Emilie Le Rhun1,2,3,4,5, Patrick Devos6, Sebastian Winklhofer7, Hafida Lmalem8, Dieta Brandsma9, Priya Kumthekar10, Antonella Castellano11, Annette Compter9, Frederic Dhermain12, Enrico Franceschi13, Peter Forsyth14, Julia Furtner15, Norbert Galldiks16, Jaime Gállego Pérez-Larraya17,18,19, Jens Gempt20, Elke Hattingen21, Johann Martin Hempel22, Slavka Lukacova23,24, Giuseppe Minniti25, Barbara O'Brien26, Tjeerd J Postma27, Patrick Roth1, Roberta Rudà28, Niklas Schaefer29, Nils O Schmidt30, Tom J Snijders31, Steffi Thust32,33, Martin van den Bent34, Anouk van der Hoorn35, Guillaume Vogin36,37, Marion Smits38, Joerg C Tonn39, Kurt A Jaeckle40, Matthias Preusser41, Michael Glantz42, Patrick Y Wen43, Martin Bendszus44, Michael Weller2. 1. Department of Neurosurgery, Clinical Neuroscience Center University Hospital and University of Zurich, Zurich, Switzerland. 2. Department of Neurology, Clinical Neuroscience Center University Hospital and University of Zurich, Zurich, Switzerland. 3. University of Lille, France. 4. Neuro-Oncology, Neurosurgery Department, CHU Lille, France. 5. Neurology, Medical Oncology Department, Oscar Lambret Center, Lille, France. 6. CHU Lille, Lille, France. 7. Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland. 8. EORTC Headquarters, Brussels, Belgium. 9. Department of Neuro-Oncology, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam, the Netherlands. 10. Malnati Brain Tumor Institute of The Robert H Lurie Comprehensive Cancer Center of Northwestern University, Chicago, Illinois, USA. 11. Neuroradiology Department, Vita-Salute San Raffaele University and IRCCS Ospedale San Raffaele, Milan, Italy. 12. Radiation Oncology Department, Gustave Roussy University Hospital, Villejuif, France. 13. Nervous System Medical Oncology Department, IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy. 14. Department of NeuroOncology, Moffitt Cancer Center and University of South Florida, Tampa, USA. 15. Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria. 16. Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne; Institute of Neuroscience and Medicine (INM-3), Research Center Juelich, Juelich; Center of Integrated Oncology (CIO) Aachen, Bonn, Cologne and Duesseldorf, University of Cologne, Cologne, Germany. 17. Health Research Institute of Navarra (IdiSNA), Pamplona, Navarra, Spain. 18. Program in Solid Tumors, Foundation for the Applied Medical Research, Pamplona, Navarra, Spain. 19. Department of Neurology, Clínica Universidad de Navarra, Pamplona, Navarra, Spain. 20. Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Department of Neurosurgery. 21. Institute of Neuroradiology, University Hospital Frankfurt/Main, Frankfurt, Germany. 22. Department of Neuroradiology, Eberhard Karls University Tübingen, Tübingen, Germany. 23. Department of Clinical Medicine, Aarhus University, Aarhus, Denmark. 24. Department of Oncology, Aarhus University Hospital, Aarhus, Denmark. 25. Radiation Oncology Unit, Department of Medicine, Surgery and Neurosciences, University of Siena; IRCCS Neuromed, Pozzilli (IS), Italy. 26. Department of Neuro-Oncology, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA. 27. Department of Neurology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands. 28. Department of Neuro-Oncology, City of Health and Science and University of Turin, Turin, Italy. 29. Division of Clinical Neuro-oncology, Department of Neurology, University Hospital Bonn, Germany. 30. Department of Neurosurgery, University Medical Center, Regensburg, Germany. 31. Department of Neurology, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, the Netherlands. 32. Lysholm Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK. 33. Department of Brain Rehabilitation and Repair, UCL Institute of Neurology, London, UK. 34. Brain Tumor Center at Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, the Netherlands. 35. Medical Imaging Center, Department of Radiology, University Medical Center Groningen, Groningen, the Netherlands. 36. IMoPA Ingénierie Moléculaire et Physiopathologie Articulaire UMR7365 CNRS-UL, Vandoeuvre les Nancy, France. 37. Centre François Baclesse, Esch-sur-Alzette, Luxemborg. 38. Department of Radiology and Nuclear Medicine, Erasmus MC-University Medical Center Rotterdam, Rotterdam, the Netherlands. 39. Department of Neurosurgery, Ludwig-Maximilians-University School of Medicine, Munich, Germany and German Cancer Consortium (DKTK), Partner Site Munich, Munich, Germany. 40. Mayo Clinic Florida, Jacksonville, Florida, USA. 41. Department of Medicine I, Division of Oncology, Medical University of Vienna, Vienna, Austria. 42. Department of Neurosurgery, Penn State College of Medicine, Hershey, Pennsylvania, USA. 43. Center for Neuro-Oncology, Dana-Farber/Brigham and Women's Cancer Center, Boston, Massachusetts, USA. 44. Department of Neuroradiology, University Hospital Heidelberg, Heidelberg, Germany.
