Minault Quentin,Philippe Barthelemy,Marie Mielcarek,Pierre Leyendecker,Mickael Ohana,Catherine  Roy,
Comparison Between CT Volumetric Measurement and RECIST 1.1 Criteria to Assess the Tumoral Response in Advanced Renal Cell Carcinoma Treated by Immunotherapy
Clinical Oncology and Research
2022
2613-4942
http://dx.doi.org/10.31487/j.COR.2022.03.03
https://www.sciencerepository.org/comparison-between-ct-volumetric_COR-2022-3-103 
Abstract: 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.Keywords: Volumetry, RECIST, CT, metastatic renal clear cell carcinoma, immunotherapy