Response evaluation in mesothelioma: Beyond RECIST

Diffusion‐weighted quantitative MRI of pleural abnormalities: Intra‐ and interobserver variability in the apparent diffusion coefficient measurements

“…Whenever quantitative data obtained from functional imaging are used for characterization or stratification of disease, it is mandatory to assess the intra‐ and interobserver variability of the manual or semiautomated method of measurement in order to determine the limits of error in obtaining quantitative data . This issue should be highly stressed when applied to the complex morphology and unique growth pattern of diffuse pleural disease (e.g., MPM, diffuse pleural implants in thymic epithelial tumors), which often grows as a rind around the pleural surface . Our study demonstrates that, in pleural abnormalities, repeatability of ADC measurements is higher in protocols that include the entire tumor on one or more slices compared to methods that include portions of tumor selected on the basis of visual assessment on ADC maps.…”

“…The issue of variability of ADC measurements between different methods, readings, and readers is critical in diffuse pleural disease, because it typically grows on the pleural surface by sheet‐like extension instead of producing spherical lesions, as generally seen in most tumors, and this growth pattern leads to an irregular rind‐like tumor encasing the lung. This condition could affect the overall accuracy of manually drawn ROIs along the tumor boundaries. Furthermore, pleural effusion is common in malignant pleural conditions and may be difficult to distinguish, especially when complicated by hemorrhage or exudates, from solid pleural disease …”

“… This condition could affect the overall accuracy of manually drawn ROIs along the tumor boundaries. Furthermore, pleural effusion is common in malignant pleural conditions and may be difficult to distinguish, especially when complicated by hemorrhage or exudates, from solid pleural disease …”

Imaging in pleural mesothelioma: A review of the 12th International Conference of the International Mesothelioma Interest Group

“…Histogram analysis demonstrates tumor heterogeneity and is the foundation for DWI as a biomarker [36][37]. Moreover, these findings suggest that DWI could be a useful tool for personalized care in mesothelioma patients; when a second-line option becomes clinically available (currently a highly unmet need), this type of therapy response evaluation will become especially crucial.…”

Clinical diagnosis of malignant pleural mesothelioma

“…Functional or molecular imaging techniques that reflect specific features of tumour pathophysiology, like PET, MRI -DWI and dynamic contrast-enhanced MRI (DCE-MRI) are attracting growing interest. However, despite accuracy limits, size measurement based response criteria remains widely used in MPM management (42,43).…”