Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2016 Mar;85(3):524-33.
doi: 10.1016/j.ejrad.2015.12.019. Epub 2016 Jan 2.

Comparison of CT volumetric measurement with RECIST response in patients with lung cancer

S A Hayes  1 , M C Pietanza  2 , D O'Driscoll  3 , J Zheng  4 , C S Moskowitz  5 , M G Kris  6 , M S Ginsberg  7
Affiliations
Comparative Study

Comparison of CT volumetric measurement with RECIST response in patients with lung cancer

S A Hayes et al. Eur J Radiol. 2016 Mar.

Abstract

Purpose: To examine the correlations between uni-dimensional RECIST and volumetric measurements in patients with lung adenocarcinoma and to assess their association with overall survival (OS) and progression-free survival (PFS).

Materials and methods: In this study of patients receiving chemotherapy for lung cancer in the setting of a clinical trial, response was prospectively evaluated using RECIST 1.0. Retrospectively, volumetric measurements were recorded and response was assessed by two different volumetric methods at each followup CT scan using a semi-automated segmentation algorithm. We subsequently evaluated the correlation between the uni-dimensional RECIST measurements and the volumetric measurements and performed landmark analyses for OS and PFS at the completion of the first and second follow-ups. Kaplan-Meier curves together with log-rank tests were used to evaluate the association between the different response criteria and patient outcome.

Results: Forty-two patients had CT scans at baseline, after the first follow up scan and second followup scan, and then every 8 weeks. The uni-dimensional RECIST measurements and volumetric measurements were strongly correlated, with a Spearman correlation coefficient (ρ) of 0.853 at baseline, ρ=0.861 at the first followup, ρ=0.843 at the 2nd followup, and ρ=0.887 overall between-subject. On first follow-up CT, partial responders and non responders as assessed by an "ellipsoid" volumetric criteria showed a significant difference in OS (p=0.008, 1-year OS of 70% for partial responders and 46% for non responders). There was no difference between the groups when assessed by RECIST criteria on first follow-up CT (p=0.841, 1-year OS rate of 64% for partial responders and 64% for non responders).

Conclusion: Volumetric response on first follow-up CT may better predict OS than RECIST response.

Clinical relevance statement: Assessment of tumor size and response is of utmost importance in clinical trials. Volumetric measurements may help to better predict OS than uni-dimensional RECIST criteria.

Keywords: Computed tomography; Lung cancer; RECIST; Response; Volumetric.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest

None

Figures

Fig. 1
Fig. 1
66 year old male with metastatic lung cancer. CT images demonstrate the volumetric segmentation and axial diameters recorded for a left upper lobe tumor at baseline (1a), first follow-up (1b) and second follow-up (1c) and a metastatic lymph node at baseline (1d), first follow-up (1e) and second follow-up (1f).
Fig. 2
Fig. 2
Scatter plots showing the correlation between volumetric percentage change and RECIST measurement percentage change at first (Fig. 2a) and second (Fig. 2b)follow-ups
Fig 3
Fig 3
Comparison of overall survival evaluated at first follow-up (34 days) using a) RECIST and b) volumetric ellipsoid criteria
Fig. 4
Fig. 4
Comparison of overall survival evaluated at second follow-up (3 months) using a) RECIST and b) volumetric ellipsoid criteria
See this image and copyright information in PMC

References

    1. Therasse P, Arbuck SG, Eisenhauer EA, Wanders J, Kaplan RS, Rubinstein L, et al. New guidelines to evaluate the response to treatment in solid tumors. European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States, National Cancer Institute of Canada. J Natl Cancer Inst. 2000;92:205–16. - PubMed
    1. Eisenhauer EA, Therasse P, Bogaerts J, Schwartz LH, Sargent D, Ford R, et al. New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1) European journal of cancer (Oxford, England : 1990) 2009;45:228–47. - PubMed
    1. Miller AB, Hoogstraten B, Staquet M, Winkler A. Reporting results of cancer treatment. Cancer. 1981;47:207–14. - PubMed
    1. Erasmus JJ, Gladish GW, Broemeling L, Sabloff BS, Truong MT, Herbst RS, et al. Interobserver and intraobserver variability in measurement of non-small-cell carcinoma lung lesions: implications for assessment of tumor response. Journal of clinical oncology : official journal of the American Society of Clinical Oncology. 2003;21:2574–82. - PubMed
    1. Zhao B, Tan Y, Bell DJ, Marley SE, Guo P, Mann H, et al. Exploring intra- and inter-reader variability in uni-dimensional, bi-dimensional, and volumetric measurements of solid tumors on CT scans reconstructed at different slice intervals. European journal of radiology. 2013;82:959–68. - PMC - PubMed

Publication types