8. 脳腫瘍の治療効果の標準評価基準施行例
(RECIST,MacDonard and RANO etc)
特にgliomaで使用される評価基準例
WHO,RECIST1.0 RECIST1.1,ir-RECIST (MacDonard Criteria or RANO etc.)
http://www.radiologyassistant.nl/en/p47f86aa182b3a
Quated from The radiology assistant Website.
Image coutesy of T.Hirano, Sapporo, Japan
Developed by Mint Medical
Presented by LISIT
10. Two or Three dimensional measurement for glioma.
Morphorogical and density tomor index:
Tumor Analysis modified using WatchinGGO
(LISIT,Co.,Ltd.)
Brain Imag coutesy of T.Hirano, Sapporo
Specific measure converting single diameter or orthogonal diameter measurements to a volume
assuming a spheric lesion using the formula V 4/3πr 3
3D diameter
Semi-Auto
Segmentation
Auto orthogonal
1D measure
Statistical Mesure
Density Mesure
15. リファレンス論文とretrospective studyによる判定
手法の違いによる結果
• Galanis E, Buckner JC, Maurer MJ, et al. Validation of neuroradiologic response assessment in gliomas:
measurement by RECIST, two-dimensional, computer-assisted tumor area, and computer-assisted tumor volume
methods.Neuro Oncol2006;8:156–65
• Shah GD, Kesari S, Xu R, et al. Comparison of linear and volumetric criteria in assessing tumor response in adult
high-grade gliomas.Neuro Oncol2006;8:38–46
• Sorensen AG, Patel S, Harmath C, et al. Comparison of diameter and perimeter methods for tumor volume
calculation.J Clin Oncol2001;19:551–57
• Warren KE, Patronas N, Aikin AA, et al. Comparison of one-, two-, and three-dimensional measurements of
childhood brain tumors.J Natl Cancer Inst2001;93:1401–05
・RECIST, Mcdonard およびVolume measureとの間で応答の検出に差がない
・コンピュータ支援のVolume Measureは、特に小さな病変のPDの早期検出によ
り敏感。1/4のケースでは、結果が異なる。
・PR would have been declared in 8% of patients ( n = 284 studies) by using
the 1D measurement compared with 17% PR rate by using the volumetric
approach.
造影の検討、Gdによる造影テクニックが重要(セグメンテーションに影響大)
16. RANO Criteriaについて
• The Revised Assessment in Neuro-Oncology (RANO)
criteria は、MacDonald criteriaを2010年にアップデータした
評価基準(Print Version:
• “Updated Response Assessment Criteria for High-Grade Gliomas: Response
• Assessment in Neuro-Oncology Working Group.” Journal of Clinical Oncology.
• 2010 Apr 10; 28(11):1963-72.)
• glioblastoma multiforme (GBM:多形成膠芽腫)に適応
•評価には最低限のMRIによる撮像
■ 非造影 T1, T2/FLAIR
■ T1造影, (Axial, Colonal and Saginal) (or a volume acquisition)
Diffusion (DWI, ADC)を補助撮像してもよい。
21. DICOM data from
facilities
(Hospitals)
Imaging
Procedure (CT,
MRI, PET
parameter
conditions)
Image Quality
Test using
Phantom
First Server
First Image
Sever is
managed by
PACS
company
Dicom Cleaning and
Normlization (KeyStone
Engine)
Automatic
Routing
(DICOM select
And Transfer)
Taiwan: tWAN
Biotech Company
Lesion management software (mint Lesion
2.0.2) RECIST1.1, irRC, Choi, Cheson2007,
PERCIST etc.
Japan: LISIT Co.Ltd.
Korea, Singapore imaging
CRO
Taiwan, Korea, Japan Asian Grobal Cloud
Storge
Taiwan, Korea, Japan
Resultant Storge
Segment:
PDF approved report,
ROI-DB and Data.
CRO company
Technical partner