RECIST versus volume measurement in medical CT using ellipsoids of known size

Levine, Zachary H.; Borchardt, Bruce R.; Brandenburg, Nolan J.; Clark, Charles W.; Muralikrishnan, Balasubramanian; Shakarji, Craig M.; Chen, Joseph J.; Siegel, Eliot L.

doi:10.1364/oe.18.008151

Cited by 20 publications

(18 citation statements)

References 10 publications

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“…However, there is evidence showing that solid bodies are better described by ellipsoidal than spherical shapes [23], supported by our observation that liver metastases in GIST patients can be either spherical or ellipsoidal and they can change morphology during imatinib therapy [24]. Since a model with only 1 degree of freedom is too constrained to capture such changes in morphology, we decided to explore the benefits of employing a volumetric description.…”

Section: Methodsmentioning

confidence: 90%

Tumor Volume as an Alternative Response Measurement for Imatinib Treated GIST Patients

Schiavon

Ruggiero²,

Schöffski³

et al. 2012

PLoS ONE

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BackgroundAssessment of tumor size changes is crucial in clinical trials and patient care. We compared imatinib-induced volume changes of liver metastases (LM) from gastro-intestinal stromal tumors (GIST) to RECIST and Choi criteria and their association with overall survival (OS).MethodsLM from 84 GIST patients (training and validation set) were evaluated using manual and semi-automated Computed Tomography measurements at baseline, after 3, 6 and 12 months of imatinib. The ability of uni-dimensional (1D) and three-dimensional (3D) measurements to detect size changes (increase/decrease) ≥20% was evaluated. Volumetric response cut-offs were derived from minimally relevant changes (+20/−30%) by RECIST, considering lesions as spherical or ellipsoidal.Results3D measurements detected size changes ≥20% more frequently than 1D at every time-point (P≤0.008). 3D and Choi criteria registered more responses than RECIST at 3 and 6 months for 3D-spheres (P≤0.03) and at all time-points for 3D-ellipsoids and Choi criteria (P<0.001). Progressive disease by 3D criteria seems to better correlate to OS at late time-points than other criteria.ConclusionVolume criteria (especially ellipsoids) classify a higher number of patients as imatinib-responders than RECIST. Volume discriminates size changes better than diameter in GIST and constitutes a feasible and robust method to evaluate response and predict patient benefit.

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Section: Methodsmentioning

confidence: 90%

Tumor Volume as an Alternative Response Measurement for Imatinib Treated GIST Patients

Schiavon

Ruggiero²,

Schöffski³

et al. 2012

PLoS ONE

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“…3 A second study using ellipsoids of known sizes found volumetric measurements to be significantly more accurate than RECIST. 4 Taken together, these studies suggest that volumetric measurements may be more accurate in regularly-shaped tumors. Pancreatic ductal adenocarcinomas (PDA) are irregular and typically have length-width ratios of 3-4:1, with the axial plane often not producing the actual longest diameter.…”

Section: Introductionmentioning

confidence: 77%

Comparison of response evaluation criteria in solid tumors with volumetric measurements for estimation of tumor burden in pancreatic adenocarcinoma and hepatocellular carcinoma

Welsh¹,

Bodeker²,

Fallon³

et al. 2012

The American Journal of Surgery

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Background RECIST (Response Evaluation Criteria in Solid Tumors) is the accepted method for determining tumor progression. However, RECIST may not accurately estimate disease burden because the axial plane often does not produce the actual longest diameter. Volumetric measurements may be an alternative to better determine tumor size. Our aim was to compare volumetric measurements with RECIST in pancreatic ductal adenocarcinomas (PDA) and hepatocellular carcinomas (HCC). Methods RECIST and volumetric measurements were determined in 9 patients with metastatic PDA and 17 patients with HCC who subsequently underwent liver transplantation. Gross pathological measurements after hepatectomy were also analyzed for volumes. Results 3-D diameter in volumetric analysis was 38% and 36% higher than RECIST diameter in PDA and HCC, respectively (p < 0.01). However, RECIST yielded 78% and 23% larger estimated tumor volumes than volumetric analysis in PDA and HCC respectively (p < 0.01). Gross pathological volume in HCC demonstrated a linear correlation with both volumetric analysis (r = 0.95, p < 0.01) and RECIST (r = 0.96, p < 0.01) but RECIST significantly overestimated gross pathological volume by an average of 28% (p < 0.01) while volumetric analysis was similar to gross pathological volume (p = 0.56). In categorizing treatment response in PDA, RECIST and volumetric analysis were in “moderate agreement” (κ = 0.49). Conclusions RECIST may significantly overestimate tumor burden compared to volumetric measurements in both PDA and HCC. Volumetric analysis may be the preferred method to detect tumor progression.

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“…In a previous study that evaluated the tumor response to combined chemotherapy and radiotherapy or radiotherapy alone, the one-dimensional size, a product of the perpendicular dimensions and volume, seemed to be approximately equally accurate (60). Conversely, Levine et al (61) established that CT volumetric measurement is more reliable than RECIST criteria evaluation in sample objects assessment. A volumetric evaluation on CT scans with a maximum slice thickness of 1.0 mm can distinguish the volumes of objects with diameters of approximately 5 mm to 10 mm dramatically better than RECIST (61).…”

Section: Perspective Of Volumetric Assessmentmentioning

confidence: 99%

Non-small cell lung cancer after surgery and chemoradiotherapy: follow-up and response assessment

Colombi¹,

Lauro²,

Silva³

et al. 2013

Diagn Interv Radiol

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The imaging techniques in patients treated for lung cancer may be challenging to interpret. Radiologists are often asked to evaluate computed tomography (CT) scans after surgery, and this interpretation requires an understanding of both the timing and type of the surgical procedure. However, follow-up strategies are still not well defined. The assessment of tumor response to chemoradiotherapy relies on a tight integration of CT and clinical findings. Positron emission tomography-computed tomography (PET-CT) with fluorodeoxyglucose may help to exclude tumor recurrence when the sole CT scan is equivocal. More efforts are needed to validate the tools for volumetric tumor measurement in routine practice and to demonstrate their superiority compared to the Response Evaluation Criteria in Solid Tumors (RECIST). Familiarity with the assessment of lung cancer perfusion is also important because of the increasing use of cytostatic therapy. In this review, we outlined the imaging assessment of tumor recurrence after surgery and the role of CT, magnetic resonance imaging, and PET-CT in the follow-up after chemotherapy, radiotherapy, and radiofrequency ablation.

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RECIST versus volume measurement in medical CT using ellipsoids of known size

Cited by 20 publications

References 10 publications

Tumor Volume as an Alternative Response Measurement for Imatinib Treated GIST Patients

Tumor Volume as an Alternative Response Measurement for Imatinib Treated GIST Patients

Comparison of response evaluation criteria in solid tumors with volumetric measurements for estimation of tumor burden in pancreatic adenocarcinoma and hepatocellular carcinoma

Non-small cell lung cancer after surgery and chemoradiotherapy: follow-up and response assessment

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