HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Zhao, B. Articles by Kris, M. G. Search for Related Content PubMed PubMed Citation Articles by Zhao, B. Articles by Kris, M. G.

Lung Cancer: Computerized Quantification of Tumor Response—Initial Results¹

¹ From the Departments of Medical Physics and Radiology (B.Z.), Radiology (L.H.S., M.S.G.), Epidemiology and Biostatistics (C.S.M.), and Medicine (N.A.R., M.G.K.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10021. Received November 18, 2005; revision requested January 5, 2006; revision received January 26; accepted February 8; final version accepted March 28. Supported in part by grants from William H. Goodwin and Alice Goodwin, the Commonwealth Foundation for Cancer Research, the Experimental Therapeutics Center of Memorial Sloan-Kettering Cancer Center, and National Cancer Institute (R21 CA113653-01 and PO1 CA005826-39). Address correspondence to B.Z. (e-mail: zhaob{at}mskcc.org).

Purpose: To prospectively quantify tumor response or progression in patients with lung cancer by using thin-section computed tomography (CT) and a semiautomated algorithm to calculate tumor volume and other parameter values.

Materials and Methods: This HIPAA-compliant study was institutional review board approved; informed patient consent was waived. CT scans of 15 measurable non–small cell lung cancers (in five men and 10 women; mean age, 64 years; range, 38–78 years) before and after gefitinib treatment were analyzed. A semiautomated three-dimensional lung cancer segmentation algorithm was developed and applied to each tumor at baseline and follow-up. The computer calculated the greatest diameter (unidimensional measurement), the product of the greatest diameter and the greatest perpendicular diameter (bidimensional measurement), and the volume of each tumor. Exact McNemar tests were used to analyze differences in the percentage change calculated with different measurement techniques.

Results: The computer accurately segmented 14 of the 15 tumors. One paramediastinal tumor required manual separation from the mediastinum. Eleven (73%) of the 15 patients had an absolute change in tumor volume of at least 20%, compared with one (7%) and four (27%) patients who had similar changes in unscaled unidimensional (P < .01) and bidimensional (P = .04) tumor measurements, respectively. Seven (47%) patients had an absolute change in tumor volume of at least 30%. In contrast, at unscaled analysis, no patients at unidimensional measurement (P = .02) and two (13%) patients at bidimensional measurement (P = .06) had a change of at least 30%.

Conclusion: Compared with the unidimensional and bidimensional techniques, semiautomated tumor segmentation enabled the identification of a larger number of patients with absolute changes in tumor volume of at least 20% and 30%.

© RSNA, 2006

This article has been cited by other articles:

				B. Zhao, L. P. James, C. S. Moskowitz, P. Guo, M. S. Ginsberg, R. A. Lefkowitz, Y. Qin, G. J. Riely, M. G. Kris, and L. H. Schwartz Evaluating Variability in Tumor Measurements from Same-day Repeat CT Scans of Patients with Non-Small Cell Lung Cancer Radiology, July 1, 2009; 252(1): 263 - 272. [Abstract] [Full Text] [PDF]

				M. A. Gavrielides, L. M. Kinnard, K. J. Myers, and N. Petrick Noncalcified Lung Nodules: Volumetric Assessment with Thoracic CT Radiology, April 1, 2009; 251(1): 26 - 37. [Abstract] [Full Text] [PDF]

				B. Zhao, L. H. Schwartz, and S. M. Larson Imaging Surrogates of Tumor Response to Therapy: Anatomic and Functional Biomarkers J. Nucl. Med., February 1, 2009; 50(2): 239 - 249. [Abstract] [Full Text] [PDF]

				W. M. Stadler Tumor Burden Endpoints and Phase II Clinical Trial Design ASCO Educational Book, January 1, 2008; 2008(1): 89 - 93. [Abstract] [Full Text] [PDF]

				G. J. Riely, M. G. Kris, B. Zhao, T. Akhurst, D. T. Milton, E. Moore, L. Tyson, W. Pao, N. A. Rizvi, L. H. Schwartz, et al. Prospective Assessment of Discontinuation and Reinitiation of Erlotinib or Gefitinib in Patients with Acquired Resistance to Erlotinib or Gefitinib Followed by the Addition of Everolimus Clin. Cancer Res., September 1, 2007; 13(17): 5150 - 5155. [Abstract] [Full Text] [PDF]