Uveal melanoma metastatic to the liver: The role of quantitative volumetric contrast-enhanced MR imaging in the assessment of early tumor response after transarterialchemo

Rafael Duran, Julius Chapiro, Constantine Frangakis, MingDe Lin, Todd R. Schlachter, Rüdiger E. Schernthaner, Zhijun Wang, Lynn J. Savic, Vania Tacher, Ihab R Kamel, Jean François Geschwind

Research output: Contribution to journalArticle

Abstract

PURPOSE: To determine whether volumetric changes of enhancement as seen on contrast-enhanced magnetic resonance (MR) imaging can help assess early tumor response and predict survival in patients with metastatic uveal melanoma after one session of transarterial chemoembolization (TACE). MATERIALS AND METHODS: Fifteen patients with 59 lesions who underwent MR imaging before and 3 to 4 weeks after the first TACE were retrospectively included. MR analysis evaluated signal intensities, World Health Organization (WHO), Response Evaluation Criteria in Solid Tumors (RECIST), European Association for the Study of the Liver (EASL), modified RECIST (mRECIST), tumor volume [volumetric RECIST (vRECIST)], and volumetric tumor enhancement [quantitative EASL (qEASL)]. qEASL was expressed in cubic centimeters [qEASL (cm3)] and as a percentage of the tumor volume [qEASL (%)]. Paired t test with its exact permutation distribution was used to compare measurements before and after TACE. The Kaplan-Meier method with the log-rank test was used to calculate overall survival for responders and non-responders. RESULTS: In target lesions, mean qEASL (%) decreased from 63.9% to 42.6% (P =.016). No significant changes were observed using the other response criteria. In non-target lesions, mean WHO, RECIST, EASL, mRECIST, vRECIST, and qEASL (cm3) were significantly increased compared to baseline. qEASL (%) remained stable (P=.214).Median overall survival was 5.6 months. qEASL (cm3) was the only parameter that could predict survival based on target lesions (3.6 vs 40.5 months, P b.001) or overall (target and nontarget lesions) response (4.4 vs 40.9 months, P =.001). CONCLUSION: Volumetric tumor enhancement may be used as a surrogate biomarker for survival prediction in patients with uveal melanoma after the first TACE.

Original languageEnglish (US)
Pages (from-to)447-455
Number of pages9
JournalTranslational Oncology
Volume7
Issue number4
DOIs
StatePublished - 2014

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Magnetic Resonance Imaging
Liver
Survival
Neoplasms
Tumor Burden
Uveal melanoma
Response Evaluation Criteria in Solid Tumors
Magnetic Resonance Spectroscopy
Biomarkers

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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Uveal melanoma metastatic to the liver : The role of quantitative volumetric contrast-enhanced MR imaging in the assessment of early tumor response after transarterialchemo. / Duran, Rafael; Chapiro, Julius; Frangakis, Constantine; Lin, MingDe; Schlachter, Todd R.; Schernthaner, Rüdiger E.; Wang, Zhijun; Savic, Lynn J.; Tacher, Vania; Kamel, Ihab R; Geschwind, Jean François.

In: Translational Oncology, Vol. 7, No. 4, 2014, p. 447-455.

Research output: Contribution to journalArticle

Duran, Rafael ; Chapiro, Julius ; Frangakis, Constantine ; Lin, MingDe ; Schlachter, Todd R. ; Schernthaner, Rüdiger E. ; Wang, Zhijun ; Savic, Lynn J. ; Tacher, Vania ; Kamel, Ihab R ; Geschwind, Jean François. / Uveal melanoma metastatic to the liver : The role of quantitative volumetric contrast-enhanced MR imaging in the assessment of early tumor response after transarterialchemo. In: Translational Oncology. 2014 ; Vol. 7, No. 4. pp. 447-455.
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title = "Uveal melanoma metastatic to the liver: The role of quantitative volumetric contrast-enhanced MR imaging in the assessment of early tumor response after transarterialchemo",
abstract = "PURPOSE: To determine whether volumetric changes of enhancement as seen on contrast-enhanced magnetic resonance (MR) imaging can help assess early tumor response and predict survival in patients with metastatic uveal melanoma after one session of transarterial chemoembolization (TACE). MATERIALS AND METHODS: Fifteen patients with 59 lesions who underwent MR imaging before and 3 to 4 weeks after the first TACE were retrospectively included. MR analysis evaluated signal intensities, World Health Organization (WHO), Response Evaluation Criteria in Solid Tumors (RECIST), European Association for the Study of the Liver (EASL), modified RECIST (mRECIST), tumor volume [volumetric RECIST (vRECIST)], and volumetric tumor enhancement [quantitative EASL (qEASL)]. qEASL was expressed in cubic centimeters [qEASL (cm3)] and as a percentage of the tumor volume [qEASL ({\%})]. Paired t test with its exact permutation distribution was used to compare measurements before and after TACE. The Kaplan-Meier method with the log-rank test was used to calculate overall survival for responders and non-responders. RESULTS: In target lesions, mean qEASL ({\%}) decreased from 63.9{\%} to 42.6{\%} (P =.016). No significant changes were observed using the other response criteria. In non-target lesions, mean WHO, RECIST, EASL, mRECIST, vRECIST, and qEASL (cm3) were significantly increased compared to baseline. qEASL ({\%}) remained stable (P=.214).Median overall survival was 5.6 months. qEASL (cm3) was the only parameter that could predict survival based on target lesions (3.6 vs 40.5 months, P b.001) or overall (target and nontarget lesions) response (4.4 vs 40.9 months, P =.001). CONCLUSION: Volumetric tumor enhancement may be used as a surrogate biomarker for survival prediction in patients with uveal melanoma after the first TACE.",
author = "Rafael Duran and Julius Chapiro and Constantine Frangakis and MingDe Lin and Schlachter, {Todd R.} and Schernthaner, {R{\"u}diger E.} and Zhijun Wang and Savic, {Lynn J.} and Vania Tacher and Kamel, {Ihab R} and Geschwind, {Jean Fran{\cc}ois}",
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T1 - Uveal melanoma metastatic to the liver

