Response evaluation in mesothelioma: Beyond RECIST. Issue 3 (December 2015)

• Record Type: Journal Article
• Authors: Cheng, Lin; Tunariu, Nina; Collins, David J.; Blackledge, Matthew D.; Riddell, Angela M.; Leach, Martin O.; Popat, Sanjay; Koh, Dow-Mu
• Is Part Of: Lung cancer. Volume 90:Issue 3(2015:Dec.)
• Page Start: 433
• Page End: 441
• Publication Date: 2015-12
• Subjects: Mesothelioma -- CT -- PET -- DWI -- DCE-MRI -- Treatment response evaluation; Lungs -- Cancer -- Periodicals; Lung Neoplasms -- Abstracts; Lung Neoplasms -- Periodicals; Poumons -- Cancer -- Périodiques; Lungs -- Cancer; Periodicals; Electronic journals; Electronic journals; 616.99424
• DOI: 10.1016/j.lungcan.2015.08.012
• Languages: English
• ISSNs: 0169-5002

Abstract

Highlights: Modified RECIST criteria for assessing treatment response have lower inter-study and interobserver variability compared with standard RECIST criteria in malignant mesothelioma. 18FDG-PET imaging can provide functional assessment of disease response. A decrease in SUVmax is associated with treatment response and longer progression free survival. Diffusion-weighted MRI (DWI) is a promising functional MRI technique, which can be used to objectively quantify disease burden and tissue cellularity to provide treatment response assessment. Abstract: Malignant pleural mesothelioma (MPM) typically demonstrates a non-spherical growth pattern, so it is often difficult to accurately categorize change in tumour burden using size-based tumour response criteria (e.g., WHO (World Health Organisation), RECIST (Response Evaluation Criteria in Solid Tumours) and modified RECIST). Functional imaging techniques are applied to derive quantitative measurements of tumours, which reflect particular aspects of the tumour pathophysiology. By quantifying how these measurements change with treatment, it is possible to observe treatment effects. In this review, we survey the existing roles of CT and MRI for the management of MPM, including the currently applied size measurement criteria for the assessment of treatment response. New functional imaging techniques, such as positron emission tomography (PET), diffusion-weighted MRI (DWI) and dynamic contrast-enhanced MRI (DCE-MRI) that may potentially improve the assessment of treatment response will be highlighted and discussed.