Emilie Le Rhun1,2,3,4, Patrick Devos5, Thomas Boulanger6, Marion Smits7, Dieta Brandsma8, Roberta Rudà9, Julia Furtner10, Johann-Martin Hempel11, Tjeerd J Postma12, Patrick Roth1, Tom J Snijders13, Frank Winkler14,15, Sebastian Winklhofer16, Antonella Castellano17, Elke Hattingen18, Jaume Capellades19, Thierry Gorlia20, Martin Van den Bent21, Patrick Y Wen22, Martin Bendszus23, Michael Weller1. 1. Department of Neurology & Brain Tumor Center, University Hospital and University of Zurich, Zurich, Switzerland. 2. University of Lille, France. 3. Neuro-oncology, Neurosurgery Deparment, CHU Lille, France. 4. Neurology, Medical oncology Department, Oscar Lambret Center, Lille, France. 5. University Lille, France. 6. Imaging Department, Oscar Lambret Center, Lille, France. 7. Department of Radiology and Nuclear Medicine, Erasmus MC-University Medical Center Rotterdam, Rotterdam, Netherlands. 8. Department of Neuro-oncology, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam, Netherlands. 9. Department of Neuro-oncology, City of Health and Science and University of Turin, Turin, Italy. 10. Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria. 11. Radiology Department, Department for Diagnostic and Interventional Radiology, University of Tübingen, Tübingen, Germany. 12. Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Neurology, Amsterdam, Netherlands. 13. Department of Neurology, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, Netherlands. 14. Neurology Clinic and National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany. 15. Clinical Cooperation Unit Neuro-oncology, German Cancer Consortium, German Cancer Research Center, Heidelberg, Germany. 16. Department of Neuroradiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland. 17. Neuroradiology Department, Vita-Salute San Raffaele University and IRCCS San Raffaele Scientific Institute, Milan, Italy. 18. Institute of Neuroradiology, University Hospital Frankfurt/Main, Frankfurt, Germany. 19. Neuroradiology Department, Hospital del Mar, Barcelona, Spain. 20. EORTC Headquarters, Brussels, Belgium. 21. Brain Tumor Center at Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, Netherlands. 22. Center for Neuro-Oncology, Dana-Farber/Brigham and Women's Cancer Center, Boston, Massachusetts, USA. 23. Department of Neuroradiology, University of Heidelberg, Heidelberg, Germany.
Abstract
BACKGROUND: A scorecard to evaluate magnetic resonance imaging (MRI) findings during the course of leptomeningeal metastases (LM) has been proposed by the Response Assessment in Neuro-Oncology (RANO) group. METHODS: To explore the feasibility of the Leptomeningeal Assessment in Neuro-Oncology (LANO) scorecard, cerebrospinal MRIs of 22 patients with LM from solid tumors were scored by 10 neuro-oncologists and 9 neuroradiologists at baseline and at follow-up after treatment. Raters were blinded for clinical data including treatment. Agreement between raters of single items was evaluated using a Krippendorff alpha coefficient. Agreement between numerical parameters such as scores for changes between baseline and follow-up and total scores was evaluated by determining the intraclass coefficient of correlation. RESULTS: Most raters experienced problems with the instructions of the scorecard. No acceptable alpha concordance coefficient was obtained for the rating of single items at baseline or follow-up. The most concordant ratings were obtained for spinal nodules. The concordances were worst for brain linear leptomeningeal enhancement and cranial nerve enhancement. Discordance was less prominent among neuroradiologists than among neuro-oncologists. High variability was also observed for evaluating changes between baseline and follow-up and for total scores. CONCLUSIONS: Assessing response of LM by MRI remains challenging. Central imaging review is therefore indispensable for clinical trials. Based on the present results, we propose a new, simplified scorecard that will require validation using a similar approach as pursued here. The main challenges are to define measurable versus nonmeasurable (target) lesions and measures of change that allow assessment of response.
