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Interobserver variability in CT-based morphologic tumor response assessment of colorectal liver metastases

Title: Interobserver variability in CT-based morphologic tumor response assessment of colorectal liver metastases
Authors: Wesdorp, Nina J.; Kemna, Ruby; Bolhuis, Karen; van Waesberghe, Jan H.T.M.; Nota, Irene M.G.C.; Struik, Femke; Abdennabi, Ikrame Oulad; 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.; Grunhagen, 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
Source: Radiology-imaging cancer ; 2638-616X
Publication Year: 2022
Collection: IRUA - Institutional Repository van de Universiteit Antwerpen
Subject Terms: Human medicine; Computer. Automation
Description: 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 k. 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 (k = 0.53, 95% CI: 0.48, 0.58 and k = 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. (C) RSNA, 2022.
Document Type: article in journal/newspaper
Language: English
Relation: info:eu-repo/semantics/altIdentifier/isi/000827888800004
Availability: https://hdl.handle.net/10067/1897640151162165141; https://repository.uantwerpen.be/docstore/d:irua:17000
Rights: info:eu-repo/semantics/openAccess
Accession Number: edsbas.8A7343EC
Database: BASE