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

Jarraya, H.; Borde, Paul; Mirabel, X.; Ernst, Olivier; Boulanger, Thomas; Lartigau, Éric; Ceugnart, L.; Kramar, Andrew; Taïeb, S.

doi:10.1016/j.ijrobp.2015.01.028

Cited by 12 publications

(7 citation statements)

References 28 publications

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“…The 1-year progression-free survival (PFS) was higher in lesions without lobulated enhancement (HR 0.80; 95% CI: 0.65-0.89) compared to lesions with lobulated enhancement (HR 0.69; 95% CI: 0.54-0.80; P<0.001). This pattern of enhancement can be reliably identified between different observers with a concordance rate of 98% (26). The same group proposed a combined response criteria incorporating RECIST 1.1, necrosis and lobulated enhancement characteristics for liver metastases treated with SBRT (25).…”

Section: Tumour Responsementioning

confidence: 96%

“…The development of lobulated enhancement on CT/ MRI after SBRT is associated with local relapse in liver metastases (25,26). A thick (>1 mm) peripheral enhancement with at least three lobulations was found to have a sensitivity of 89%, specificity of 100%, positive predictive value of 100%, negative predictive value of 95% and accuracy of 97% in predicting local disease progression.…”

Section: Tumour Responsementioning

confidence: 99%

See 1 more Smart Citation

Challenges in imaging assessment following liver stereotactic body radiotherapy: pitfalls to avoid in clinical practice

Yip¹,

Cook²,

Owczarczyk³

2017

Chin. Clin. Oncol.

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Stereotactic body radiotherapy (SBRT) is increasingly used in the management of unresectable liver metastases and hepatocellular carcinoma (HCC) as it allows delivery of high-dose conformal radiotherapy with limited toxicities. However, it may be difficult to differentiate viable tumour from radiotherapy-related changes after SBRT. The imaging changes observed after SBRT may also differ from those observed following conventionally fractionated radiotherapy. Hence, we aim to review the imaging changes that occur within the tumour and adjacent normal liver after SBRT which may help to identify local relapse in clinical practice.

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Section: Tumour Responsementioning

confidence: 96%

Section: Tumour Responsementioning

confidence: 99%

Challenges in imaging assessment following liver stereotactic body radiotherapy: pitfalls to avoid in clinical practice

Yip¹,

Cook²,

Owczarczyk³

2017

Chin. Clin. Oncol.

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“…Pseudoprogression (PP) is defined as a treatment‐related transient tumour growth that mimics true progression 16,17 . It was first described in gliomas treated with high dose radiotherapy and chemotherapy 18 and has since been described in several anatomic sites following SBRT, including brain, 19,20 lung 21,22 and liver 23 . The phenomenon is also recognised in patients treated with immunotherapy and was first described in melanoma patients treated with ipilimumab 24,25 .…”

Section: Resultsmentioning

confidence: 99%

Imaging response assessment following stereotactic body radiotherapy for solid tumour metastases of the spine: Current challenges and future directions

O'Sullivan

McDermott

Keys³

et al. 2020

J Med Imag Rad Onc

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Patients with metastatic disease are routinely serially imaged to assess disease burden and response to systemic and local therapies, which places ever‐expanding demands on our healthcare resources. Image interpretation following stereotactic body radiotherapy (SBRT) for spine metastases can be challenging; however, appropriate and accurate assessment is critical to ensure patients are managed correctly and resources are optimised. Here, we take a critical review of the merits and pitfalls of various imaging modalities, current response assessment guidelines, and explore novel imaging approaches and the potential for radiomics to add value in imaging assessment.

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“…36 That enhancement was observed in 89% of progressive lesions, occurring before size-based progression in half of the cases, with a median delay of 3.2 months. The sensitivity of Lobular Enhancement to predict progression was 89%, and its specificity was 100%.…”

Section: Patients 41 Tumorsmentioning

confidence: 94%

Evaluation of response after SBRT for liver tumors

Tétreau

Llacer

Riou

et al. 2017

Reports of Practical Oncology & Radiotherapy

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Use of RECIST criteria is also inadequate in the evaluation of response after SBRT for hepatic metastases. Response of liver metastases to SBRT is better assessed with a combination of size and enhancement pattern. The occurrence of a lobulated enhancement during follow up is efficient to predict local progression in a specific, reproducible, and sensitive way. Patients with FDG-avid hepatic metastases are also better evaluated with PET-CT and functional criteria than routine imaging and metric evaluation alone.

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

Abstract: 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.

Cited by 12 publications

References 28 publications

Challenges in imaging assessment following liver stereotactic body radiotherapy: pitfalls to avoid in clinical practice

Challenges in imaging assessment following liver stereotactic body radiotherapy: pitfalls to avoid in clinical practice

Imaging response assessment following stereotactic body radiotherapy for solid tumour metastases of the spine: Current challenges and future directions

Evaluation of response after SBRT for liver tumors

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