• Title/Summary/Keyword: Tumor response assessment

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Assessment of Tumor Response to Therapy in Lymphoma Using $^{18}F$-FDG PET: Diagnostic Performance of $^{18}F$-FDG PET and Interval Likelihood Ratio PET and Interval Likelihood Ratio ($^{18}F$-FDG PET을 이용한 림프종 치료 반응 평가: $^{18}F$-FDG PET의 진단 성능 특성과 구간 우도비)

  • Kim, Chang-Guhn;Kim, Dae-Weung;Park, Moo-Rim
    • Nuclear Medicine and Molecular Imaging
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    • v.43 no.5
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    • pp.369-385
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    • 2009
  • In this paper, the authors intended to summarize briefly the features of lymphoma with regard to $^{18}F$-FDG PET for assessment of tumor response to therapy, to describe why assessment of treatment response should be performed, to review what method so far has been used in monitoring treatment response, to discuss what limitations of morphologic imaging criteria for assessing tumor response are, in compared with $^{18}F$-FDG PET, and to introduce recently proposed criteria for assessing tumor response in malignant lymphoma. And also the authors emphasize the need to understand the characteristics of diagnostic performance of $^{18}F$-FDG PET in several clinical settings in order to interpret $^{18}F$-FDG PET results appropriately, and to encourage the use of interval likelihood ratio to enhance clinical implications of test results which, in turns, allows referring physicians to understand the meaning of interpretation with easy. Until recently, treatment response has been assessed according to the morphologic criteria. Metabolic imaging with $^{18}F$-FDG PET was adopted to have important role for treatment assessment in IWC+PET criteria proposed recently by IHP. To accomplish this role, we should perform and interpret $^{18}F$-FDG PET according to IWC+PET criteria. It is important for referring physicians to understand the various limitations of $^{18}F$-FDG PET and pitfalls in PET interpretation, and to understand that clinical information are needed by nuclear medicine physicians to optimize the interpretation of $^{18}F$-FDG PET.

Evaluation of Cancer Treatment Using FDG-PET (FDG-PET을 이용한 암 치료 효과의 평가)

  • Ryu, Jin-Sook
    • The Korean Journal of Nuclear Medicine
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    • v.36 no.1
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    • pp.64-73
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    • 2002
  • FDG-PET has potential as an effective, non-invasive tool to measure tumor response to anticancer therapy. The changes in tumor FDG uptake may provide an early, sensitive guide to the clinical and subclinical response of tumors to cancer treatment, as well as functional assessment of residual viable tumor. This may allow the evaluation of subclinical response to anticancer drugs in early clinical trials and improvements in patients management. However, monitoring tumor responses with FDG-PET is still in its infancy. The methods of measurement of FDG uptake are currently diverse and timing with respect to anti cancer therapy variable. Therefore, there is a need for larger-scale trials along with standardized methodology and a collection of reproducibility data. The recent guideline from the European group seems to be the most comprehensive. In future, the combination of morphological and metabolic images may improve the quantitative nature of these measurements by relating tumor viability to total tumor mass. More data on sensitivity and specificity of FDG-PET technique are needed along with continued advancement of PET methodology.

BIOLOGICALLY BASED DOSE-RESPONSE (BBDR) MODELING USING BIOMARKERS FOR CANCEER RISK ASSESSMENT

  • Song, Hyun-Sue;Lee, Byung-Mu
    • Proceedings of the Korean Society of Toxicology Conference
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    • 2002.05a
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    • pp.137-137
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    • 2002
  • Biologically Based Dose-Response (BBDR) models were developed using biomarkers for cancer risk assessment. To establish the relationship among biomarkers, exposure dose and tumor response, biomarkers in the lung, liver, stomach or blood were measured after a single or continuous administration of selected carcinogen (; BaP) in mice or rats.(omitted)

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Response Evaluation of Chemotherapy for Lung Cancer

