Chloe Gui1,2, Jonathan C Lau3,4,5, Suzanne E Kosteniuk3,4, Donald H Lee4,6, Joseph F Megyesi3,4. 1. Department of Clinical Neurological Sciences (Neurosurgery), Schulich School of Medicine & Dentistry, London, Canada. cgui2@uwo.ca. 2. London Health Sciences Centre, University Hospital, 339 Windermere Road, London, Ontario, N6A 5A5, Canada. cgui2@uwo.ca. 3. Department of Clinical Neurological Sciences (Neurosurgery), Schulich School of Medicine & Dentistry, London, Canada. 4. London Health Sciences Centre, University Hospital, 339 Windermere Road, London, Ontario, N6A 5A5, Canada. 5. Imaging Research Laboratories, Robarts Research Institute, London, Canada. 6. Department of Medical Imaging, Schulich Medicine & Dentistry, Western University, London, Canada.
Abstract
BACKGROUND: An important aspect in the management of patients with diffuse low-grade gliomas (LGGs) involves monitoring the lesions via serial magnetic resonance imaging (MRI). However, radiological interpretations of LGG interval scans are often qualitative and thus difficult to use clinically. METHODS: To contextualize these assessments, we retrospectively compared radiological interpretations of LGG growth or stability to volume change measured by manual segmentation. Tumor diameter was also measured in one, two, and three dimensions to evaluate reported methods for assessment of glioma progression, including RECIST criteria, Macdonald/RANO criteria, and mean tumor diameter/ellipsoid method. RESULTS: Tumors evaluated as stable by radiologists grew a median volume of 5.1 mL (11.1%) relative to the comparison scan, and those evaluated as having grown had a median volume increase of 13.3 mL (23.7%). Diameter-based measurements corresponded well but tended to overestimate gold standard segmented volumes. In addition, agreement with segmented volume measurements improved from 17.6 ± 8.0 to 4.5 ± 5.8 to 3.9 ± 3.6 mm for diameter and from 104.0 ± 96.6 to 25.3 ± 36.8 to 15.9 ± 21.3 mL for volume with radiological measurements in one, two, and three dimensions, respectively. Measurement overestimation increased with tumor size. CONCLUSIONS: Given accumulating evidence that LGG volume and growth are prognostic factors, there is a need for objective lesion measurement. Current radiological reporting workflows fail to appreciate and communicate the true expansion of LGGs. While volumetric analysis remains the gold standard for assessment of growth, careful diametric measurements in three dimensions may be an acceptable alternative.
BACKGROUND: An important aspect in the management of patients with diffuse low-grade gliomas (LGGs) involves monitoring the lesions via serial magnetic resonance imaging (MRI). However, radiological interpretations of LGG interval scans are often qualitative and thus difficult to use clinically. METHODS: To contextualize these assessments, we retrospectively compared radiological interpretations of LGG growth or stability to volume change measured by manual segmentation. Tumor diameter was also measured in one, two, and three dimensions to evaluate reported methods for assessment of glioma progression, including RECIST criteria, Macdonald/RANO criteria, and mean tumor diameter/ellipsoid method. RESULTS:Tumors evaluated as stable by radiologists grew a median volume of 5.1 mL (11.1%) relative to the comparison scan, and those evaluated as having grown had a median volume increase of 13.3 mL (23.7%). Diameter-based measurements corresponded well but tended to overestimate gold standard segmented volumes. In addition, agreement with segmented volume measurements improved from 17.6 ± 8.0 to 4.5 ± 5.8 to 3.9 ± 3.6 mm for diameter and from 104.0 ± 96.6 to 25.3 ± 36.8 to 15.9 ± 21.3 mL for volume with radiological measurements in one, two, and three dimensions, respectively. Measurement overestimation increased with tumor size. CONCLUSIONS: Given accumulating evidence that LGG volume and growth are prognostic factors, there is a need for objective lesion measurement. Current radiological reporting workflows fail to appreciate and communicate the true expansion of LGGs. While volumetric analysis remains the gold standard for assessment of growth, careful diametric measurements in three dimensions may be an acceptable alternative.
Authors: Alba Corell; Sandra Ferreyra Vega; Nickoleta Hoefling; Louise Carstam; Anja Smits; Thomas Olsson Bontell; Isabella M Björkman-Burtscher; Helena Carén; Asgeir Store Jakola Journal: BMC Cancer Date: 2020-05-20 Impact factor: 4.430
Authors: Michael Weller; Martin van den Bent; Matthias Preusser; Emilie Le Rhun; Jörg C Tonn; Giuseppe Minniti; Martin Bendszus; Carmen Balana; Olivier Chinot; Linda Dirven; Pim French; Monika E Hegi; Asgeir S Jakola; Michael Platten; Patrick Roth; Roberta Rudà; Susan Short; Marion Smits; Martin J B Taphoorn; Andreas von Deimling; Manfred Westphal; Riccardo Soffietti; Guido Reifenberger; Wolfgang Wick Journal: Nat Rev Clin Oncol Date: 2020-12-08 Impact factor: 66.675