Felice D'Arco1,2, Patricia O'Hare3, Fatima Dashti4, Alvaro Lassaletta5, Thalia Loka3, Uri Tabori5, Giacomo Talenti6, Stefanie Thust7, Giancarlo Messalli8, Patrick Hales9, Eric Bouffet5, Suzanne Laughlin4. 1. Pediatric Neuroradiology, Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Canada. darcofel@gmail.com. 2. Department of Pediatric Neuroradiology, Department of Radiology, Great Ormond Street Hospital NHS Trust, London, WC1N 3JH, UK. darcofel@gmail.com. 3. Department of Pediatric Oncology, Great Ormond Street Hospital, London, UK. 4. Pediatric Neuroradiology, Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Canada. 5. Division of Pediatric Neuro-oncology, The Hospital for Sick Children, Toronto, Canada. 6. Department of Pediatric Neuroradiology, Department of Radiology, Great Ormond Street Hospital NHS Trust, London, WC1N 3JH, UK. 7. National Hospital for Neurology and Neurosurgery, Queen Square, London, UK. 8. Radiology Unit, "Villa Malta" Hospital, Sarno, Italy. 9. Developmental Imaging and Biophysics Section, Institute of Child Health, University College London, London, UK.
Abstract
PURPOSE: We report a retrospective comparison between bi-dimensional RANO criteria and manual volumetric segmentation (MVS) in pediatric low-grade gliomas. METHODS: MRI FLAIR or T1 post contrast images were used for assessment of tumor response. Seventy patients were included in this single center study, for each patient two scans were assessed ("time 0" and "end of therapy") and response to therapy was evaluated for both methods. Inter-reader variability and average time for volumetric assessment were also calculated. RESULTS: Fourteen (20%) of the 70 patients had discordant results in terms of response assessment between the bi-dimensional measurements and MVS. All volumetric response assessments were in keeping with the subjective analysis of tumor (radiology report). Of the 14 patients, 6 had stable disease (SD) on MVS and progressive disease (PD) on 2D assessment, 5 patients had SD on MVS and partial response (PR) on 2D assessment, 2 patients had PD on MVS and SD on 2D assessment, and 1 patient had PR on MVS and SD on 2D analysis. The number of discordant results rises to 21(30%) if minor response is integrated in the response assessment. MVS was relatively fast and showed high inter-reader concordance. CONCLUSION: Our analysis shows that therapeutic response classification may change in a significant number of children by performing a volumetric tumor assessment. Furthermore, MVS is not particularly time consuming and has very good inter-reader concordance.
PURPOSE: We report a retrospective comparison between bi-dimensional RANO criteria and manual volumetric segmentation (MVS) in pediatric low-grade gliomas. METHODS: MRI FLAIR or T1 post contrast images were used for assessment of tumor response. Seventy patients were included in this single center study, for each patient two scans were assessed ("time 0" and "end of therapy") and response to therapy was evaluated for both methods. Inter-reader variability and average time for volumetric assessment were also calculated. RESULTS: Fourteen (20%) of the 70 patients had discordant results in terms of response assessment between the bi-dimensional measurements and MVS. All volumetric response assessments were in keeping with the subjective analysis of tumor (radiology report). Of the 14 patients, 6 had stable disease (SD) on MVS and progressive disease (PD) on 2D assessment, 5 patients had SD on MVS and partial response (PR) on 2D assessment, 2 patients had PD on MVS and SD on 2D assessment, and 1 patient had PR on MVS and SD on 2D analysis. The number of discordant results rises to 21(30%) if minor response is integrated in the response assessment. MVS was relatively fast and showed high inter-reader concordance. CONCLUSION: Our analysis shows that therapeutic response classification may change in a significant number of children by performing a volumetric tumor assessment. Furthermore, MVS is not particularly time consuming and has very good inter-reader concordance.
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