Katharina S Winter1, Felix O Hofmann2, Kolja M Thierfelder3, Julian W Holch4,5, Nina Hesse2, Alena B Baumann2, Dominik P Modest4,5, Sebastian Stintzing4,5, Volker Heinemann4,5, Jens Ricke2, Wieland H Sommer2, Melvin D'Anastasi2,6. 1. Department of Radiology, University Hospital, LMU Munich, Marchioninistrasse 15, 81377, Munich, Germany. stella.winter@med.uni-muenchen.de. 2. Department of Radiology, University Hospital, LMU Munich, Marchioninistrasse 15, 81377, Munich, Germany. 3. Institute of Diagnostic and Interventional Radiology, University Medical Center Rostock, Ernst-Heydemann-Str. 6, Rostock, 18057, Germany. 4. Department of Internal Medicine III, Comprehensive Cancer Center Munich, University Hospital Grosshadern, Ludwig-Maximilians-Universität München, Marchioninistrasse 15, Munich, 81377, Germany. 5. German Cancer Consortium (DKTK), Partner Site Munich and German Cancer Research Centre (DKFZ), Heidelberg, Germany. 6. Medical Imaging Department, Mater Dei Hospital, Msida, Malta.
Abstract
OBJECTIVES: To empirically determine thresholds for volumetric assessment of response and progress of liver metastases in line with the unidimensional RECIST thresholds. METHODS: Patients with metastatic colorectal cancer initially enrolled in a multicentre clinical phase-III trial were included. In all CT scans, the longest axial diameters and volumes of hepatic lesions were determined semi-automatically. The sum of diameters and volumes of 1, ≤2 and ≤5 metastases were compared to all previous examinations. Volumetric thresholds corresponding to RECIST 1.1 thresholds were predicted with loess-regression. In sensitivity analysis, the concordances of proposed thresholds, weight-maximizing thresholds and thresholds from loess-regression were compared. Classification concordance for measurements of ≤2 metastases was further analyzed. RESULTS: For measurements of ≤2 metastases, 348 patients with 629 metastases were included, resulting in 4,773 value pairs. Regression analysis yielded volumetric thresholds of -65.3% for a diameter change of -30%, and +64.6% for a diameter change of +20%. When comparing measurements of unidimensional RECIST assessment with volumetric measurements, there was a concordance of significant progress (≥+20% and ≥+65%) in 88.3% and of significant response (≤-30% and ≤-65%) in 85.0%. CONCLUSIONS: In patients with hepatic metastases, volumetric thresholds of +65% and -65% were yielded corresponding to RECIST thresholds of +20% and -30%. KEY POINTS: • Volumes and diameters of liver metastases from colorectal cancer were determined. • Volumetric thresholds of +65%/-65% corresponding to RECIST 1.1 are proposed. • Comparing both measurements, concordance was 88.3% (significant progress) and 85.0% (significant response).
OBJECTIVES: To empirically determine thresholds for volumetric assessment of response and progress of liver metastases in line with the unidimensional RECIST thresholds. METHODS:Patients with metastatic colorectal cancer initially enrolled in a multicentre clinical phase-III trial were included. In all CT scans, the longest axial diameters and volumes of hepatic lesions were determined semi-automatically. The sum of diameters and volumes of 1, ≤2 and ≤5 metastases were compared to all previous examinations. Volumetric thresholds corresponding to RECIST 1.1 thresholds were predicted with loess-regression. In sensitivity analysis, the concordances of proposed thresholds, weight-maximizing thresholds and thresholds from loess-regression were compared. Classification concordance for measurements of ≤2 metastases was further analyzed. RESULTS: For measurements of ≤2 metastases, 348 patients with 629 metastases were included, resulting in 4,773 value pairs. Regression analysis yielded volumetric thresholds of -65.3% for a diameter change of -30%, and +64.6% for a diameter change of +20%. When comparing measurements of unidimensional RECIST assessment with volumetric measurements, there was a concordance of significant progress (≥+20% and ≥+65%) in 88.3% and of significant response (≤-30% and ≤-65%) in 85.0%. CONCLUSIONS: In patients with hepatic metastases, volumetric thresholds of +65% and -65% were yielded corresponding to RECIST thresholds of +20% and -30%. KEY POINTS: • Volumes and diameters of liver metastases from colorectal cancer were determined. • Volumetric thresholds of +65%/-65% corresponding to RECIST 1.1 are proposed. • Comparing both measurements, concordance was 88.3% (significant progress) and 85.0% (significant response).
Authors: P Therasse; S G Arbuck; E A Eisenhauer; J Wanders; R S Kaplan; L Rubinstein; J Verweij; M Van Glabbeke; A T van Oosterom; M C Christian; S G Gwyther Journal: J Natl Cancer Inst Date: 2000-02-02 Impact factor: 13.506
Authors: Sebastian Keil; Cedric Plumhans; Florian F Behrendt; Sven Stanzel; Michael Suehling; Georg Mühlenbruch; Andreas H Mahnken; Rolf W Günther; Marco Das Journal: Invest Radiol Date: 2009-02 Impact factor: 6.016
Authors: P David Mozley; Claus Bendtsen; Binsheng Zhao; Lawrence H Schwartz; Matthias Thorn; Yuanxin Rong; Luduan Zhang; Andrea Perrone; René Korn; Andrew J Buckler Journal: Transl Oncol Date: 2012-02-01 Impact factor: 4.243
Authors: Sebastian Keil; Cedric Plumhans; Istvan A Nagy; Katharina Schiffl; Grzegorz Soza; Florian F Behrendt; Andreas H Mahnken; Rolf W Günther; Marco Das Journal: Invest Radiol Date: 2010-02 Impact factor: 6.016
Authors: Sebastian Stintzing; Dominik P Modest; Lisa Rossius; Markus M Lerch; Ludwig Fischer von Weikersthal; Thomas Decker; Alexander Kiani; Ursula Vehling-Kaiser; Salah-Eddin Al-Batran; Tobias Heintges; Christian Lerchenmüller; Christoph Kahl; Gernot Seipelt; Frank Kullmann; Martina Stauch; Werner Scheithauer; Swantje Held; Clemens Giessen-Jung; Markus Moehler; Andreas Jagenburg; Thomas Kirchner; Andreas Jung; Volker Heinemann Journal: Lancet Oncol Date: 2016-08-27 Impact factor: 41.316
Authors: Volker Heinemann; Ludwig Fischer von Weikersthal; Thomas Decker; Alexander Kiani; Ursula Vehling-Kaiser; Salah-Eddin Al-Batran; Tobias Heintges; Christian Lerchenmüller; Christoph Kahl; Gernot Seipelt; Frank Kullmann; Martina Stauch; Werner Scheithauer; Jörg Hielscher; Michael Scholz; Sebastian Müller; Hartmut Link; Norbert Niederle; Andreas Rost; Heinz-Gert Höffkes; Markus Moehler; Reinhard U Lindig; Dominik P Modest; Lisa Rossius; Thomas Kirchner; Andreas Jung; Sebastian Stintzing Journal: Lancet Oncol Date: 2014-07-31 Impact factor: 41.316