Nuclear Medicine Department, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy.
Department of Radiodiagnostics and Radiotherapy, IRCCS Fondazione Istituto Nazionale Tumori, Milan, Italy.
Sci Rep. 2024 Jul 9;14(1):15782. doi: 10.1038/s41598-024-66668-9.
This study aims to assess the predictive capability of cylindrical Tumor Growth Rate (cTGR) in the prediction of early progression of well-differentiated gastro-entero-pancreatic tumours after Radio Ligand Therapy (RLT), compared to the conventional TGR. Fifty-eight patients were included and three CT scans per patient were collected at baseline, during RLT, and follow-up. RLT response, evaluated at follow-up according to RECIST 1.1, was calculated as a percentage variation of lesion diameters over time (continuous values) and as four different RECIST classes. TGR between baseline and interim CT was computed using both conventional (approximating lesion volume to a sphere) and cylindrical (called cTGR, approximating lesion volume to an elliptical cylinder) formulations. Receiver Operating Characteristic (ROC) curves were employed for Progressive Disease class prediction, revealing that cTGR outperformed conventional TGR (area under the ROC equal to 1.00 and 0.92, respectively). Multivariate analysis confirmed the superiority of cTGR in predicting continuous RLT response, with a higher coefficient for cTGR (1.56) compared to the conventional one (1.45). This study serves as a proof of concept, paving the way for future clinical trials to incorporate cTGR as a valuable tool for assessing RLT response.
本研究旨在评估圆柱形肿瘤生长率 (cTGR) 在预测放射性配体治疗 (RLT) 后高分化胃肠胰腺肿瘤早期进展方面的预测能力，与传统 TGR 相比。纳入了 58 名患者，每位患者在基线、RLT 期间和随访时采集了三次 CT 扫描。根据 RECIST 1.1 标准，在随访时评估 RLT 反应，计算为病变直径随时间的百分比变化（连续值）和四个不同的 RECIST 类别。使用传统（将病变体积近似为球体）和圆柱形（称为 cTGR，将病变体积近似为椭圆形圆柱体）公式在基线和中期 CT 之间计算 TGR。采用受试者工作特征 (ROC) 曲线预测进行性疾病类别，结果表明 cTGR 优于传统 TGR（ROC 下面积分别为 1.00 和 0.92）。多变量分析证实 cTGR 在预测连续 RLT 反应方面具有优越性，cTGR 的系数（1.56）高于传统 TGR（1.45）。本研究为概念验证，为未来临床试验将 cTGR 作为评估 RLT 反应的有价值工具铺平了道路。
