title: Evaluation of clinical outcomes of antiangiogenic-targeted therapy in patients with pulmonary metastatic renal cell carcinoma using non-contrast-enhanced computed tomography.
abstract: OBJECTIVE
  The objective of this study was to assess whether changes to radiographic parameters before and after treatment with antiangiogenic drugs would improve performance in predicting tumor response with non-contrast-enhanced computed tomography (NCECT) compared to Response Evaluation Criteria in Solid Tumors (RECIST).
  
  
  METHODS
  The exploration sample group and the validation sample group consisted of 58 and 25 patients, respectively, who had pulmonary metastatic renal cell carcinoma and were receiving antiangiogenic drugs. All patients underwent NCECT scans at baseline and at first evaluation (after two cycles of treatment) with the same scan protocol. Tumor diameter, attenuation value, entropy, and uniformity of the exploration sample group were examined by receiver operating characteristic (ROC) analysis and stepwise discriminant analysis. The threshold value derived from ROC analysis and discriminant function of the exploration sample group were also used for the validation sample group and were compared to RECIST using Kaplan-Meier survival curves.
  
  
  RESULTS
  According to the model obtained from the exploration group, Kaplan-Meier curves for patients without disease progression were significantly different for the discriminant analysis of the validation sample group (P = .04) and better than individually using RECIST (P = .08), percentage change for attenuation value (P = .49), entropy (P = .47, .89, .72, .73, and .58), and uniformity (P = .53, .72, .51, .39, and .16; without filtration, at scale values of 1.0, 1.5, 2.0, and 2.5, respectively).
  
  
  CONCLUSIONS
  Combined with changes to imaging parameters, including size, attenuation value, and uniformity between pre- and post-treatment, discrimination analysis can help predict biologic response to antiangiogenic drugs and provide a more accurate response assessment than RECIST criteria.
authors.affiliation: Department of Radiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, No. 1630, Dongfang Rd, Pudong, Shanghai 200120, China.
authors.forename: Guang-yu
authors.initials: GY
authors.lastname: Wu
authors.affiliation: Department of Radiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, No. 1630, Dongfang Rd, Pudong, Shanghai 200120, China.
authors.forename: Shi-teng
authors.initials: ST
authors.lastname: Suo
authors.affiliation: Department of Urinary Surgery, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Pudong, Shanghai, China.
authors.forename: Wen
authors.initials: W
authors.lastname: Kong
authors.affiliation: Department of Urinary Surgery, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Pudong, Shanghai, China.
authors.forename: Di
authors.initials: D
authors.lastname: Jin
authors.affiliation: Department of Urinary Surgery, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Pudong, Shanghai, China.
authors.forename: Jin
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Radiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, No. 1630, Dongfang Rd, Pudong, Shanghai 200120, China. Electronic address: renjixujr@163.com.
authors.forename: Jian-rong
authors.initials: JR
authors.lastname: Xu
mesh_terms: D000328:Adult; D000368:Aged; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D002292:Carcinoma, Renal Cell / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000556:secondary*; D003287:Contrast Media; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000556:secondary*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D020533:Angiogenesis Inhibitors; D003287:Contrast Media
keywords: Renal cell carcinoma; antiangiogenic-targeted therapy; clinical outcome; non–contrast-enhanced computed tomography