Comparison Between CT Volumetric Measurement and RECIST 1.1 Criteria to Assess the Tumoral Response in Advanced Renal Cell Carcinoma Treated by Immunotherapy

Comparison Between CT Volumetric Measurement and RECIST 1.1 Criteria to Assess the Tumoral Response in Advanced Renal Cell Carcinoma Treated by Immunotherapy

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Catherine Roy
Department of Radiology B, University Hospital of Strasbourg – New Civil Hospital, Strasbourg, Cedex, France

A B S T R A C T

Objective: Assessment of a volumetric method versus gold standard unidimensional measurement based on RECIST 1.1 in advanced renal clear cell carcinoma (RCC) treated by immunotherapy. Materials and Methods: We retrospectively recorded the CT data of 14 adult patients treated with immunotherapy for metastatic RCC from February 2016 to January 2018. Follow-up CT scanners were independently reviewed by two radiologists. Unidimensional RECIST 1.1 and volumetric measurements were compared at each time point, with a total of 810 measurements performed for statistical analysis. The main criterion was the inter-observer agreement for each method. The secondary criterion was the tumoral response assessment based on three different items: RECIST 1.1, spherical volumetric method, ellipsoidal volumetric method. Results: Intraclass coefficient correlation in volumetric method (0.986 [95% CI: 0.980, 0.990]) was higher than in RECIST (0.903 [95% CI: 0.861, 0.928]). Relative measurement differences with Bland and Altman plot were lower in the volumetric method with shorter limits of agreement (0.8%; upper LOA95%: 36.5; lower LOA95%: −35), versus those in RECIST (-5.1 % (upper LOA95%: 46; lower LOA95%: −57). The volumetric method (especially the ellipsoidal one) assesses the progression disease earlier than RECIST for 57% of patients, but there is no formal difference for partial response assessment. Conclusion: Volumetric assessment for tumoral response in metastatic RCC compared to unidimensional measurements had a higher inter-observer agreement and might predict disease progression earlier.

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Article Type
Research Article
Publication history
Received: Sat 09, Jul 2022
Accepted: Mon 25, Jul 2022
Published: Fri 05, Aug 2022
Copyright
© 2023 Catherine Roy. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Hosting by Science Repository.
DOI: 10.31487/j.COR.2022.03.03