  • Hwang, Ki-Eun;Kim, Hak-Ryul
    • Tuberculosis and Respiratory Diseases
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    • v.80 no.2
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    • pp.136-142
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    • 2017
  • Assessing response to therapy allows for prospective end point evaluation in clinical trials and serves as a guide to clinicians for making decisions. Recent prospective and randomized trials suggest the development of imaging techniques and introduction of new anti-cancer drugs. However, the revision of methods, or proposal of new methods to evaluate chemotherapeutic response, is not enough. This paper discusses the characteristics of the Response Evaluation Criteria In Solid Tumor (RECIST) version 1.1 suggested in 2009 and used widely by experts. It also contains information about possible dilemmas arising from the application of response assessment by the latest version of the response evaluation method, or recently introduced chemotherapeutic agents. Further data reveals the problems and limitations caused by applying the existing RECIST criteria to anti-cancer immune therapy, and the application of a new technique, immune related response criteria, for the response assessment of immune therapy. Lastly, the paper includes a newly developing response evaluation method and suggests its developmental direction.

Maximum diameter versus volumetric assessment for the response evaluation of vestibular schwannomas receiving stereotactic radiotherapy

  • Choi, Youngmin;Kim, Sungmin;Kwak, Dong-Won;Lee, Hyung-Sik;Kang, Myung-Koo;Lee, Dong-Kun;Hur, Won-Joo
    • Radiation Oncology Journal
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    • v.36 no.2
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    • pp.114-121
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    • 2018
  • Purpose: To explore the feasibility of maximum diameter as a response assessment method for vestibular schwannomas (VS) after stereotactic radiosurgery or fractionated stereotactic radiotherapy (RT), we analyzed the concordance of RT responses between maximum diameters and volumetric measurements. Materials and Methods: Forty-two patients receiving curative stereotactic radiosurgery or fractionated stereotactic RT for VS were analyzed retrospectively. Twelve patients were excluded: 4 did not receive follow-up magnetic resonance imaging (MRI) scans and 8 had initial MRI scans with a slice thickness >3 mm. The maximum diameter, tumor volume (TV), and enhanced tumor volume (ETV) were measured in each MRI study. The percent change after RT was evaluated according to the measurement methods and their concordances were calculated with the Pearson correlation. The response classifications were determined by the assessment modalities, and their agreement was analyzed with Cohen kappa statistics. Results: Median follow-up was 31.0 months (range, 3.5 to 86.5 months), and 90 follow-up MRI studies were analyzed. The percent change of maximum diameter correlated strongly with TV and ETV (r(p) = 0.85, 0.63, p = 0.000, respectively). Concordance of responses between the Response Evaluation Criteria in Solid Tumors (RECIST) using the maximum diameters and either TV or ETV were moderate (kappa = 0.58; 95% confidence interval, 0.32-0.85) or fair (kappa = 0.32; 95% confidence interval, 0.05-0.59), respectively. Conclusions: The percent changes in maximum diameter and the responses in RECIST were significantly concordant with those in the volumetric measurements. Therefore, the maximum diameters can be used for the response evaluation of VS following stereotactic RT.

Anti-Cancer Effects of Salvia Miltiorrhiza, Carydalis Turtschaminovii, Reynoutria Elliptica Herbal Acupuncture on Solid Tumor of Rats induced by Injection of RK3E-ras Cells (RK3E-ras cells로 유발된 흰쥐의 고형종양에 대한 단삼, 현호색, 호장근 약침의 항종양 효과)

