1. Interobserver Variability in CT-based Morphologic Tumor Response Assessment of Colorectal Liver Metastases
- Author
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Wesdorp, Nina J, Kemna, Ruby, Bolhuis, Karen, van Waesberghe, Jan H T M, Nota, Irene M G C, Struik, Femke, Oulad Abdennabi, Ikrame, Phoa, Saffire S K S, van Dieren, Susan, van Amerongen, Martinus J, Chapelle, Thiery, Dejong, Cornelis H C, Engelbrecht, Marc R W, Gerhards, Michael F, Grünhagen, Dirk, van Gulik, Thomas M, Hermans, John J, de Jong, Koert P, Klaase, Joost M, Liem, Mike S L, van Lienden, Krijn P, Molenaar, I Quintus, Patijn, Gijs A, Rijken, Arjen M, Ruers, Theo M, Verhoef, Cornelis, de Wilt, Johannes H W, Swijnenburg, Rutger-Jan, Punt, Cornelis J A, Huiskens, Joost, Stoker, Jaap, Kazemier, Geert, Surgery, MUMC+: MA Heelkunde (9), RS: NUTRIM - R2 - Liver and digestive health, Internal medicine, Radiology and nuclear medicine, AGEM - Re-generation and cancer of the digestive system, VU University medical center, CCA - Imaging and biomarkers, Radiology & Nuclear Medicine, Graduate School, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, Radiology and Nuclear Medicine, AGEM - Digestive immunity, APH - Methodology, Oncology, Groningen Institute for Organ Transplantation (GIOT), Guided Treatment in Optimal Selected Cancer Patients (GUTS), and Value, Affordability and Sustainability (VALUE)
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Colorectal Neoplasms/diagnostic imaging ,Male ,Tumor Response ,Abdomen/Gastrointestinal ,Tomography, X-Ray Computed/methods ,Observer Performance ,Metastases ,Tumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14] ,Liver Neoplasms/diagnostic imaging ,Humans ,Prospective Studies ,Tomography ,Original Research ,Computer. Automation ,Observer Variation ,Liver Neoplasms ,General Medicine ,Middle Aged ,X-Ray Computed/methods ,Liver ,Oncology ,Female ,Human medicine ,Colorectal Neoplasms ,Tomography, X-Ray Computed ,Rare cancers Radboud Institute for Health Sciences [Radboudumc 9] ,CT - Abstract
Item does not contain fulltext Purpose To evaluate interobserver variability in the morphologic tumor response assessment of colorectal liver metastases (CRLM) managed with systemic therapy and to assess the relation of morphologic response with gene mutation status, targeted therapy, and Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 measurements. Materials and Methods Participants with initially unresectable CRLM receiving different systemic therapy regimens from the randomized, controlled CAIRO5 trial (NCT02162563) were included in this prospective imaging study. Three radiologists independently assessed morphologic tumor response on baseline and first follow-up CT scans according to previously published criteria. Two additional radiologists evaluated disagreement cases. Interobserver agreement was calculated by using Fleiss κ. On the basis of the majority of individual radiologic assessments, the final morphologic tumor response was determined. Finally, the relation of morphologic tumor response and clinical prognostic parameters was assessed. Results In total, 153 participants (median age, 63 years [IQR, 56-71]; 101 men) with 306 CT scans comprising 2192 CRLM were included. Morphologic assessment performed by the three radiologists yielded 86 (56%) agreement cases and 67 (44%) disagreement cases (including four major disagreement cases). Overall interobserver agreement between the panel radiologists on morphology groups and morphologic response categories was moderate (κ = 0.53, 95% CI: 0.48, 0.58 and κ = 0.54, 95% CI: 0.47, 0.60). Optimal morphologic response was particularly observed in patients treated with bevacizumab (P = .001) and in patients with RAS/BRAF mutation (P = .04). No evidence of a relationship between RECIST 1.1 and morphologic response was found (P = .61). Conclusion Morphologic tumor response assessment following systemic therapy in participants with CRLM demonstrated considerable interobserver variability. Keywords: Tumor Response, Observer Performance, CT, Liver, Metastases, Oncology, Abdomen/Gastrointestinal Clinical trial registration no. NCT02162563 Supplemental material is available for this article. © RSNA, 2022.
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- 2022