Therapy Response Evaluation of Malignant Lymphoma in a Multicenter Study: Comparison of Manual and Semiautomatic Measurements in CT

Abstract

Abdomen 768Weßling J et al. Purpose:Comparison of manual one-/bi-dimensional measurements versus semi-automatically derived one-/bi-dimensional and volumetric measurements for therapy response evaluation of malignant lymphoma during CT follow-up examinations in a multicenter setting. Materials and Methods: MSCT data sets of patients with malignant lymphoma were evaluated before (baseline) and after two cycles of chemotherapy (follow-up) at radiological centers of five university hospitals. The long axis diameter (LAD), the short axis diameter (SAD) and the bidimensional WHO of 307 target lymph nodes were measured manually and semi-automatically using dedicated software. Lymph node volumetry was performed semi-automatically only. The therapeutic response was evaluated according to lymphoma-adapted RECIST. Results: Based on a single lymph node, semi-automatically derived multidimensional parameters allowed for significantly more accurate therapy response classification than the manual or the semi-automatic unidimensional parameters. Incorrect classifications were reduced by up to 9.6 %. Compared to the manual approach, the influence of the study center on correct therapy classification is significantly less relevant when using semi-automatic measurements. Conclusion: Semi-automatic volumetry and bi-dimensional WHO significantly reduce the number of incorrectly classified lymphoma patients by approximately 9.6 % in the multicenter setting in comparison to linear parameters. Semi-automatic quantitative software tools may help to significantly reduce wrong classifications that are associated with the manual assessment approach.

Criteria-Based Imaging and Response Evaluation of Lymphoma 20 Years After Cheson: What is New?

“…Nonetheless, if possible, one examiner should be assigned to each patient and kept consistent to at least avoid interobserver variability in studies. Studies have since been able to show that semiautomatic measurement was significantly more accurate for response evaluation in lymphoma than the manual measurement method [39,40].…”

“…Even if a return to one-dimensional measurement of lesions is recommended in the latest RECIL classification for simplification, the role of the volumetric measurement of target lesions for lymphomas should also be examined in the future. This is particularly true in light of the increasingly better functioning of automatic volumetry [39,40]. Volumetric limits have already been calculated for RECIST 1.1.…”

Radiological Evaluation of the Therapeutic Response of Malignant Diseases: Status Quo, Innovative Developments and Requirements for Radiology

“…Both the steadily growing number of interdisciplinary tumor centers (Comprehensive Cancer Center: CCC), as well as the increasing mobility of cancer patients who are occasionally treated in two or more different centers lead to the radiological assessment of the same patient by different radiologists at various locations. Some single-and multi-center examinations have already demonstrated that this course of action, i. e. manual and/or one-dimensional evaluation of malignant lesions by several radiologists results in high inter-and intra-observer variability [17,44], and that semi-automated determination of multi-dimensional parameters can reduce the rate of misclassification of the therapeutic response [45]. Together with recent advances in CT technology, this knowledge has led to the development of software that can be used to measure and segment lesions semi-automatically ( • " Fig.…”