T2 - The role of quantitative volumetric contrast-enhanced MR imaging in the assessment of early tumor response after transarterialchemo

AU - Duran, Rafael

AU - Chapiro, Julius

AU - Frangakis, Constantine

AU - Lin, MingDe

AU - Schlachter, Todd R.

AU - Schernthaner, Rüdiger E.

AU - Wang, Zhijun

AU - Savic, Lynn J.

AU - Tacher, Vania

AU - Kamel, Ihab R

AU - Geschwind, Jean François

PY - 2014

Y1 - 2014

N2 - PURPOSE: To determine whether volumetric changes of enhancement as seen on contrast-enhanced magnetic resonance (MR) imaging can help assess early tumor response and predict survival in patients with metastatic uveal melanoma after one session of transarterial chemoembolization (TACE). MATERIALS AND METHODS: Fifteen patients with 59 lesions who underwent MR imaging before and 3 to 4 weeks after the first TACE were retrospectively included. MR analysis evaluated signal intensities, World Health Organization (WHO), Response Evaluation Criteria in Solid Tumors (RECIST), European Association for the Study of the Liver (EASL), modified RECIST (mRECIST), tumor volume [volumetric RECIST (vRECIST)], and volumetric tumor enhancement [quantitative EASL (qEASL)]. qEASL was expressed in cubic centimeters [qEASL (cm3)] and as a percentage of the tumor volume [qEASL (%)]. Paired t test with its exact permutation distribution was used to compare measurements before and after TACE. The Kaplan-Meier method with the log-rank test was used to calculate overall survival for responders and non-responders. RESULTS: In target lesions, mean qEASL (%) decreased from 63.9% to 42.6% (P =.016). No significant changes were observed using the other response criteria. In non-target lesions, mean WHO, RECIST, EASL, mRECIST, vRECIST, and qEASL (cm3) were significantly increased compared to baseline. qEASL (%) remained stable (P=.214).Median overall survival was 5.6 months. qEASL (cm3) was the only parameter that could predict survival based on target lesions (3.6 vs 40.5 months, P b.001) or overall (target and nontarget lesions) response (4.4 vs 40.9 months, P =.001). CONCLUSION: Volumetric tumor enhancement may be used as a surrogate biomarker for survival prediction in patients with uveal melanoma after the first TACE.

AB - PURPOSE: To determine whether volumetric changes of enhancement as seen on contrast-enhanced magnetic resonance (MR) imaging can help assess early tumor response and predict survival in patients with metastatic uveal melanoma after one session of transarterial chemoembolization (TACE). MATERIALS AND METHODS: Fifteen patients with 59 lesions who underwent MR imaging before and 3 to 4 weeks after the first TACE were retrospectively included. MR analysis evaluated signal intensities, World Health Organization (WHO), Response Evaluation Criteria in Solid Tumors (RECIST), European Association for the Study of the Liver (EASL), modified RECIST (mRECIST), tumor volume [volumetric RECIST (vRECIST)], and volumetric tumor enhancement [quantitative EASL (qEASL)]. qEASL was expressed in cubic centimeters [qEASL (cm3)] and as a percentage of the tumor volume [qEASL (%)]. Paired t test with its exact permutation distribution was used to compare measurements before and after TACE. The Kaplan-Meier method with the log-rank test was used to calculate overall survival for responders and non-responders. RESULTS: In target lesions, mean qEASL (%) decreased from 63.9% to 42.6% (P =.016). No significant changes were observed using the other response criteria. In non-target lesions, mean WHO, RECIST, EASL, mRECIST, vRECIST, and qEASL (cm3) were significantly increased compared to baseline. qEASL (%) remained stable (P=.214).Median overall survival was 5.6 months. qEASL (cm3) was the only parameter that could predict survival based on target lesions (3.6 vs 40.5 months, P b.001) or overall (target and nontarget lesions) response (4.4 vs 40.9 months, P =.001). CONCLUSION: Volumetric tumor enhancement may be used as a surrogate biomarker for survival prediction in patients with uveal melanoma after the first TACE.

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