Online citations, reference lists, and bibliographies.
← Back to Search

A Comparison Between MRI And CT In The Assessment Of Primary Tumour Volume In Mesothelioma.

S. Tsim, G. Cowell, Andrew C Kidd, R. Woodward, L. Alexander, C. Kelly, J. Foster, K. Blyth
Published 2020 · Medicine

Cite This
Download PDF
Analyze on Scholarcy
INTRODUCTION Primary tumour staging in Malignant Pleural Mesothelioma (MPM) using Computed Tomography (CT) imaging is confounded by perception errors reflecting low spatial resolution between tumour and adjacent structures. Augmentation using perfusion CT is constrained by radiation dosage. In this study, we evaluated an alternative tumour staging method using perfusion-tuned Magnetic Resonance Imaging (MRI). METHODS Consecutive patients with suspected MPM were recruited to a prospective observational study. All had MRI (T1-weighted, isotropic, contrast-enhanced 3-Tesla perfusion imaging) and CT (contrast-enhanced) pre-biopsy. Patients diagnosed with MPM underwent MRI and CT volumetry, with readers blinded to clinical data. MRI volumetry was semi-automated, using signal intensity limits from perfusion studies to grow tumour regions within a pleural volume. A similar CT method was not possible, therefore all visible tumour was manually segmented. MRI and CT volumes were compared (agreement, correlation, analysis time, reproducibility) and associations with survival examined using Cox regression. RESULTS 58 patients were recruited and had MRI before biopsy. 31/58 were diagnosed with MPM and these scans were used for volumetry. Mean (SD) MRI and CT volumes were 370 cm3 and 302 cm3, respectively. MRI volumes were larger (average bias 61.9 cm3 (SD 116), 95 % limits (-165.5 - 289 cm3), moderately correlated with CT (r = 0.56, p = 0.002) and independently associated with survival (HR 4.03 (95 % CI 1.5-11.55), p = 0.006). CT volumes were not associated with survival, took longer to compute than MRI volumes (mean (SD) 151 (19) v 14 (2) minutes, p=<0.0001) and were less reproducible (inter-observer ICC 0.72 for CT, 0.96 for MRI). CONCLUSIONS MRI and CT generate different tumour volumes in MPM. In this study, MRI volumes were larger and were independently associated with survival. MRI volumetry was quicker and more reproducible than CT.
This paper references
Initial Analysis of the International Association For the Study of Lung Cancer Mesothelioma Database
V. Rusch (2012)
Epithelial malignant pleural mesothelioma after extrapleural pneumonectomy: stratification of survival with CT-derived tumor volume.
R. Gill (2012)
Preoperative tumor volume is associated with outcome in malignant pleural mesothelioma.
H. Pass (1998)
Current trends in radiologic management of malignant pleural mesothelioma.
R. Gill (2009)
Optimization of Response Classification Criteria for Patients with Malignant Pleural Mesothelioma
Z. Labby (2012)
British Thoracic Society Guideline for the investigation and management of malignant pleural mesothelioma
I. Woolhouse (2018)
Imaging in pleural mesothelioma: a review of the 11th International Conference of the International Mesothelioma Interest Group.
S. Armato (2013)
The IASLC Lung Cancer Staging Project: Proposals for the Revisions of the T Descriptors in the Forthcoming Eighth Edition of the TNM Classification for Lung Cancer
R. Rami-Porta (2015)
Malignant pleural mesothelioma: evaluation with CT, MR imaging, and PET.
Z. Wang (2004)
Modified RECIST criteria for assessment of response in malignant pleural mesothelioma.
M. Byrne (2004)
The clinical importance of magnetic resonance imaging versus computed tomography in malignant pleural mesothelioma.
A. Knuuttila (1998)
North American Multicenter Volumetric CT Study for Clinical Staging of Malignant Pleural Mesothelioma: Feasibility and Logistics of Setting Up a Quantitative Imaging Study
R. Gill (2016)
Computer-aided volumetric assessment of malignant pleural mesothelioma on CT using a random walk-based method
Mitchell Chen (2016)
Assessment of Therapy Responses and Prediction of Survival in Malignant Pleural Mesothelioma Through Computer-Aided Volumetric Measurement on Computed Tomography Scans
F. Liu (2010)
The value of delayed phase enhanced imaging in malignant pleural mesothelioma.
Akash M Patel (2017)
Evaluation of pleural disease using MR and CT. With special reference to malignant pleural mesothelioma.
A. Knuuttila (2001)
Early Contrast Enhancement: A novel magnetic resonance imaging biomarker of pleural malignancy
S. Tsim (2018)
Therapy response in malignant pleural mesothelioma-role of MRI using RECIST, modified RECIST and volumetric approaches in comparison with CT
C. Plathow (2008)
Staging of malignant pleural mesothelioma: comparison of CT and MR imaging.
R. Heelan (1999)
Diagnostic and Prognostic Biomarkers in the Rational Assessment of Mesothelioma (DIAPHRAGM) study: protocol of a prospective, multicentre, observational study
S. Tsim (2016)
Volumetry: an alternative to assess therapy response for malignant pleural mesothelioma?
T. Frauenfelder (2011)
Imaging of tumor angiogenesis: functional or targeted?
B. Turkbey (2009)
Computed Tomography, Positron Emission Tomography, Positron Emission Tomography/Computed Tomography, and Magnetic Resonance Imaging for Staging of Limited Pleural Mesothelioma: Initial Results
C. Plathow (2008)
A Multicenter Study of Volumetric Computed Tomography for Staging Malignant Pleural Mesothelioma.
V. Rusch (2016)
Asbestos-Related Pleural Disease: Value of Dedicated Magnetic Resonance Imaging Techniques
M. Weber (2004)
Evaluation of pleural disease using MR and CT: With special reference to malignant pleural mesothelioma
A. Knuuttila (2001)
Variability of tumor area measurements for response assessment in malignant pleural mesothelioma.
Z. Labby (2013)
Morphologic and functional imaging of malignant pleural mesothelioma.
M. Yamamuro (2007)
The IASLC Mesothelioma Staging Project: Proposals for Revisions of the N Descriptors in the Forthcoming Eighth Edition of the TNM Classification for Pleural Mesothelioma
D. Rice (2016)
Challenging a dogma; AJCC 8th staging system is not sufficient to predict outcomes of patients with malignant pleural mesothelioma.
O. Abdel-Rahman (2017)
Is there a role for pre-operative contrast-enhanced magnetic resonance imaging for radical surgery in malignant pleural mesothelioma?
D. Stewart (2003)
Radiologic-pathologic correlation of mesothelioma tumor volume.
S. Armato (2015)
CT imaging of angiogenesis.
T-Y Lee (2003)

Semantic Scholar Logo Some data provided by SemanticScholar