  • Park, Soo-Gon;Shin, Mi-Suk;Choi, Jin-Bong;Kim, Sun-Jong
    • Journal of Korean Medicine Rehabilitation
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    • v.19 no.1
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    • pp.91-102
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    • 2009
  • Objectives : The present study was carried out investigate the anti-cancer effect of Salvia miltiorrhiza, Carydalis turtschaminovii and Reynoutria elliptica herbal acupuncture on solid tumor of rats induced by injection of RK3E-ras cells. Methods : RK3E-ras cells were injected on the right lumbar region of rats. After 1 weeks, the experimental rats were divided into four groups : Control group, Salvia miltiorrhiza herbal acupuncture group(SM), Carydalis turtschaminovii herbal acupuncture group(CT), Reynoutria elliptica herbal acupuncture group(RE). And we investigated the weight and size of tumor tissue, gross anatomy, histological and PCNA immunohistochemical study, hepatic and renal metastasis for tumor of each group. Results : 1. In the weight of tumor tissue assessment, SM and CT's weight of tumor tissue was decreased. 2. In the size of tumor tissue assessment, SM was smaller than any other group. 3. In the histological observation, SM's formation of tunica fibrosa that surround the tumor cell was obvious and vasculature that developes circumference of tumor cell was not observed, and density of tumor cell was very low. 4. In the PCNA immunohistochemical study, Control group, SM, RE showed strong immune response in the central site of tumor tissue. 5. In observation of liver and kidney tissue, we were not able to observe tumor cell in the SM. Conclusions : Consequently, SM and CT showed a inhibition of growth and metastasis.

Tumor Habitat Analysis Using Longitudinal Physiological MRI to Predict Tumor Recurrence After Stereotactic Radiosurgery for Brain Metastasis

  • Da Hyun Lee;Ji Eun Park;NakYoung Kim;Seo Young Park;Young-Hoon Kim;Young Hyun Cho;Jeong Hoon Kim;Ho Sung Kim
    • Korean Journal of Radiology
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    • v.24 no.3
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    • pp.235-246
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    • 2023
  • Objective: It is difficult to predict the treatment response of tissue after stereotactic radiosurgery (SRS) because radiation necrosis (RN) and tumor recurrence can coexist. Our study aimed to predict tumor recurrence, including the recurrence site, after SRS of brain metastasis by performing a longitudinal tumor habitat analysis. Materials and Methods: Two consecutive multiparametric MRI examinations were performed for 83 adults (mean age, 59.0 years; range, 27-82 years; 44 male and 39 female) with 103 SRS-treated brain metastases. Tumor habitats based on contrast-enhanced T1- and T2-weighted images (structural habitats) and those based on the apparent diffusion coefficient (ADC) and cerebral blood volume (CBV) images (physiological habitats) were defined using k-means voxel-wise clustering. The reference standard was based on the pathology or Response Assessment in Neuro-Oncologycriteria for brain metastases (RANO-BM). The association between parameters of single-time or longitudinal tumor habitat and the time to recurrence and the site of recurrence were evaluated using the Cox proportional hazards regression analysis and Dice similarity coefficient, respectively. Results: The mean interval between the two MRI examinations was 99 days. The longitudinal analysis showed that an increase in the hypovascular cellular habitat (low ADC and low CBV) was associated with the risk of recurrence (hazard ratio [HR], 2.68; 95% confidence interval [CI], 1.46-4.91; P = 0.001). During the single-time analysis, a solid low-enhancing habitat (low T2 and low contrast-enhanced T1 signal) was associated with the risk of recurrence (HR, 1.54; 95% CI, 1.01-2.35; P = 0.045). A hypovascular cellular habitat was indicative of the future recurrence site (Dice similarity coefficient = 0.423). Conclusion: After SRS of brain metastases, an increased hypovascular cellular habitat observed using a longitudinal MRI analysis was associated with the risk of recurrence (i.e., treatment resistance) and was indicative of recurrence site. A tumor habitat analysis may help guide future treatments for patients with brain metastases.

