Interobserver reliability of computed tomography‐derived primary tumor volume measurement in patients with supraglottic carcinoma

Abstract

Background: According to WHO 2008 guidelines, an important role is designated for cytoplasmic myeloperoxidase (cMPO) as measured by flow cytometry for classifying acute leukemia of myeloid or ambiguous origin (AML or MPAL). However, no threshold with respect to expression level and percentage positive cells is provided. Since the expression of solely cMPO can change the diagnosis from acute lymphoid leukemia into MPAL in the current WHO 2008, a consensus is needed for the cut‐off for cMPO. Methods: In this study, we investigated whether or not a cut‐off of 10% positivity for cMPO equally defines an acute leukemia as AML or MPAL as compared to a cut‐off for cMPO of 20% and compared this with results obtained for Sudan Black B (SBB) staining by cytomorphology. Results: Cell lineage‐defining markers and SBB staining were analyzed retrospectively in a cohort of 198 patients who presented with acute leukemia. Eight patients were positive for SBB (>3%), but were considered negative for cMPO (<10%); six patients were negative for SBB (≤3%) and positive for cMPO (≥10%) staining. In six patients, we found 10–20% cMPO positive leukemic cells. Five of these cases were SBB positive; the sixth patient showed a clear myeloid phenotype without positivity of any lymphoid marker. Using a 10% cut‐off instead of 20% would have changed diagnosis from ALL into MPAL in two patients; both cases were SBB positive by morphology. Conclusion: We conclude that a 10% cut‐off is a secure lower limit for cMPO expression and can be used independently from SBB expression. © 2013 International Clinical Cytometry Society

An evaluation of the variability of tumor-shape definition derived by experienced observers from CT images of supraglottic carcinomas (ACRIN protocol 6658)

“…The first is the reproducibility of tumor volume measurements. We previously have reported high levels of agreement among the authors in the determination of the volumes of tumor as part of this ACRIN study (1). This is reassuring for decisions concerning the suitability of radiation therapy as a treatment modality for a given tumor in light of the data suggesting quasi-thresholds of volume above which radiation therapy alone is not likely to eradicate disease.…”

Oesophageal cancer: assessment of tumour response to chemoradiotherapy with tridimensional CT

“…Similar results were obtained in nasopharyngeal cancers, and a significant decrease in disease-specific survival was found in patients with larger primary TV. Several other studies have demonstrated that TV is an important prognostic factor in patients affected by non-small-cell lung cancers treated with radiation therapy [3,4,6]. T stage, and thus TV, appeared to have no prognostic significance in oesophageal cancer [18].…”

“…Tumour volume (TV) has nevertheless been demonstrated to be an independent prognostic factor in head and neck tumours and in lung cancers while its role in hepatocarcinomas, lymphomas and germ cell tumours is still being studied [4][5][6][7][8][9][10][11][12][13]. Several studies have, in fact, shown that macroscopic TV, calculated on the basis of pretreatment computed tomography (CT) scan, can predict local response after radiation therapy in squamous cell carcinoma arising in different subsites of the head and neck.…”

Interobserver and Intraobserver Variability among Measurements of FDG PET/CT Parameters in Pulmonary Tumors

“…In the literature, several studies have reported good interobserver and intraobserver agreement of tumor size measurements (20,21). However, some other studies have demonstrated substantial variation (22,23). They found that in the setting of different reading experiences, FDG metabolic parameters have higher interobserver agreement than size measurements.…”