BACKGROUND: A scorecard to evaluate magnetic resonance imaging (MRI) findings during the course of leptomeningeal metastases (LM) has been proposed by the Response Assessment in Neuro-Oncology (RANO) group. METHODS: To explore the feasibility of the Leptomeningeal Assessment in Neuro-Oncology (LANO) scorecard, cerebrospinal MRIs of 22 patients with LM from solid tumors were scored by 10 neuro-oncologists and 9 neuroradiologists at baseline and at follow-up after treatment. Raters were blinded for clinical data including treatment. Agreement between raters of single items was evaluated using a Krippendorff alpha coefficient. Agreement between numerical parameters such as scores for changes between baseline and follow-up and total scores was evaluated by determining the intraclass coefficient of correlation. RESULTS: Most raters experienced problems with the instructions of the scorecard. No acceptable alpha concordance coefficient was obtained for the rating of single items at baseline or follow-up. The most concordant ratings were obtained for spinal nodules. The concordances were worst for brain linear leptomeningeal enhancement and cranial nerve enhancement. Discordance was less prominent among neuroradiologists than among neuro-oncologists. High variability was also observed for evaluating changes between baseline and follow-up and for total scores. CONCLUSIONS: Assessing response of LM by MRI remains challenging. Central imaging review is therefore indispensable for clinical trials. Based on the present results, we propose a new, simplified scorecard that will require validation using a similar approach as pursued here. The main challenges are to define measurable versus nonmeasurable (target) lesions and measures of change that allow assessment of response.
Authors: E Le Rhun; M Weller; D Brandsma; M Van den Bent; E de Azambuja; R Henriksson; T Boulanger; S Peters; C Watts; W Wick; P Wesseling; R Rudà; M Preusser Journal: Ann Oncol Date: 2017-07-01 Impact factor: 32.976
Authors: Justine L Kuiper; Lizza E Hendriks; Anthonie J van der Wekken; Adrianus J de Langen; Idris Bahce; Erik Thunnissen; Daniëlle A M Heideman; Yvonne Berk; Ed J M Buijs; Ernst-Jan M Speel; Frans H Krouwels; Hans J M Smit; Harry J M Groen; Anne-Marie C Dingemans; Egbert F Smit Journal: Lung Cancer Date: 2015-06-06 Impact factor: 5.705
Authors: Marc Chamberlain; Larry Junck; Dieta Brandsma; Riccardo Soffietti; Roberta Rudà; Jeffrey Raizer; Willem Boogerd; Sophie Taillibert; Morris D Groves; Emilie Le Rhun; Julie Walker; Martin van den Bent; Patrick Y Wen; Kurt A Jaeckle Journal: Neuro Oncol Date: 2017-04-01 Impact factor: 12.300
Authors: Sausan Abouharb; Joe Ensor; Monica Elena Loghin; Ruth Katz; Stacy L Moulder; Francisco J Esteva; Benjamin Smith; Vicente Valero; Gabriel N Hortobagyi; Amal Melhem-Bertrandt Journal: Breast Cancer Res Treat Date: 2014-07-20 Impact factor: 4.872
Authors: Jeffrey V Brower; Sandeep Saha; Stephen A Rosenberg; Craig R Hullett; H Ian Robins Journal: J Clin Neurosci Date: 2016-01-08 Impact factor: 1.961
Authors: Nicholas B Figura; Victoria T Rizk; Avan J Armaghani; John A Arrington; Arnold B Etame; Hyo S Han; Brian J Czerniecki; Peter A Forsyth; Kamran A Ahmed Journal: Breast Cancer Res Treat Date: 2019-06-17 Impact factor: 4.872
Authors: Timothy J Kaufmann; Marion Smits; Jerrold Boxerman; Raymond Huang; Daniel P Barboriak; Michael Weller; Caroline Chung; Christina Tsien; Paul D Brown; Lalitha Shankar; Evanthia Galanis; Elizabeth Gerstner; Martin J van den Bent; Terry C Burns; Ian F Parney; Gavin Dunn; Priscilla K Brastianos; Nancy U Lin; Patrick Y Wen; Benjamin M Ellingson Journal: Neuro Oncol Date: 2020-06-09 Impact factor: 12.300
Authors: Emilie Le Rhun; Jennifer Wallet; Audrey Mailliez; Marie Cecile Le Deley; Isabelle Rodrigues; Thomas Boulanger; Veronique Lorgis; Jerome Barrière; Yves Marie Robin; Michael Weller; Jacques Bonneterre Journal: Neuro Oncol Date: 2020-04-15 Impact factor: 12.300
Authors: Emilie Le Rhun; Patrick Devos; Johannes Weller; Katharina Seystahl; Francesca Mo; Annette Compter; Anna S Berghoff; Joost L M Jongen; Fabian Wolpert; Roberta Rudà; Dieta Brandsma; Martin van den Bent; Matthias Preusser; Ulrich Herrlinger; Michael Weller Journal: Neuro Oncol Date: 2021-07-01 Impact factor: 12.300