Vascular Morphometric Changes During Tumor Growth and Chemotherapy in a Murine Mammary Tumor Model Using OCT Angiography: a Preliminary Study

  • Kim, Hoonsup;Eom, Tae Joong;Kim, Jae Gwan
    • Current Optics and Photonics
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    • v.3 no.1
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    • pp.54-65
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    • 2019
  • To develop a biomarker predicting tumor treatment efficacy is helpful to reduce time, medical expenditure, and efforts in oncology therapy. In clinics, microvessel density using immunohistochemistry has been proposed as an indicator that correlates with both tumor size and metastasis of cancer. In the preclinical study, we hypothesized that vascular morphometrics using optical coherence tomography angiography (OCTA) could be potential indicators to estimate the treatment efficacy of breast cancer. To verify this hypothesis, a 13762-MAT-B-III rat breast tumor was grown in a dorsal skinfold window chamber which was applied to a nude mouse, and the change in vascular morphology was longitudinally monitored during tumor growth and metronomic cyclophosphamide treatment. Based on the daily OCTA maximum intensity projection map, multiple vessel parameters (vessel skeleton density, vessel diameter index, fractal dimension, and lacunarity) were compared with the tumor size in no tumor, treated tumor, and untreated tumor cases. Although each case has only one animal, we found that the vessel skeleton density (VSD), vessel diameter index and fractal dimension (FD) tended to be positively correlated with tumor size while lacunarity showed a partially negative correlation. Moreover, we observed that the changes in the VSD and FD are prior to the morphological change of the tumor. This feasibility study would be helpful in evaluating the tumor vascular response to treatment in preclinical settings.

Changes in Breast-tumor Blood Flow in Response to Hypercapnia during Chemotherapy with Laser Speckle Flowmetry

  • Kim, Hoonsup;Lee, Youngjoo;Lee, Songhyun;Kim, Jae Gwan
    • Current Optics and Photonics
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    • v.3 no.6
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    • pp.555-565
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    • 2019
  • Development of a biomarker for predicting tumor-treatment efficacy is a matter of great concern, to reduce time, medical expense, and effort in oncology therapy. In a preclinical study, we hypothesized that the blood-flow parameter based on laser speckle flowmetry (LSF) could be a potential indicator to estimate the efficacy of breast-cancer treatment. To verify this hypothesis, a 13762-MAT-B-III rat breast tumor was grown in a dorsal skinfold window chamber applied to a nude mouse, and the change in blood flow rate (BFR) - or the speckle flow index (SFI) is used together as the same meaning in this manuscript - was longitudinally monitored during tumor growth and metronomic cyclophosphamide treatment. Based on the daily LSF angiogram, several BFR parameters (baseline SFI, normalized SFI, and △rBFR) were compared to tumor size in the normal, treated, and untreated tumor groups. Despite the incomplete tumor treatment, we found that the daily changes in all BFR parameters tended to have partially positive correlation with tumor size. Moreover, we observed that the changes in baseline SFI and normalized SFI responded one day earlier than the tumor shrinkage during chemotherapy. However, daily variations in the hypercapnia-induced △rBFR lagged tumor shrinkage by one day. This study would contribute not only to evaluating tumor vascular response to treatment, but also to monitoring blood-flow-mediated diseases (in brain, skin, and retina) by using LSF in preclinical settings.

Interpretation of Rectal MRI after Neoadjuvant Treatment in Patients with Rectal Cancer (수술 전 선행보조치료를 받은 직장암 환자의 직장 자기공명영상의 해석)

  • Nieun Seo;Joon Seok Lim
    • Journal of the Korean Society of Radiology
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    • v.84 no.3
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    • pp.550-564
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    • 2023
  • MRI is currently the imaging modality of choice to evaluate rectal cancer after neoadjuvant treatment. The purposes of restaging MRI are to assess the resectability of rectal cancer and to decide whether organ preservation strategies can be applied in patients with a complete clinical response. This review article indicates the key MRI features needed to evaluate rectal cancer after neoadjuvant treatment using a systematic approach. Assessment of primary tumor response including MRI findings to predict a complete response is discussed. Additionally, MRI evaluation of the relationship between the primary tumor and adjacent structures, lymph node response, extramural venous invasion, and tumor deposits after neoadjuvant treatment is presented. Knowledge of these imaging features and their clinical relevance may help radiologists provide an accurate and clinically valuable interpretation of restaging rectal MRI.