Tumor Response Criteria in Oncoimaging: RECIST Criteria and beyond—Part 2

Baheti, Akshay D.; Rastogi, Ashita; Natarajan, Aravintho; Patra, Anurima; Tirumani, Sree Harsha

doi:10.1055/s-0039-1692016

Cited by 4 publications

(5 citation statements)

References 36 publications

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“…Because of the strong positive relationship between tracer uptake and the number of viable cancer cells, PET response criteria in solid tumors (PERCIST) were proposed in 2009 not to replace RECIST criteria but to complement them. It depends on standardized uptake value (SUV uptake) changes by the tumoral mass and has a unique advantage of predicting response by assessing the change in tumor metabolism [8].…”

Section: Introductionmentioning

confidence: 99%

Role of PET/CT in post-therapeutic assessment of bronchogenic carcinoma

Shaheen

Mohammed

Elshimy

et al. 2021

Egypt J Radiol Nucl Med

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Background Lung cancer is the most common among all kinds of cancers. It still constitutes the leading cause of cancer-related deaths worldwide, even with major advancements in prevention and treatments available. More than 85% of the cases are of non-small cell lung cancer (NSCLC), while less than 15% are of small cell lung cancers (SCLCs). Patients and methods This is a prospective study of 20 patients confirmed histopathologically to have bronchogenic carcinoma, who came for assessment of therapeutic response. All patients underwent positron emission tomography/computed tomography (PET/CT) before and after therapy. Semiquantitative assessment was used to determine maximum standardized uptake value (SUVmax). Treatment response evaluation was assessed according to the Response Evaluation Criteria in Solid Tumors (RECIST) criteria. Results Comparison of the pre- and post-treatment SUVmax in the responder and non-responder groups revealed that the post-treatment SUV was significantly lower than the baseline SUV in the responder group (P = 0.008). The responder post-treatment SUV and ∆ SUV were significantly lower than the non-responder values (P = 0.014 and 0.0004 respectively). The optimum threshold values of post-treatment SUV and ∆ SUV threshold defined by the receiver operating characteristic (ROC) curve analysis were ≤ 8 and ≤ −48.3 respectively. The sensitivity, specificity, PPV, NPV, and AUC of post-treatment SUV for predicting tumor response were 100%, 66.67%, 66.7%, 100%, and 0.833 respectively. The sensitivity, specificity, PPV, NPV, and AUC of ∆ SUV for predicting tumor response were 100%, 91.67%, 88.9%, 100%, and 0.979% respectively. Conclusion PET/CT proved itself as useful, efficient, and reliable tool in follow-up of lung cancer patients as it gives an early and accurate metabolic response assessment before any CT changes, leading to early modification of therapy or confirmation of its efficiency.

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Section: Introductionmentioning

confidence: 99%

Role of PET/CT in post-therapeutic assessment of bronchogenic carcinoma

Shaheen

Mohammed

Elshimy

et al. 2021

Egypt J Radiol Nucl Med

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“…If a prior exam was available, tumor response of irradiated LBLs on conventional CT images was rated by the MD Anderson (MDA) criteria, as adopted by the most recent Response Evaluation Criteria in Solid Tumors (RECIST) ( 18 ). Therapy response of each irradiated lesion was assessed by comparison to the immediate previous examination.…”

Section: Methodsmentioning

confidence: 99%

“…Therapy response of each irradiated lesion was assessed by comparison to the immediate previous examination. The MDA criteria comprise a scale of four response categories: ) complete response with a new complete sclerotic fill-in, 2) partial response with a new partial sclerotic fill-in or development of a sclerotic rim, 3) progressive disease with ≥25% increase in lesion size, 4) stable disease, conforming to neither of the categories above (18).…”

Section: Assessment Of Conventional and Vnca Dect Imagesmentioning

confidence: 99%

Radiotherapy Response Assessment of Multiple Myeloma: A Dual-Energy CT Approach With Virtual Non-Calcium Images

