011) Simultaneous screening for osteoporosis at CT colonography: bone mineral density assessment using MDCT attenuation techniques compared with the DXA reference standard. J Bone Miner Res 26(9):2194\u20132203","journal-title":"J Bone Miner Res"},{"key":"1723_CR9","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2022.974116","volume":"12","author":"S Rizzo","year":"2022","unstructured":"Rizzo S, Scala I, Robayo AR et al (2022) Body composition as a predictor of chemotherapy-related toxicity in pancreatic cancer patients: a systematic review. Front Oncol 12:974116","journal-title":"Front Oncol"},{"key":"1723_CR10","doi-asserted-by":"publisher","first-page":"1450","DOI":"10.21037\/qims-21-619","volume":"12","author":"C Zaffina","year":"2022","unstructured":"Zaffina C, Wyttenbach R, Pagnamenta A et al (2022) Body composition assessment: comparison of quantitative values between magnetic resonance imaging and computed tomography. Quant Imaging Med Surg 12:1450\u20131466","journal-title":"Quant Imaging Med Surg"},{"key":"1723_CR11","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2021.718815","volume":"11","author":"M Del Grande","year":"2021","unstructured":"Del Grande M, Rizzo S, Nicolino GM et al (2021) Computed tomography-based body composition in patients with ovarian cancer: association with chemotoxicity and prognosis. Front Oncol 11:718815","journal-title":"Front Oncol"},{"key":"1723_CR12","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2022.826058","volume":"12","author":"S Rizzo","year":"2022","unstructured":"Rizzo S, Petrella F, Bardoni C et al (2022) CT-derived body composition values and complications after pneumonectomy in lung cancer patients: time for a sex-related analysis? Front Oncol 12:826058","journal-title":"Front Oncol"},{"key":"1723_CR13","doi-asserted-by":"publisher","first-page":"135","DOI":"10.1017\/S0029665118000046","volume":"77","author":"LE Daly","year":"2018","unstructured":"Daly LE, Prado CM, Ryan AM (2018) A window beneath the skin: how computed tomography assessment of body composition can assist in the identification of hidden wasting conditions in oncology that profoundly impact outcomes. Proc Nutr Soc 77:135\u2013151","journal-title":"Proc Nutr Soc"},{"key":"1723_CR14","doi-asserted-by":"publisher","first-page":"20180451","DOI":"10.1259\/bjr.20180451","volume":"91","author":"DF Halpenny","year":"2018","unstructured":"Halpenny DF, Goncalves M, Schwitzer E et al (2018) Computed tomography-derived assessments of regional muscle volume: Validating their use as predictors of whole body muscle volume in cancer patients. Br J Radiol 91:20180451","journal-title":"Br J Radiol"},{"key":"1723_CR15","doi-asserted-by":"publisher","first-page":"671","DOI":"10.1148\/radiol.2362041565","volume":"236","author":"T Dalal","year":"2005","unstructured":"Dalal T, Kalra MK, Rizzo SM et al (2005) Metallic prosthesis: technique to avoid increase in CT radiation dose with automatic tube current modulation in a phantom and patients. Radiology 236:671\u2013675","journal-title":"Radiology"},{"key":"1723_CR16","doi-asserted-by":"publisher","first-page":"175","DOI":"10.3758\/BF03193146","volume":"39","author":"F Faul","year":"2007","unstructured":"Faul F, Erdfelder E, Lang AG et al (2007) G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods 39:175\u2013191. https:\/\/doi.org\/10.3758\/BF03193146","journal-title":"Behav Res Methods"},{"key":"1723_CR17","doi-asserted-by":"publisher","first-page":"1539","DOI":"10.1200\/JCO.2012.45.2722","volume":"31","author":"L Martin","year":"2013","unstructured":"Martin L, Birdsell L, Macdonald N et al (2013) Cancer cachexia in the