title: Qualitative radiology assessment of tumor response: does it measure up?
abstract: Our purpose was to assess whether a simpler qualitative evaluation of tumor response by computed tomography is as reproducible and predictive of clinical outcome as the Response Evaluation Criteria in Solid Tumors (RECIST) and World Health Organization (WHO) methods. This study was a two-reader retrospective evaluation in which qualitative assessment resulted in agreement in 21 of 23 patients with metastatic colorectal carcinoma (91.3%, kappa=0.78; 95% CI, 0.51-1.00). Hepatic metastases were classified as increased, decreased, or unchanged, compared with agreement in 20 of 23 patients (87.0%) for RECIST (kappa=0.62; 95% CI, 0.23-1.00) and WHO (kappa=0.67; 95% CI, 0.34-1.00) methods. Patients were placed into partial response, stable disease, and disease progression categories. Time to progression of disease was better predicted qualitatively than by RECIST or WHO. Our pilot data suggest that our qualitative scoring system is more reproducible and predictive of patient clinical outcome than the RECIST and WHO methods.
authors.affiliation: Roswell Park Cancer Institute, Buffalo, NY 14263, USA. ronald.gottlieb@roswellpark.org
authors.forename: Ronald H
authors.initials: RH
authors.lastname: Gottlieb
authors.forename: Alan
authors.initials: A
authors.lastname: Litwin
authors.forename: Bhavna
authors.initials: B
authors.lastname: Gupta
authors.forename: John
authors.initials: J
authors.lastname: Taylor
authors.forename: Cheryl
authors.initials: C
authors.lastname: Raczyk
authors.forename: Terry
authors.initials: T
authors.lastname: Mashtare
authors.forename: Gregory
authors.initials: G
authors.lastname: Wilding
authors.forename: Marwan
authors.initials: M
authors.lastname: Fakih
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000473:pathology*; D003287:Contrast Media; D018450:Disease Progression; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000401:mortality / Q000473:pathology / Q000556:secondary*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D015996:Survival Rate; D014057:Tomography, X-Ray Computed
chemical_list: D003287:Contrast Media