scholarly journals OTHR-06. PACS Lesion Tracking Tool provides real time automatic information on brain tumor metastasis growth curves and RECIST criteria

2021 ◽  
Vol 3 (Supplement_3) ◽  
pp. iii15-iii15
Author(s):  
Benjamin Jang ◽  
MingDe Lin ◽  
Randy Owens ◽  
Khaled Bousabarah ◽  
Amit Mahajan ◽  
...  
Keyword(s):  
Real Time ◽  
Patient Management ◽  
Brain Mri ◽  
Evaluation Criteria ◽  
Growth Curves ◽  
Complete Response ◽  
Lesion Size ◽  
Intracranial Metastasis ◽  
Radiology Reports ◽  
Clinical Difference

Abstract Objective Communicating metastatic brain treatment response can be complicated. A widely used method to assess clinical response is called response evaluation criteria in solid tumors or RECIST. In our study, we use a PACS Lesion Tracking Tool (TT) to assess intracranial metastasis using RECIST criteria. We predict that the TT will be superior to the standard radiology reports. Methods Nuance ® mPowerTM was used to identify 30 patients with brain metastasis who received brain MRI from 4/2020–4/2021. Patient’s first brain MRI with metastasis was set as baseline and subsequent 3 brain MRI studies were examined. All lesions were measured on post-gadolinium sequence and defined as target lesions or new lesions. The TT was used to measure lesion size over time with creation of growth curves and RECIST outcomes, which include stable disease, progressive disease, partial response, or complete response. Subsequently, RECIST evaluations were compared with radiologic impressions for discrepancy, and further evaluations were made to see if it made a clinical difference in patient management and/or provide additional useful information. These evaluations were given a rating of agree/yes, equivocal, or disagree/no. They were assessed by 3 neuroradiologists. Results Number of lesions ranged from 1–27. The assessments from 3 neuroradiologists were averaged. Comparing impression versus RECIST evaluation, the results demonstrated the following: 8/30 disagreement, 4/30 equivocal, and 18/30 agreement. Using more stringent criteria, assessing whether the TT would result in either change in patient management or provide additional useful information, the results were the following: 6/30 yes, 4/30 equivocal, and 20/30 no. Discussion In addition to providing real time RECIST criteria evaluations and visually descriptive lesion growth tables, the TT was easy to use. Interpretation of these additional data provided more clarity and was found to be superior to standard radiology report.

scholarly journals Stereotactic body radiation therapy in combination with systemic therapy for metastatic renal cell carcinoma: a prospective multicentre study

ESMO Open ◽  
2019 ◽  
Vol 4 (5) ◽  
pp. e000535 ◽  
Author(s):  
Natalia Dengina ◽  
Timur Mitin ◽  
Sergey Gamayunov ◽  
Sufia Safina ◽  
Yuliya Kreinina ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Metastatic Renal Cell Carcinoma ◽  
Renal Cell ◽  
Kinase Inhibitors ◽  
Checkpoint Inhibitors ◽  
Evaluation Criteria ◽  
Complete Response ◽  
Lesion Size ◽  
Target Lesion

BackgroundTyrosine kinase inhibitors (TKIs) and checkpoint inhibitors have been established as effective treatment for metastatic renal cell carcinoma (mRCC), but only a minority of patients achieve complete response. Additional strategies are necessary to improve these agents’ efficacy.MethodsPatients with stable disease for at least 4 months on TKI or checkpoint inhibitors were included. Stereotactic body radiotherapy (SBRT) was delivered to an organ with comparable lesions, where one lesion was in the treatment target and the other one was intentionally left untreated (control lesion). Response in both lesions was scored using the Response Evaluation Criteria in Solid Tumors V.1.1 criteria 2 months after completion of SBRT. The primary endpoint was the rate of SBRT adverse events, and the secondary endpoints included the rate of reduction in target lesion size.Results17 patients were enrolled (14 men and 3 women, median age: 54.5 years old). SBRT was delivered to the lungs (n=5), bones (n=4), lymph nodes (n=4), liver (n=1), primary renal cell carcinoma (RCC) (n=1) and locally recurrent RCC (n=2). The equivalent dose in 2 Gy with an alpha to beta ratio of 2.6 was 114 Gy. With a median follow-up of 8 months, the cumulative rate of SBRT-related toxicity (grade 1) was 12% (n=2), consisting of oesophagitis and skin erythema. No grade 2 or higher toxicity was detected. Radiographic response in the target lesion was seen in 13 patients (76%), with complete response in 5 (29%) patients and partial response in 8 (47%), including abscopal effect in 1 patient. Control lesions remained stable in 16 patients. The difference between response in the target and control lesions as judged by the mean sizes of these lesions before and at 2 months after SBRT was statistically significant (p<0.01). Fraction size of 10 Gy or greater was associated with complete response (p<0.01).ConclusionExtracranial SBRT in patients with mRCC treated with TKI or checkpoint inhibitors is well tolerated and could be effective.Trial registration numberNCT02864615

