TY - JOUR
T1 - Prospective validation of a new imaging scorecard to p g j and RANO effort
AU - Le Rhun, Emilie
AU - Devos, Patrick
AU - Winklhofer, Sebastian
AU - Lmalem, Hafida
AU - Brandsma, Dieta
AU - Kumthekar, Priya
AU - Castellano, Antonella
AU - Compter, Annette
AU - Dhermain, Frederic
AU - Franceschi, Enrico
AU - Forsyth, Peter
AU - Furtner, Julia
AU - Galldiks, Norbert
AU - Pérez-Larraya, Jaime Gállego
AU - Gempt, Jens
AU - Hattingen, Elke
AU - Hempel, Johann Martin
AU - Lukacova, Slavka
AU - Minniti, Giuseppe
AU - O’Brien, Barbara
AU - Postma, Tjeerd J.
AU - Roth, Patrick
AU - Rudà, Roberta
AU - Schaefer, Niklas
AU - Schmidt, Nils O.
AU - Snijders, Tom J.
AU - Thust, Steffi
AU - van den Bent, Martin
AU - van der Hoorn, Anouk
AU - Vogin, Guillaume
AU - Smits, Marion
AU - Tonn, Joerg C.
AU - Jaeckle, Kurt A.
AU - Preusser, Matthias
AU - Glantz, Michael
AU - Wen, Patrick Y.
AU - Bendszus, Martin
AU - Weller, Michael
N1 - Publisher Copyright:
© The Author(s) 2022. Published by Oxford University Press on behalf of the Society for Neuro-Oncology. All rights reserved.
PY - 2022/10/1
Y1 - 2022/10/1
N2 - Background. Validation of the 2016 RANO MRI scorecard for leptomeningeal metastasis failed for multiple reasons. Accordingly, this joint EORTC BrainTumor Group and RANO effort sought to prospectively validate a revised MRI scorecard for response assessment in leptomeningeal metastasis. Methods. Coded paired cerebrospinal MRI of 20 patients with leptomeningeal metastases from solid cancers at baseline and follow-up after treatment and instructions for assessment were provided via the EORTC imaging platform.The Kappa coefficient was used to evaluate the interobserver pairwise agreement. Results. Thirty-five raters participated, including 9 neuroradiologists, 17 neurologists, 4 radiation oncologists, 3 neurosurgeons, and 2 medical oncologists. Among single leptomeningeal metastases-related imaging findings at baseline, the best median concordance was noted for hydrocephalus (Kappa = 0.63), and the worst median concordance for spinal linear enhancing disease (Kappa = 0.46).The median concordance of raters for the overall response assessment was moderate (Kappa = 0.44). Notably, the interobserver agreement for the presence of parenchymal brain metastases at baseline was fair (Kappa = 0.29) and virtually absent for their response to treatment. 394 of 700 ratings (20 patients x 35 raters, 56%) were fully completed. In 308 of 394 fully completed ratings (78%), the overall response assessment perfectly matched the summary interpretation of the single ratings as proposed in the scorecard instructions. Conclusion. This study confirms the principle utility of the new scorecard, but also indicates the need for training of MRI assessment with a dedicated reviewer panel in clinical trials. Electronic case report forms with “blocking options” may be required to enforce completeness and quality of scoring.
AB - Background. Validation of the 2016 RANO MRI scorecard for leptomeningeal metastasis failed for multiple reasons. Accordingly, this joint EORTC BrainTumor Group and RANO effort sought to prospectively validate a revised MRI scorecard for response assessment in leptomeningeal metastasis. Methods. Coded paired cerebrospinal MRI of 20 patients with leptomeningeal metastases from solid cancers at baseline and follow-up after treatment and instructions for assessment were provided via the EORTC imaging platform.The Kappa coefficient was used to evaluate the interobserver pairwise agreement. Results. Thirty-five raters participated, including 9 neuroradiologists, 17 neurologists, 4 radiation oncologists, 3 neurosurgeons, and 2 medical oncologists. Among single leptomeningeal metastases-related imaging findings at baseline, the best median concordance was noted for hydrocephalus (Kappa = 0.63), and the worst median concordance for spinal linear enhancing disease (Kappa = 0.46).The median concordance of raters for the overall response assessment was moderate (Kappa = 0.44). Notably, the interobserver agreement for the presence of parenchymal brain metastases at baseline was fair (Kappa = 0.29) and virtually absent for their response to treatment. 394 of 700 ratings (20 patients x 35 raters, 56%) were fully completed. In 308 of 394 fully completed ratings (78%), the overall response assessment perfectly matched the summary interpretation of the single ratings as proposed in the scorecard instructions. Conclusion. This study confirms the principle utility of the new scorecard, but also indicates the need for training of MRI assessment with a dedicated reviewer panel in clinical trials. Electronic case report forms with “blocking options” may be required to enforce completeness and quality of scoring.
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U2 - 10.1093/neuonc/noac043
DO - 10.1093/neuonc/noac043
M3 - Article
C2 - 35157772
AN - SCOPUS:85132351587
SN - 1522-8517
VL - 24
SP - 1726
EP - 1735
JO - Neuro-oncology
JF - Neuro-oncology
IS - 10
ER -