Keywords:
Oncology, Molecular imaging, Computer applications, CT, MR, PET-CT, Computer Applications-Teleradiology, Efficacy studies, Structured reporting, Metastases, Outcomes, Multidisciplinary cancer care
Authors:
M. SHARMA1, O. Bohnsack2, D. Clark2, N. Rohra1; 1HYDERABAD/IN, 2Berlin/DE
DOI:
10.26044/ecr2019/C-2951
Results
Location / Organ of “new lesion” metastasis was recorded for each subject per study across all visits.
Understanding the mode of spread and site of metastasis is critical in designing effective treatment therapy.
Based on the results from total count,
frequency of various organs involved in OC metastasis was evaluated.
For all studies combined involving 1491 subjects,
total subjects with new metastasis observed in decreasing order for various organs were peritoneum/omentum (527),
lymph nodes (415),
ascites (303),
liver (142),
pleural effusion (117),
pelvis (99) & lung (89).
Other less common locations for new metastasis was abdominal wall,
pleural deposits,
spleen,
brain,
retroperitoneum and adrenal.
The location of new metastasis was consistent across of studies,
mainly in peritoneum/omentum,
lymph nodes,
liver,
pelvis and lung; besides ascites and pleural effusion.
According to RECIST 1.1,
appearance of an unequivocal new lesion leads to overall assessment of progression [4].
Accurate assessment of progression is critical for timely withdrawal of subjects.
The criteria for equivocal and unequivocal new lesions are subjective and not consistently implemented across a study and across different readers.
Our additional analysis on the frequency of disagreement between two readers for appearance of an unequivocal new lesion leading to progression revealed high discordance for more subjective locations like peritoneum/omentum,
pelvis and lymph nodes.
There was high level of agreement between two readers for objective locations like brain,
adrenal,
liver and ascites/pleural effusion.
Other locations with high level of disagreement for unequivocal nature of new lesion were the ones' which are either unusual like abdominal wall,
retroperitoneum or locations where there is possibility of equivocal imaging findings like lung,
pleura and spleen.