et al. 2021

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BackgroundLife expectancy of patients with multiple myeloma (MM) has increased over the past decades, underlining the importance of local tumor control and avoidance of dose-dependent side effects of palliative radiotherapy (RT). Virtual noncalcium (VNCa) imaging from dual-energy computed tomography (DECT) has been suggested to estimate cellularity and metabolic activity of lytic bone lesions (LBLs) in MM.ObjectiveTo explore the feasibility of RT response monitoring with DECT-derived VNCa attenuation measurements in MM.MethodsThirty-three patients with 85 LBLs that had been irradiated and 85 paired non-irradiated LBLs from the same patients were included in this retrospective study. Irradiated and non-irradiated LBLs were measured by circular regions of interest (ROIs) on conventional and VNCa images in a total of 216 follow-up measurements (48 before and 168 after RT). Follow-ups were rated as therapy response, stable disease, or local progression according to the MD Anderson criteria. Receiver operating characteristic (ROC) analysis was performed to discriminate irradiated vs. non-irradiated and locally progressive vs. stable/responsive LBLs using absolute attenuation post-irradiation and percentage attenuation change for patients with pre-irradiation DECT, if available.ResultsAttenuation of LBLs decreased after RT depending on the time that had passed after irradiation [absolute thresholds for identification of irradiated LBLs 30.5–70.0 HU [best area under the curve [AUC] 0.75 (0.59–0.91)] and -77.0 to -22.5 HU [best AUC 0.85 (0.65–1.00)]/-50% and -117% to -167% proportional change of attenuation on conventional and VNCa images, respectively]. VNCa CT was significantly superior for identification of RT effects in LBLs with higher calcium content [best VNCa AUC 0.96 (0.91–1.00), best conventional CT AUC 0.64 (0.45–0.83)]. Thresholds for early identification of local irradiation failure were >20.5 HU on conventional CT [AUC 0.78 (0.68–0.88)] and >-27 HU on VNCa CT [AUC 0.83 (0.70–0.96)].ConclusionTherapy response of LBLs after RT can be monitored by VNCa imaging based on regular myeloma scans, which yields potential for optimizing the lesion-specific radiation dose for local tumor control. Decreasing attenuation indicates RT response, while above threshold attenuation of LBLs precedes local irradiation failure.

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“…Therapy response of each irradiated lesion was assessed by comparison to the immediate previous examination. The MDA criteria comprise a scale of four response categories: 1) complete response with a new complete sclerotic fill-in, 2) partial response with a new partial sclerotic fill-in or development of a sclerotic rim, 3) progressive disease with ≥25% increase in lesion size, 4) stable disease, conforming to neither of the categories above (18).…”

Section: Assessment Of Conventional and Vnca Dect Imagesmentioning

confidence: 99%

Radiotherapy Response Assessment of Multiple Myeloma: A Dual-Energy CT Approach With Virtual Non-Calcium Images

Fervers

Celik²,

Bratke³

et al. 2022

RöFo - Fortschritte Auf Dem Gebiet Der Röntgenstrahlen Und Der Bildgebenden Verfahren

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Background: Life expectancy of patients with multiple myeloma (MM) has increased over the past decades, underlining the importance of local tumor control and avoidance of dose-dependent side effects of palliative radiotherapy (RT). Virtual noncalcium (VNCa) imaging from dual-energy computed tomography (DECT) has been suggested to estimate cellularity and metabolic activity of lytic bone lesions (LBLs) in MM.Objective: To explore the feasibility of RT response monitoring with DECT-derived VNCa attenuation measurements in MM.Methods: Thirty-three patients with 85 LBLs that had been irradiated and 85 paired nonirradiated LBLs from the same patients were included in this retrospective study. Irradiated and non-irradiated LBLs were measured by circular regions of interest (ROIs) on conventional and VNCa images in a total of 216 follow-up measurements (48 before and 168 after RT). Follow-ups were rated as therapy response, stable disease, or local progression according to the MD Anderson criteria. Receiver operating characteristic (ROC) analysis was performed to discriminate irradiated vs. non-irradiated and locally progressive vs. stable/responsive LBLs using absolute attenuation post-irradiation and percentage attenuation change for patients with pre-irradiation DECT, if available.Results: Attenuation of LBLs decreased after RT depending on the time that had passed after irradiation [absolute thresholds for identification of irradiated LBLs 30.5-70.0 HU [best area under the curve [AUC] 0.75 (0.59-0.91)] and -77.0 to -22.5 HU [best AUC 0.85 (0.65-1.00)]/-50% and -117% to -167% proportional change of attenuation on conventional and VNCa images, respectively]. VNCa CT was significantly superior for identification of RT effects in LBLs with higher calcium content [best VNCa AUC 0.96 (0.91-1.00), best conventional CT AUC 0.64 (0.45-0.83)]. Thresholds for early identification of local irradiation failure were >20.5 HU on conventional CT [AUC 0.78 (0.68-0.88)] and >-27 HU on VNCa CT ].

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Tumor Response Criteria in Oncoimaging: RECIST Criteria and beyond—Part 2

Cited by 4 publications

References 36 publications

Role of PET/CT in post-therapeutic assessment of bronchogenic carcinoma

Role of PET/CT in post-therapeutic assessment of bronchogenic carcinoma

Radiotherapy Response Assessment of Multiple Myeloma: A Dual-Energy CT Approach With Virtual Non-Calcium Images

Radiotherapy Response Assessment of Multiple Myeloma: A Dual-Energy CT Approach With Virtual Non-Calcium Images

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