title: Comparison of CT volumetric measurement with RECIST response in patients with lung cancer.
abstract: OBJECTIVE
  To examine the correlations between uni-dimensional RECIST and volumetric measurements in patients with lung adenocarcinoma and to assess their association with overall survival (OS) and progression-free survival (PFS).
  
  
  METHODS
  In this study of patients receiving chemotherapy for lung cancer in the setting of a clinical trial, response was prospectively evaluated using RECIST 1.0. Retrospectively, volumetric measurements were recorded and response was assessed by two different volumetric methods at each followup CT scan using a semi-automated segmentation algorithm. We subsequently evaluated the correlation between the uni-dimensional RECIST measurements and the volumetric measurements and performed landmark analyses for OS and PFS at the completion of the first and second follow-ups. Kaplan-Meier curves together with log-rank tests were used to evaluate the association between the different response criteria and patient outcome.
  
  
  RESULTS
  Forty-two patients had CT scans at baseline, after the first follow up scan and second followup scan, and then every 8 weeks. The uni-dimensional RECIST measurements and volumetric measurements were strongly correlated, with a Spearman correlation coefficient (ρ) of 0.853 at baseline, ρ=0.861 at the first followup, ρ=0.843 at the 2nd followup, and ρ=0.887 overall between-subject. On first follow-up CT, partial responders and non responders as assessed by an "ellipsoid" volumetric criteria showed a significant difference in OS (p=0.008, 1-year OS of 70% for partial responders and 46% for non responders). There was no difference between the groups when assessed by RECIST criteria on first follow-up CT (p=0.841, 1-year OS rate of 64% for partial responders and 64% for non responders).
  
  
  CONCLUSIONS
  Volumetric response on first follow-up CT may better predict OS than RECIST response.
  
  
  CONCLUSIONS
  Assessment of tumor size and response is of utmost importance in clinical trials. Volumetric measurements may help to better predict OS than uni-dimensional RECIST criteria.
authors: Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, United States. Electronic address: hayess@mskcc.org.
authors: S A
authors: SA
authors: Hayes
authors: Department of Medicine, Memorial Sloan Kettering Cancer Center, 300 East 66th Street Breast & Imaging Center, NY 10065, United States. Electronic address: pietanzm@mskcc.org.
authors: M C
authors: MC
authors: Pietanza
authors: Department of Radiology, Mater Misericordiae University Hospital, Eccles Street, Dublin 7, Ireland. Electronic address: deemeagle@gmail.com.
authors: D
authors: D
authors: O'Driscoll
authors: Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, 307 East 63rd Street, New York, NY 10065, United States. Electronic address: zhengj@mskcc.org.
authors: J
authors: J
authors: Zheng
authors: Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, 307 East 63rd Street, New York, NY 10065, United States. Electronic address: moskowc1@mskcc.org.
authors: C S
authors: CS
authors: Moskowitz
authors: Department of Medicine, Memorial Sloan Kettering Cancer Center, 300 East 66th Street Breast & Imaging Center, NY 10065, United States. Electronic address: krism@mskcc.org.
authors: M G
authors: MG
authors: Kris
authors: Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, United States. Electronic address: ginsberm@mskcc.org.
authors: M S
authors: MS
authors: Ginsberg
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging*; D000077192:Adenocarcinoma of Lung; D000328:Adult; D000368:Aged; D054893:Cone-Beam Computed Tomography / Q000379:methods*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging; D008175:Lung Neoplasms / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D066066:Response Evaluation Criteria in Solid Tumors; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Computed tomography; Lung cancer; RECIST; Response; Volumetric