Abstract
BACKGROUND: Validation of the 2016 RANO MRI scorecard for leptomeningeal metastasis failed for multiple reasons. Accordingly, this joint EORTC Brain Tumor Group and RANO effort sought to prospectively validate a revised MRI scorecard for response assessment in leptomeningeal metastasis. METHODS: Coded paired cerebrospinal MRI of 20 patients with leptomeningeal metastases from solid cancers at baseline and follow-up after treatment and instructions for assessment were provided via the EORTC imaging platform. The Kappa coefficient was used to evaluate the interobserver pairwise agreement. RESULTS: Thirty-five raters participated, including 9 neuroradiologists, 17 neurologists, 4 radiation oncologists, 3 neurosurgeons, and 2 medical oncologists. Among single leptomeningeal metastases-related imaging findings at baseline, the best median concordance was noted for hydrocephalus (Kappa = 0.63), and the worst median concordance for spinal linear enhancing disease (Kappa = 0.46). The median concordance of raters for the overall response assessment was moderate (Kappa = 0.44). Notably, the interobserver agreement for the presence of parenchymal brain metastases at baseline was fair (Kappa = 0.29) and virtually absent for their response to treatment. 394 of 700 ratings (20 patients x 35 raters, 56%) were fully completed. In 308 of 394 fully completed ratings (78%), the overall response assessment perfectly matched the summary interpretation of the single ratings as proposed in the scorecard instructions. CONCLUSION: This study confirms the principle utility of the new scorecard, but also indicates the need for training of MRI assessment with a dedicated reviewer panel in clinical trials. Electronic case report forms with "blocking options" may be required to enforce completeness and quality of scoring.
BACKGROUND: Validation of the 2016 RANO MRI scorecard for leptomeningeal metastasis failed for multiple reasons. Accordingly, this joint EORTC Brain Tumor Group and RANO effort sought to prospectively validate a revised MRI scorecard for response assessment in leptomeningeal metastasis. METHODS: Coded paired cerebrospinal MRI of 20 patients with leptomeningeal metastases from solid cancers at baseline and follow-up after treatment and instructions for assessment were provided via the EORTC imaging platform. The Kappa coefficient was used to evaluate the interobserver pairwise agreement. RESULTS: Thirty-five raters participated, including 9 neuroradiologists, 17 neurologists, 4 radiation oncologists, 3 neurosurgeons, and 2 medical oncologists. Among single leptomeningeal metastases-related imaging findings at baseline, the best median concordance was noted for hydrocephalus (Kappa = 0.63), and the worst median concordance for spinal linear enhancing disease (Kappa = 0.46). The median concordance of raters for the overall response assessment was moderate (Kappa = 0.44). Notably, the interobserver agreement for the presence of parenchymal brain metastases at baseline was fair (Kappa = 0.29) and virtually absent for their response to treatment. 394 of 700 ratings (20 patients x 35 raters, 56%) were fully completed. In 308 of 394 fully completed ratings (78%), the overall response assessment perfectly matched the summary interpretation of the single ratings as proposed in the scorecard instructions. CONCLUSION: This study confirms the principle utility of the new scorecard, but also indicates the need for training of MRI assessment with a dedicated reviewer panel in clinical trials. Electronic case report forms with "blocking options" may be required to enforce completeness and quality of scoring.