age of obesity: skeletal muscle depletion is a powerful prognostic factor, independent of body mass index. J Clin Oncol 31:1539\u20131547","journal-title":"J Clin Oncol"},{"key":"1723_CR18","doi-asserted-by":"publisher","first-page":"1514","DOI":"10.1080\/10428190701471973","volume":"48","author":"ME Cabanillas","year":"2007","unstructured":"Cabanillas ME, Lu H, Fang S, Du XL (2007) Elderly patients with non-Hodgkin lymphoma who receive chemotherapy are at higher risk for osteoporosis and fractures. Leuk Lymphoma 48:1514\u20131521","journal-title":"Leuk Lymphoma"},{"key":"1723_CR19","doi-asserted-by":"publisher","first-page":"M211","DOI":"10.1093\/gerona\/50A.4.M211","volume":"50","author":"JK Richardson","year":"1995","unstructured":"Richardson JK, Hurvitz EA (1995) Peripheral neuropathy: a true risk factor for falls. J Gerontol A Biol Sci Med Sci 50:M211-215","journal-title":"J Gerontol A Biol Sci Med Sci"},{"key":"1723_CR20","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0078043","volume":"8","author":"T Rana","year":"2013","unstructured":"Rana T, Chakrabarti A, Freeman M, Biswas S (2013) Doxorubicin-mediated bone loss in breast cancer bone metastases is driven by an interplay between oxidative stress and induction of TGFbeta. PLoS ONE 8:e78043","journal-title":"PLoS ONE"},{"key":"1723_CR21","doi-asserted-by":"publisher","first-page":"798","DOI":"10.1016\/j.ctrv.2015.09.003","volume":"41","author":"S D'Oronzo","year":"2015","unstructured":"D\u2019Oronzo S, Stucci S, Tucci M, Silvestris F (2015) Cancer treatment-induced bone loss (CTIBL): pathogenesis and clinical implications. Cancer Treat Rev 41:798\u2013808","journal-title":"Cancer Treat Rev"},{"key":"1723_CR22","doi-asserted-by":"publisher","first-page":"481","DOI":"10.1093\/annonc\/mdt560","volume":"25","author":"J Paccou","year":"2014","unstructured":"Paccou J, Merlusca L, Henry-Desailly I et al (2014) Alterations in bone mineral density and bone turnover markers in newly diagnosed adults with lymphoma receiving chemotherapy: a 1-year prospective pilot study. Ann Oncol 25:481\u2013486","journal-title":"Ann Oncol"},{"key":"1723_CR23","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1146\/annurev.immunol.24.021605.090646","volume":"24","author":"MC Walsh","year":"2006","unstructured":"Walsh MC, Kim N, Kadono Y et al (2006) Osteoimmunology: interplay between the immune system and bone metabolism. Annu Rev Immunol 24:33\u201363","journal-title":"Annu Rev Immunol"},{"key":"1723_CR24","unstructured":"Rosen CJ (2000) The Epidemiology and Pathogenesis of Osteoporosis. In: Feingold KR, Anawalt B, Boyce A et al, (eds) Endotext. MDText.com, Inc. Copyright \u00a9 2000\u20132022, MDText.com, Inc., South Dartmouth (MA)"},{"key":"1723_CR25","doi-asserted-by":"publisher","first-page":"326","DOI":"10.1080\/10428194.2021.1975193","volume":"63","author":"D Kaddu-Mulindwa","year":"2022","unstructured":"Kaddu-Mulindwa D, Lesan V, Berdel C et al (2022) Significant reduced loss of bone mineral density after four vs. six cycles of R-CHOP: an analysis of the FLYER-trial. Leuk Lymphoma 63:326\u2013334","journal-title":"Leuk Lymphoma"},{"issue":"11","key":"1723_CR26","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1093\/jnci\/djw145","volume":"108","author":"DY Xiao","year":"2016","unstructured":"Xiao DY, Luo S, O\u2019Brian K et al (2016) longitudinal body composition changes in diffuse large b-cell lymphoma survivors: a retrospective cohort study of United States Veterans. J Natl Cancer Inst 108(11):145","journal-title":"J Natl Cancer Inst"},{"key":"1723_CR27","doi-asserted-by":"publisher","first-page":"1558","DOI":"10.4067\/S0034-98872020001101558","volume":"148","author":"DL