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Metastatic Sarcoma Assessment using CT Volumetric Density

Thursday, October 11, 2012 — Poster Session III

10:00 a.m. – Noon

Natcher Conference Center, Building 45




  • V.M. Derderian
  • E.C. Jones
  • M.S. Merchant
  • B.C. Widemann
  • A.J. Dwyer
  • A.M. Venkatesan
  • S.M. Steinberg
  • L.R. Folio


Background: Recent studies in metastatic cancers demonstrate potential added value of accounting for tumor density and volume (SACT, MASS, Choi) beyond axial dimensions (RECIST) or selective region of interest (ROI). We propose a more comprehensive tumor response method, Total Volume of Viable Tumor (TVVT), to quantify change in viable versus necrotic tumor volumes across all lesions through volumetric characterization of density, necrosis, and HU distribution throughout all parts of all measurable tumors. Purpose: Compare RECIST and volume/HU (TVVT) CT measurements in a subset of metastatic sarcoma lesions and correlate to therapeutic response and survival measures, allowing future comparisons in larger subsets of sarcomas treated with various therapies. Hypothesis: Volumetric density and percent necrosis analysis algorithms (TVVT) lead to improved evaluation, treatment and response in metastatic lesions, more accurately reflecting tumor burden and improving survival predictions. Use of automated VOI decreases inter-observer tumor measurement variability. Aims: 1) Retrospectively compare TVVT (all lesions) vs. RECIST/other density criteria (target lesions) 2) Correlate TVVT, RECIST and treatment response/outcomes 3) Assess inter-observer variation in TVVT vs. RECIST Clinical impact: Automated, comprehensive analysis of tumor volumetric density in PACS should better predict outcomes, improve cancer staging, and make tumor reporting more widespread.

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