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Title: Lobulated Enhancement Evaluation in the Follow-Up of Liver Metastases Treated by Stereotactic Body Radiation Therapy

Objective: The Response Evaluation Criteria in Solid Tumors (RECIST) can have limitations when used to evaluate local treatments for cancer, especially for liver malignancies treated by stereotactic body radiation therapy (SBRT). The aim of this study was to validate the relationship between the occurrence of lobulated enhancement (LE) and local relapse and to evaluate the utility of this relationship for predicting local progression. Patients and Methods: Imaging data of 59 lesions in 46 patients, including 281 computed tomographic (CT) scans, were retrospectively and blindly reviewed by 3 radiologists. One radiologist measured the lesion size, for each CT and overall, to classify responses using RECIST threshold criteria. The second studied LE occurrence. A third radiologist was later included and studied LE occurrence to evaluate the interobserver consistency for LE evaluation. Results: The mean duration of follow-up was 13.6 months. LE was observed in 16 of 18 progressive lesions, occurring before size-based progression in 50% of cases, and the median delay of LE detection was 3.2 months. The sensitivity of LE to predict progression was 89%, and its specificity was 100%. The positive predictive value was 100%, the negative predictive value was 95.3%, and the overall accuracy was 97%. The probability of local progression-freemore » survival at 12 months was significantly higher for lesions without LE compared with all lesions: 0.80 (CI 95%: 0.65-0.89) versus 0.69 (CI 95%: 0.54-0.80), respectively. The overall concordance rate between the 2 readers of LE was 97.9%. Conclusion: Response assessment of liver metastases treated by SBRT can be improved by including LE. This study demonstrates the diagnostic and predictive utility of LE for assessing local progression at a size still eligible for local salvage treatment.« less
Authors:
 [1] ;  [1] ;  [2] ;  [3] ;  [1] ;  [2] ;  [1] ;  [4] ;  [1]
  1. Department of Radiology, Oscar Lambret Oncologic Center, Lille (France)
  2. Department of Radiotherapy, Oscar Lambret Oncologic Center, Lille (France)
  3. Department of Body Imaging, Claude Huriez University Hospital, Lille (France)
  4. Statistical Unit, Oscar Lambret Oncologic Center, Lille (France)
Publication Date:
OSTI Identifier:
22458721
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 92; Journal Issue: 2; Other Information: Copyright (c) 2015 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; ACCURACY; BIOMEDICAL RADIOGRAPHY; CAT SCANNING; CHARGES; COMPARATIVE EVALUATIONS; DETECTION; LIVER; METASTASES; NEOPLASMS; PATIENTS; RADIOTHERAPY; REVIEWS; SPECIFICITY