Evaluation Criteria for Real-Time Specification Languages

1992 ◽  
Author(s):  
Paul C. Clements ◽  
Carolyn E. Gasarch ◽  
Ralph D. Jeffords
Keyword(s):  
Real Time ◽  
Evaluation Criteria ◽  
Specification Languages

scholarly journals A Novel Optical Bioimaging Method for Direct Assessment of Ovarian Cancer Chemotherapy Response at Laparoscopy

2016 ◽  
Vol 15 ◽  
pp. CIN.S40660 ◽  
Author(s):  
Alexandros Laios ◽  
Davide Volpi ◽  
Rajeev Kumar ◽  
Zoe Traill ◽  
Borivoj Vojnovic ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Unit Length ◽  
Evaluation Criteria ◽  
Advanced Ovarian Cancer ◽  
Software Tool ◽  
Lesion Size ◽  
Chemotherapy Response ◽  
Direct Assessment ◽  
Before And After ◽  
Image Pixels

In patients with advanced ovarian cancer (AOC), additional imaging of disseminated disease at laparoscopy could complement conventional imaging for estimation of chemotherapy response. We developed an image segmentation method and evaluated its use in making accurate and objective measurements of peritoneal metastases in comparison to Response Evaluation Criteria In Solid Tumors (RECIST) criteria. A software tool using a custom ImageJ macro-based approach was employed to estimate lesion size by converting image pixels into unit length. The software tool was tested as a proof-of-principle in an AOC patient with two isolated peritoneal deposits. Image analysis of representative laparoscopic snapshots before and after three cycles of neoadjuvant chemotherapy (NACT) revealed an average tumor nodule response ratio (TNRR) of 40% (partial response), which was in concordance with RECIST evaluation by computed tomography (CT). We demonstrated the feasibility of using this novel anatomical analysis for direct assessment of chemotherapy response in an AOC patient as an adjunct to RECIST criteria.

scholarly journals Doughnut bother! Histopathological examination of anastomotic doughnuts following colorectal anastomosis does not change patient management

2020 ◽  
Vol 3 (1) ◽  
Author(s):  
Steven Dixon ◽  
Hannah Barrow ◽  
Jane Hughes
Keyword(s):  
Patient Management ◽  
Residual Disease ◽  
Histopathological Examination ◽  
Colorectal Anastomosis ◽  
Complete Response ◽  
Patient Treatment ◽  
Histopathological Analysis ◽  
Retrospective Case ◽  
Female Ratio ◽  
Stapling Device

Abstract Introduction The use of a circular stapling device to create an anastomosis following colonic or rectal resection is common practice in the United Kingdom. Histopathological analysis of the anastomotic doughnuts produced takes time and resources, but does it ever change patient management? The aim of this study was to review the examination of doughnuts and whether patient treatment was altered by the findings. Method A retrospective case note review of all cases involving anastomotic doughnuts in a single trust between December 2010 and January 2018, was performed. Results There were 435 cases identified, male to female ratio was 2.0:1, age range 20–86 years and a median age of 66 years. 376 Doughnut samples were received by the pathology department (86.4%) and 354 were examined (81.4%). The disease processes involved were adenocarcinoma (n = 352, 80.9%), diverticular disease (n = 47, 10.8%), no residual disease/complete response (n = 22, 5.1%), adenoma (n = 7, 1.6%), mucinous (n = 5, 1.1%), Crohn’s disease (n = 1, 0.2%) and neuroendocrine (n = 1, 0.2%). Benign adenomatous change was identified in 4 cases (0.9%). No doughnuts examined contained dysplastic or malignant changes. Conclusion The histological examination of anastomotic doughnuts is extremely unlikely to identify malignant change and subsequently does not change patient management. Pathology departments could save time and resources by not routinely examining doughnuts.