Guevara","year":"2020","unstructured":"Guevara DL, Bernard S, Manhood S, Melani S, Yerovi F, Rodriguez MLA (2020) Prognostic value of interim PET\/CT in non-hodgkin lymphoma. Rev Med Chil 148:1558\u20131567","journal-title":"Rev Med Chil"},{"key":"1723_CR28","doi-asserted-by":"publisher","first-page":"1325","DOI":"10.3390\/curroncol28020126","volume":"28","author":"J Guo","year":"2021","unstructured":"Guo J, Cai P, Li P et al (2021) Body composition as a predictor of toxicity and prognosis in patients with diffuse large B-Cell lymphoma receiving R-CHOP immunochemotherapy. Curr Oncol 28:1325\u20131337","journal-title":"Curr Oncol"},{"key":"1723_CR29","doi-asserted-by":"publisher","first-page":"1556","DOI":"10.1080\/10428194.2022.2034160","volume":"63","author":"M Lucijanic","year":"2022","unstructured":"Lucijanic M, Huzjan Korunic R, Sedinic M et al (2022) Baseline and progressive adipopenia in newly diagnosed patients with diffuse large B-cell lymphoma with unfavorable features are associated with worse clinical outcomes. Leuk Lymphoma 63:1556\u20131565","journal-title":"Leuk Lymphoma"},{"key":"1723_CR30","doi-asserted-by":"publisher","first-page":"152144","DOI":"10.1016\/j.semarthrit.2022.152144","volume":"58","author":"ML Marques","year":"2023","unstructured":"Marques ML, da Silva NP, van der Heijde D, Reijnierse M, Baraliakos X, Braun J, van Gaalen F, Ramiro S (2023) Hounsfield Units measured in low dose CT reliably assess vertebral trabecular bone density changes over two years in axial spondyloarthritis. Semin Arthritis Rheum 58:152144. https:\/\/doi.org\/10.1016\/j.semarthrit.2022.152144","journal-title":"Semin Arthritis Rheum"},{"issue":"2","key":"1723_CR31","doi-asserted-by":"publisher","first-page":"e002149","DOI":"10.1136\/rmdopen-2021-002149","volume":"8","author":"ML Marques","year":"2022","unstructured":"Marques ML, Pereira da Silva N, van der Heijde D, Reijnierse M, Baraliakos X, Braun J, van Gaalen FA, Ramiro S (2022) Low-dose CT hounsfield units: a reliable methodology for assessing vertebral bone density in radiographic axial spondyloarthritis. RMD Open 8(2):e002149. https:\/\/doi.org\/10.1136\/rmdopen-2021-002149","journal-title":"RMD Open"}],"container-title":["La radiologia medica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11547-023-01723-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s11547-023-01723-5\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11547-023-01723-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,6]],"date-time":"2023-12-06T14:07:20Z","timestamp":1701871640000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s11547-023-01723-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9,26]]},"references-count":31,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2023,12]]}},"alternative-id":["1723"],"URL":"https:\/\/doi.org\/10.1007\/s11547-023-01723-5","relation":{},"ISSN":["1826-6983"],"issn-type":[{"value":"1826-6983","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,9,26]]},"assertion":[{"value":"1 February 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 September 2023","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 September 2023","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors have no relevant financial or non-financial interests to disclose.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Swissethics (2022\u201301111).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"Waiver of informed content was granted by Swissethics for deceased patients; a no-objection letter was sent to all other patients.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}}]}}