title: Semiautomated volumetric response evaluation as an imaging biomarker in superior sulcus tumors.
abstract: BACKGROUND
  Volumetric response to therapy has been suggested as a biomarker for patient-centered outcomes. The primary aim of this pilot study was to investigate whether the volumetric response to induction chemoradiotherapy was associated with pathological complete response (pCR) or survival in patients with superior sulcus tumors managed with trimodality therapy. The secondary aim was to evaluate a semiautomated method for serial volume assessment.
  
  
  METHODS
  In this retrospective study, treatment outcomes were obtained from a departmental database. The tumor was delineated on the computed tomography (CT) scan used for radiotherapy planning, which was typically performed during the first cycle of chemotherapy. These contours were transferred to the post-chemoradiotherapy diagnostic CT scan using deformable image registration (DIR) with/without manual editing.
  
  
  RESULTS
  CT scans from 30 eligible patients were analyzed. Median follow-up was 51 months. Neither absolute nor relative reduction in tumor volume following chemoradiotherapy correlated with pCR or 2-year survival. The tumor volumes determined by DIR alone and DIR + manual editing correlated to a high degree (R(2) = 0.99, P < 0.01).
  
  
  CONCLUSIONS
  Volumetric response to induction chemoradiotherapy was not correlated with pCR or survival in patients with superior sulcus tumors managed with trimodality therapy. DIR-based contour propagation merits further evaluation as a tool for serial volumetric assessment.
authors.affiliation: Departments of Surgery, VU University Medical Center, De Boelelaan 1117, 1081, Amsterdam, The Netherlands, c.vos@vumc.nl.
authors.forename: C G
authors.initials: CG
authors.lastname: Vos
authors.forename: M
authors.initials: M
authors.lastname: Dahele
authors.forename: J R
authors.initials: JR
authors.lastname: van Sörnsen de Koste
authors.forename: S
authors.initials: S
authors.lastname: Senan
authors.forename: I
authors.initials: I
authors.lastname: Bahce
authors.forename: M A
authors.initials: MA
authors.lastname: Paul
authors.forename: E
authors.initials: E
authors.lastname: Thunnissen
authors.forename: E F
authors.initials: EF
authors.lastname: Smit
authors.forename: K J
authors.initials: KJ
authors.lastname: Hartemink
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D014408:Biomarkers, Tumor; D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D059248:Chemoradiotherapy; D003131:Combined Modality Therapy; D054893:Cone-Beam Computed Tomography / Q000379:methods*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D060828:Induction Chemotherapy; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods*; D012189:Retrospective Studies; D015996:Survival Rate; D047368:Tumor Burden
chemical_list: D014408:Biomarkers, Tumor