Abstract WP204: Genetic Variant in VCAM1 Mediates Acute Infarct Size in Ischemic Stroke Patients

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Anne-Katrin Giese ◽  
Patricia Musolino ◽  
Huichun Xu ◽  
Kathleen Ryan ◽  
Markus D Schirmer ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Infarct Size ◽  
Adhesion Molecule ◽  
Genetic Variant ◽  
Brain Mri ◽  
Lesion Size ◽  
European Ancestry ◽  
Lesion Volume ◽  
Tgf Beta ◽  
Acute Cerebral Ischemia

Introduction: Even though neuroinflammation is increasingly recognized as an essential contributor to ischemic brain injury, the exact underlying mechanisms remain unclear. Higher expression of the vascular cell adhesion molecule 1 (VCAM-1) increases leukocyte-brain endothelium interaction and has been associated with larger infarct size following acute ischemic stroke (AIS). The activation of the TGF-β signaling pathways can down-regulate VCAM-1 expression and ameliorate deleterious tissue outcome during neuroinflammation. Hypothesis: We sought to investigate whether genetic variation in the TGF-beta pathway and adhesion molecule genes is associated with acute stroke lesion size. Methods: We completed genome-wide association (GWA) testing and diffusion-weighted imaging lesion volume (DWIv) analysis in a discovery cohort of 532 AIS patients of European ancestry enrolled within 48 hours of symptom onset. An independent European ancestry cohort of 724 AIS patients with GWA data and automated DWIv served as replication cohort. GWA testing per SNP was performed using linear regression modeling of natural log-transformed DWIv adjusted for age, sex and relevant principal components. We selected 42 inflammatory genes in the TGF-beta pathway for a gene-based analysis using VEGAS (Versatile Gene-based -Association Study) software. A pre-specified discovery phase Bonferroni-corrected threshold was set at p<0.001. In the replication phase, 14 SNPs overlapping were tested at the Bonferroni-corrected p-value threshold of p<0.004. Results: Of all genes in the TGF-beta pathway, VCAM1 (p=0.0006) was significantly associated with DWIv in the discovery AIS cohort (age: 66 ± 14.9 years, sex: 63.4% male, DWIv: 2.2cm 3 (IQR: 0.6-11.7cm 3 )). A single SNP within the VCAM1 gene boundaries (rs3176876 (BETA=0.2341, p=0.003)) was significantly associated with DWIv in the replication AIS cohort (age: 65 ± 14.1 years, sex: 68.6% male, DWIv: 4cm 3 (IQR: 1.3-17.2cm 3 )). Conclusion: The genetic variant rs3176876 in the VCAM1 gene is associated with larger infarct lesion size measured on brain MRI of AIS patients. These findings suggest genetic contribution to the pro-inflammatory mechanisms in acute cerebral ischemia and warrant further investigation.

scholarly journals Hypothyroidism Is a Predictive Factor for Better Clinical Outcomes in Patients with Advanced Hepatocellular Carcinoma Undergoing Lenvatinib Therapy

Cancers ◽  
2020 ◽  
Vol 12 (11) ◽  
pp. 3078
Author(s):  
Masako Shomura ◽  
Haruka Okabe ◽  
Emi Sato ◽  
Kota Fukai ◽  
Koichi Shiraishi ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Treatment Duration ◽  
Hormone Replacement ◽  
Evaluation Criteria ◽  
Complete Response ◽  
Good Prognosis ◽  
Advanced Hepatocellular Carcinoma ◽  
Thyroid Hormone Replacement ◽  
Advanced Hcc ◽  
Therapy Initiation

Patients with advanced hepatocellular carcinoma (HCC) undergoing molecular targeted therapy often experience non-negligible adverse events (AEs). Paradoxically, certain AEs are reportedly associated with a good prognosis. We aimed to identify factors predictive of treatment duration and overall survival (OS) in patients with HCC undergoing lenvatinib therapy. Forty-six consecutive patients with advanced HCC who received lenvatinib therapy from April 2018 to November 2019 were prospectively followed until November 2019. Treatment efficacy was assessed according to the modified Response Evaluation Criteria in Solid Tumors for 2–3 months after therapy initiation. The disease control rate (DCR) was defined as the percentage of patients with a complete response, partial response, or stable disease. The DCR was 65.2%, with a median survival of 10.2 months. Grade 2/3 hypoalbuminemia resulted in shorter treatment duration. Factors predictive of longer OS were a Child-Pugh score of 5 at baseline and the occurrence of Grade 2/3 hypothyroidism. Conversely, Grade 2/3 hypoalbuminemia was associated with a poorer prognosis. An AE of Grade 2/3 hypothyroidism was associated with a better prognosis in patients receiving lenvatinib treatment for advanced HCC. Continuing anticancer therapy with appropriate thyroid hormone replacement may contribute to longer OS.

