Usability of German hospital administrative claims data for healthcare research: General assessment and use case of multiple myeloma in Munich university hospital in 2015-2017.

OBJECTIVES: To assess the usability of German hospital administrative claims data (GHACD) to determine inpatient management patterns, healthcare resource utilization, and quality-of-care in patients with multiple myeloma (PwMM). METHODS: Based on German tertiary hospital's claims data (2015-2017), PwMM aged >18 years were included if they had an International Classification of Diseases, Tenth Revision, code of C90.0 or received anti-MM therapy. Subgroup analysis was performed on stem cell transplantation (SCT) patients. RESULTS: Of 230 PwMM, 59.1% were men; 56.1% were aged ≥65 years. Hypertension and infections were present in 50% and 67.0%, respectively. Seventy percent of PwMM received combination therapy. Innovative drugs such as bortezomib and lenalidomide were given to 36.1% and 10.9% of the patients, respectively. Mean number of admissions and mean hospitalization length/patient were 3.69 (standard deviation (SD) 2.71 (1-16)) and 12.52 (SD 9.55 (1-68.5)) days, respectively. In-hospital mortality was recorded in 12.2%. Seventy-two percent of SCT patients (n = 88) were aged ≤65 years, 22.7% required second transplantation, and 89.8% received platelet transfusion at a mean of 1.42(SD 0.63 (1-3)). CONCLUSION: GHACD provided relevant information essential for healthcare studies about PwMM from routine care settings. Data fundamental for quality-of-care assessment were also captured.

Two-dimensional CT measurements enable assessment of body composition on head and neck CT.

OBJECTIVES: The aim of this study was to evaluate whether simple 2D measurements in axial slices of head and neck CT examinations correlate with generally established measurements of body composition in abdominal CT at the height of the third lumbar vertebra and thus allow for an estimation of muscle and fat masses. METHODS: One hundred twenty-two patients who underwent concurrent CT of the head and neck and the abdomen between July 2016 and July 2020 were retrospectively included. For a subset of 30 patients, additional bioelectrical impedance analysis (BIA) was available. Areas of paraspinal muscles at the height of the third (C3) and fifth cervical vertebrae (C5) as well as the total cross-sectional area at the height of C3 and at the submandibular level were correlated with the results of abdominal measurements and BIA. Furthermore, intra- and interreader variabilities of all measurements were assessed. RESULTS: Regarding adipose tissue, good correlations were found between the total cross-sectional area of the patient's body at the submandibular level and at the height of C3 between both abdominal measurements and BIA results (r = 0.8-0.92; all p < 0.001). Regarding muscle, the total paraspinal muscle area at the height of C3 and C5 showed strong correlations with abdominal measurements and moderate to strong correlations with BIA results (r = 0.44-0.80; all p < 0.001), with the muscle area on C5 yielding slightly higher correlations. CONCLUSIONS: Body composition information can be obtained with comparable reliability from head and neck CT using simple biplanar measurements as from abdominal CT. KEY POINTS: • The total paraspinal muscle area at the height of C3 and C5 correlates strongly with abdominal muscle mass. • The total cross-sectional area at the submandibular level and at the height of C3 shows good correlations with abdominal fat mass. • The described measurements facilitate a rapid, opportunistic assessment of relevant body composition parameters.

Single-slice CT measurements allow for accurate assessment of sarcopenia and body composition.

OBJECTIVES: To evaluate the correlation between simple planimetric measurements in axial computed tomography (CT) slices and measurements of patient body composition and anthropometric data performed with bioelectrical impedance analysis (BIA) and metric clinical assessments. METHODS: In this prospective cross-sectional study, we analyzed data of a cohort of 62 consecutive, untreated adult patients with advanced malignant melanoma who underwent concurrent BIA assessments at their radiologic baseline staging by CT between July 2016 and October 2017. To assess muscle and adipose tissue mass, we analyzed the areas of the paraspinal muscles as well as the cross-sectional total patient area in a single CT slice at the height of the third lumbar vertebra. These measurements were subsequently correlated with anthropometric (body weight) and body composition parameters derived from BIA (muscle mass, fat mass, fat-free mass, and visceral fat mass). Linear regression models were built to allow for estimation of each parameter based on CT measurements. RESULTS: Linear regression models allowed for accurate prediction of patient body weight (adjusted R2 = 0.886), absolute muscle mass (adjusted R2 = 0.866), fat-free mass (adjusted R2 = 0.855), and total as well as visceral fat mass (adjusted R2 = 0.887 and 0.839, respectively). CONCLUSIONS: Our data suggest that patient body composition can accurately and quantitatively be determined by using simple measurements in a single axial CT slice. This could be useful in various medical and scientific settings, where the knowledge of the patient's anthropometric parameters is not immediately or easily available. KEY POINTS: • Easy to perform measurements on a single CT slice highly correlate with clinically valuable parameters of body composition. • Body composition data were acquired using bioelectrical impedance analysis to correlate CT measurements with a non-imaging-based method, which is frequently lacking in previous studies. • The obtained equations facilitate a quick, opportunistic assessment of relevant parameters of body composition.

18-Fluorodeoxyglucose positron emission tomography/computed tomography for assessment of response to brentuximab vedotin treatment in relapsed and refractory Hodgkin lymphoma.

Brentuximab vedotin has emerged as a possible treatment option in patients suffering from relapsed and refractory Hodgkin lymphoma (HL). We investigated the role of 18-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) for monitoring treatment response to brentuximab vedotin in patients with relapsed and refractory HL. Twelve consecutive, heavily pretreated patients with relapsed and refractory HL treated with brentuximab vedotin were available for analysis. FDG-PET/CT studies were performed early during treatment after a median of 3 cycles (range, 2-5 cycles), and were analyzed visually using a 5-point scale (5PS) and quantitatively using the maximum standardized uptake value (SUV(max)) and the three-dimensional (3D) isocontour at 50% of the maximum pixel value (SUV(50)) in the hottest single lesion. The median follow-up in our study cohort was 16 months (range, 5-30 months). The median progression-free survival (PFS) was 12.5 months and PFS at 12 months was 58%. Patients treated with brentuximab vedotin and negative interim FDG-PET/CT assessed by visual or quantitative analysis demonstrated a significantly prolonged PFS compared to patients with positive interim FDG-PET/CT. The 1-year PFS was 100% in patients with negative interim FDG-PET/CT assessed by visual analysis, whereas patients with positive interim FDG-PET/CT had a worse outcome with a 1-year PFS of 38% (p = 0.033). The 1-year PFS was 75% in patients with negative interim FDG-PET/CT assessed by quantitative analysis using the SUV(50), whereas patients with positive interim FDG-PET/CT had a worse outcome with a 1-year PFS of 25% (p = 0.017) Interim FDG-PET/CT might be a suitable diagnostic approach to predict response to brentuximab vedotin in relapsed and refractory HL.