Authors: Benjamin M Ellingson; Martin Bendszus; Jerrold Boxerman; Daniel Barboriak; Bradley J Erickson; Marion Smits; Sarah J Nelson; Elizabeth Gerstner; Brian Alexander; Gregory Goldmacher; Wolfgang Wick; Michael Vogelbaum; Michael Weller; Evanthia Galanis; Jayashree Kalpathy-Cramer; Lalitha Shankar; Paula Jacobs; Whitney B Pope; Dewen Yang; Caroline Chung; Michael V Knopp; Soonme Cha; Martin J van den Bent; Susan Chang; W K Al Yung; Timothy F Cloughesy; Patrick Y Wen; Mark R Gilbert Journal: Neuro Oncol Date: 2015-08-05 Impact factor: 12.300
Authors: Philipp Kickingereder; David Bonekamp; Martha Nowosielski; Annekathrin Kratz; Martin Sill; Sina Burth; Antje Wick; Oliver Eidel; Heinz-Peter Schlemmer; Alexander Radbruch; Jürgen Debus; Christel Herold-Mende; Andreas Unterberg; David Jones; Stefan Pfister; Wolfgang Wick; Andreas von Deimling; Martin Bendszus; David Capper Journal: Radiology Date: 2016-09-16 Impact factor: 11.105
Authors: Emilie Le Rhun; Patrick Devos; Thomas Boulanger; Marion Smits; Dieta Brandsma; Roberta Rudà; Julia Furtner; Johann-Martin Hempel; Tjeerd J Postma; Patrick Roth; Tom J Snijders; Frank Winkler; Sebastian Winklhofer; Antonella Castellano; Elke Hattingen; Jaume Capellades; Thierry Gorlia; Martin Van den Bent; Patrick Y Wen; Martin Bendszus; Michael Weller Journal: Neuro Oncol Date: 2019-05-06 Impact factor: 12.300
Authors: Marc Chamberlain; Riccardo Soffietti; Jeffrey Raizer; Roberta Rudà; Dieta Brandsma; Willem Boogerd; Sophie Taillibert; Morris D Groves; Emilie Le Rhun; Larry Junck; Martin van den Bent; Patrick Y Wen; Kurt A Jaeckle Journal: Neuro Oncol Date: 2014-05-27 Impact factor: 12.300
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: Georgina V Long; Victoria Atkinson; Serigne Lo; Shahneen Sandhu; Alexander D Guminski; Michael P Brown; James S Wilmott; Jarem Edwards; Maria Gonzalez; Richard A Scolyer; Alexander M Menzies; Grant A McArthur Journal: Lancet Oncol Date: 2018-03-27 Impact factor: 41.316
Authors: Maiken K Brix; Eric Westman; Andrew Simmons; Geir Andre Ringstad; Per Kristian Eide; Kari Wagner-Larsen; Christian M Page; Valeria Vitelli; Mona K Beyer Journal: Eur J Radiol Date: 2017-07-20 Impact factor: 3.528
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
Authors: Nancy U Lin; Virginia Borges; Carey Anders; Rashmi K Murthy; Elisavet Paplomata; Erika Hamilton; Sara Hurvitz; Sherene Loi; Alicia Okines; Vandana Abramson; Philippe L Bedard; Mafalda Oliveira; Volkmar Mueller; Amelia Zelnak; Michael P DiGiovanna; Thomas Bachelot; A Jo Chien; Ruth O'Regan; Andrew Wardley; Alison Conlin; David Cameron; Lisa Carey; Giuseppe Curigliano; Karen Gelmon; Sibylle Loibl; JoAl Mayor; Suzanne McGoldrick; Xuebei An; Eric P Winer Journal: J Clin Oncol Date: 2020-05-29 Impact factor: 44.544