MP18-20 ASSESSMENT OF TO RESPONSE RATE FOLLOWING NEOADJUVANT CHEMOTHERAPY FOR BLADDER CANCER UTILIZING A COMPUTERIZED VOLUME ANALYSIS SYSTEM

Abstract

You have accessJournal of UrologyImaging/Radiology: Uroradiology III1 Apr 2017MP18-20 ASSESSMENT OF TO RESPONSE RATE FOLLOWING NEOADJUVANT CHEMOTHERAPY FOR BLADDER CANCER UTILIZING A COMPUTERIZED VOLUME ANALYSIS SYSTEM Amir H. Lebastchi, Christopher M. Russel, Kenny H. Cha, Lubomir Hadjiyski, Haeng-Ping Chan, Rich Cohan, Elaine Caoili, Ajjai Alva, and Alon Z. Weizer Amir H. LebastchiAmir H. Lebastchi More articles by this author , Christopher M. RusselChristopher M. Russel More articles by this author , Kenny H. ChaKenny H. Cha More articles by this author , Lubomir HadjiyskiLubomir Hadjiyski More articles by this author , Haeng-Ping ChanHaeng-Ping Chan More articles by this author , Rich CohanRich Cohan More articles by this author , Elaine CaoiliElaine Caoili More articles by this author , Ajjai AlvaAjjai Alva More articles by this author , and Alon Z. WeizerAlon Z. Weizer More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.630AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Neoadjuvant chemotherapy (NAC) for bladder cancer is underutilized in partdue to concern for disease progression during chemotherapy. In an effort to quantify lesion response during NAC, we describe the utilization of a computerized system for segmenting bladder lesions on contrast enhanced pelvic CT scans. The accuracy of this modality is then demonstrated through a comparison of the computerized estimation of lesion volume change and pT0 status with an experienced radiologists assessment and RECIST criteria. METHODS Pre and posttreatment CT scans were reviewed in 82 patients receiving NAC for bladder cancer prior to cystectomy. Patient information and disease outcomes at the time of cystectomy were abstracted. Estimations of the response to treatment were obtained through either (1) the computerized volume analysis system utilizing 3D CT segmentation of bladder lesions, or (2) using RECIST criteria as characterized by one of two independent board certified radiologists. Receiver operating characteristic (ROC) curves were generated to identify sensitivity and specificity of detecting pT0 (complete response) at the time of cystectomy and an area under the curve (AUC) was calculated. RESULTS There were 67 men and 15 women with a mean age of 64 years (64.0± 10.6, age range 37 to 84 years of age). All patients had clinical stage T2- T4, N0 tumors, and received 3 to 6 cycles of a platinum based chemotherapy. A total of 27% of patients had pT0 disease at time of cystectomy. The AUC for correct prediction of pT0 at the time of cystectomy was 0.77 ±0.05 for the computer assisted technique compared to 0.75 ±0.05 and 0.70 ±0.06 when two separate radiologists predicted pT0 disease using RECIST criteria (Figure 1). CONCLUSIONS The utilization of a computerized segmentation system for the assessment of change in tumor volume and subsequent pT0 disease following cystectomy is equivalent to that performed by experienced radiologists. Furthermore, the accurate assessment of timely treatment response during NAC may have important implications in determining duration of chemotherapy and in the utilization of bladder preservation protocols. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e228 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Amir H. Lebastchi More articles by this author Christopher M. Russel More articles by this author Kenny H. Cha More articles by this author Lubomir Hadjiyski More articles by this author Haeng-Ping Chan More articles by this author Rich Cohan More articles by this author Elaine Caoili More articles by this author Ajjai Alva More articles by this author Alon Z. Weizer More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...