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Tomography
Volume 8
Issue 5
10.3390/tomography8050214
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Article
Peer-Review Record

Evaluation of the Effects of R-CHOP Chemotherapy on Brain Glucose Metabolism in Patients with Diffuse Large B Cell Lymphoma: A Baseline, Interim, and End-of-Treatment PET/CT Study

Tomography 2022, 8(5), 2565-2573; https://doi.org/10.3390/tomography8050214
by Haiyan Zhu 1,†, Fei Li 1,†, Yan Chang 2, Yabing Sun 2, Nan Wang 1 and Ruimin Wang 2,*
Reviewer 1:
Muhammad Rawi Mohamed Mohamed Zin
Reviewer 2:
Ambuga Badari
Tomography 2022, 8(5), 2565-2573; https://doi.org/10.3390/tomography8050214
Submission received: 3 August 2022 / Revised: 7 October 2022 / Accepted: 8 October 2022 / Published: 12 October 2022
(This article belongs to the Topic Lymphoma: Update on the Role of Imaging in the Understanding, Diagnosis, Treatment and Management)

Round 1

Reviewer 1 Report

1). Data resulting from statistical parametric maps transformed to distribution Z-score map was not presented in the article. Several examples might be required as the evident the profile of distribution.

2). Methodology involved likely the processing of CT images. An explanation about image analysis conducted may be needed to some extend, because uncertainty in selecting the common point in the CT images are strongly influenced by the positioning of the patient and location of scanning. 

3). Consistency in the selecting of images to make the clusters also might be explained, this is crucial because it will plays the role in the statistical analysis.  

Author Response

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Reviewer 2 Report

The idea of analyzing serial PET CT changes in brain metabolism in DLBCL patients treated with RCHOP is  interesting.

The serial findings at PET 0, PET C2 and PET C6 are interesting, especially in complete responders versus non-responders and partial responders. 

However, without a baseline and serial evaluation of the neuro-cognitive function in these patients, and without healthy matched controls, it is difficult to draw the inference that RCHOP chemotherapy in patients without known CNS involvement leads to changes in brain metabolism with time, and in turn, possibly explains the concept of 'chemo brain'.  

Author Response

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Author Response File: Author Response.doc

Round 2

Reviewer 2 Report

 

It is an interesting, and conducting this in a  prospective fashion,  possibly with healthy control., can substantiate the authors' findings. It would also be interesting to see if the PET findings differed by the baseline IPI score, and germinal versus non-germinal sub types. At least some of the high IPI DLBCL patients develop CNS relapses. Is there any data in this set of patients who eventually had CNS relapse, and if so, did their brains on PET CT at the end of treatment  look different compared to those who did not?

Author Response

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Author Response File: Author Response.docx

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