Volumetric endpoints in diffuse intrinsic pontine glioma: comparison to cross-sectional measures and outcome correlations in the International DIPG/DMG Registry

Cross-sectional tumor measures are traditional clinical trial endpoints; however volumetric measures may better assess tumor growth. We determined the correlation and compared the prognostic impact of cross-sectional and volumetric measures of progressive disease (PD) among patients with DIPG. Imagi...

Full description

Saved in:
Bibliographic Details
Published in:Neuro-oncology (Charlottesville, Va.) Vol. 24; no. 9; p. 1598
Main Authors: Lazow, Margot A, Nievelstein, Martijn T, Lane, Adam, Bandopadhayhay, Pratiti, DeWire-Schottmiller, Mariko, Fouladi, Maryam, Glod, John W, Greiner, Robert J, Hoffman, Lindsey M, Hummel, Trent R, Kilburn, Lindsay, Leary, Sarah, Minturn, Jane E, Packer, Roger, Ziegler, David S, Chaney, Brooklyn, Black, Katie, de Blank, Peter, Leach, James L
Format: Journal Article
Language:English
Published: England 01.09.2022
Subjects:
Astrocytoma
Brain Stem Neoplasms - diagnostic imaging
Brain Stem Neoplasms - drug therapy
Brain Stem Neoplasms - radiotherapy
Cross-Sectional Studies
Diffuse Intrinsic Pontine Glioma
Glioma - pathology
Humans
Registries
volume
three-dimensional (3D)
progressive disease
cross-product
diffuse intrinsic pontine glioma (DIPG)
ISSN:1523-5866, 1523-5866
Online Access:Get more information
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Cross-sectional tumor measures are traditional clinical trial endpoints; however volumetric measures may better assess tumor growth. We determined the correlation and compared the prognostic impact of cross-sectional and volumetric measures of progressive disease (PD) among patients with DIPG. Imaging and clinical data were abstracted from the International DIPG Registry. Tumor volume and cross-sectional product (CP) were measured with mint Lesion™ software using manual contouring. Correlation between CP and volume (segmented and mathematical [ellipsoid] model) thresholds of PD were assessed by linear regression. Landmark analyses determined differences in survival (via log-rank) between patients classified as PD versus non-PD by CP and volumetric measurements at 1, 3, 5, 7, and 9 months postradiotherapy (RT). Hazard ratios (HR) for survival after these time points were calculated by Cox regression. A total of 312 MRIs (46 patients) were analyzed. Comparing change from the previous smallest measure, CP increase of 25% (PD) correlated with a segmented volume increase of 30% (R2 = 0.710), rather than 40% (spherical model extrapolation). CP-determined PD predicted survival at 1 month post-RT (HR = 2.77), but not other time points. Segmented volumetric-determined PD (40% threshold) predicted survival at all imaging timepoints (HRs = 2.57, 2.62, 3.35, 2.71, 16.29), and 30% volumetric PD threshold predicted survival at 1, 3, 5, and 9 month timepoints (HRs = 2.57, 2.62, 4.65, 5.54). Compared to ellipsoid volume, segmented volume demonstrated superior survival associations. Segmented volumetric assessments of PD correlated better with survival than CP or ellipsoid volume at most time points. Semiautomated tumor volume likely represents a more accurate, prognostically-relevant measure of disease burden in DIPG.
Bibliography:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
ISSN:1523-5866
1523-5866
DOI:10.1093/neuonc/noac037