scholarly journals A Real-Time Multiplexed Microbial Growth Intervalometer for Capturing High-Resolution Growth Curves

2019 ◽  
Vol 10 ◽  
Author(s):  
David C. Vuono ◽  
Bruce Lipp ◽  
Carl Staub ◽  
Evan Loney ◽  
Zoë R. Harrold ◽  
...  
Keyword(s):  
High Resolution ◽  
Real Time ◽  
Microbial Growth ◽  
Growth Curves

scholarly journals Statistical post-processing of ensemble forecasts of the height of new snow

2019 ◽  
Vol 26 (3) ◽  
pp. 339-357 ◽  
Author(s):  
Jari-Pekka Nousu ◽  
Matthieu Lafaysse ◽  
Matthieu Vernay ◽  
Joseph Bellier ◽  
Guillaume Evin ◽  
...  
Keyword(s):  
Real Time ◽  
Spatial Scales ◽  
Weather Prediction ◽  
Evaluation Criteria ◽  
Training Dataset ◽  
Post Processing ◽  
Probabilistic Forecasting ◽  
Ensemble Forecasts ◽  
Heterogeneous Model ◽  
The Impact

Abstract. Forecasting the height of new snow (HN) is crucial for avalanche hazard forecasting, road viability, ski resort management and tourism attractiveness. Météo-France operates the PEARP-S2M probabilistic forecasting system, including 35 members of the PEARP Numerical Weather Prediction system, where the SAFRAN downscaling tool refines the elevation resolution and the Crocus snowpack model represents the main physical processes in the snowpack. It provides better HN forecasts than direct NWP diagnostics but exhibits significant biases and underdispersion. We applied a statistical post-processing to these ensemble forecasts, based on non-homogeneous regression with a censored shifted Gamma distribution. Observations come from manual measurements of 24 h HN in the French Alps and Pyrenees. The calibration is tested at the station scale and the massif scale (i.e. aggregating different stations over areas of 1000 km2). Compared to the raw forecasts, similar improvements are obtained for both spatial scales. Therefore, the post-processing can be applied at any point of the massifs. Two training datasets are tested: (1) a 22-year homogeneous reforecast for which the NWP model resolution and physical options are identical to the operational system but without the same initial perturbations; (2) 3-year real-time forecasts with a heterogeneous model configuration but the same perturbation methods. The impact of the training dataset depends on lead time and on the evaluation criteria. The long-term reforecast improves the reliability of severe snowfall but leads to overdispersion due to the discrepancy in real-time perturbations. Thus, the development of reliable automatic forecasting products of HN needs long reforecasts as homogeneous as possible with the operational systems.

Lung Cancer Single Intramedullary Metastasis Vs Delayed Radionecrosis

2009 ◽  
Vol 22 (4) ◽  
pp. 458-463
Author(s):  
R. Conforti ◽  
G. Tagliatatela ◽  
M. De Cristoforo ◽  
A. Di Costanzo ◽  
A. Scuotto ◽  
...  
Keyword(s):  
Patient Management ◽  
Spinal Metastases ◽  
Lesion Size ◽  
Radiation Myelopathy ◽  
Intramedullary Metastasis ◽  
Metastatic Lesions ◽  
Contrast Enhanced ◽  
Highly Sensitive ◽  
History Of ◽  
Spinal Mri

Intramedullary metastases are rare, accounting for 0.9–5% of spinal metastases. Radiation myelopathy is considered one of the most distressing complications of radiotherapy. In both cases symptoms are aspecific, and there are no characteristic neuroradiologic findings. We describe a case of single intramedullary metastasis from lung microcytoma in a 55-year-old man with a history of malignancy, treated by radiotherapy five years previously. The patient returned to our observation complaining of pain and paraesthesia in the left C7 area. Spinal MRI and rachicentesis findings were aspecific. Ten days later a new MRI showed that the lesion size had increased, and neoplastic cells were found in CSF. Intramedullary metastases are extremely rare, accounting for 0.1–0.4% of all CNS tumors. The risk of developing delayed radionecrosis varies with the total dose administered. In both cases diagnosis is histological, while contrast-enhanced MRI is highly sensitive and specific in identifying and characterizing the lesion. In case of metastatic lesions the prognosis is unfavorable. Differential diagnosis is important because it has a strong effect on patient management.

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