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Variability in Mesothelioma Tumor Response Classification

Samuel G. Armato, III1, Joseph L. Ogarek1, Adam Starkey1, Nicholas J. Vogelzang2, Hedy L. Kindler3, Masha Kocherginsky4 and Heber MacMahon1

1 Department of Radiology, The University of Chicago, 5841 S Maryland Ave., Chicago, IL 60637.
2 Nevada Cancer Institute, Las Vegas, NV 89135.
3 Department of Medicine, The University of Chicago, Chicago, IL 60637.
4 Department of Health Studies, The University of Chicago, Chicago, IL 60637.


Figure 1
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  		Fig. 1 —Screen capture shows interface used for side-by-side comparison of temporally sequential CT scans from 38-year-old man. Baseline scan is viewed on left side, and follow-up scan (for which measurements were acquired for this study) is viewed on right side. For visual approach of measurement, line segments representing baseline scan measurements were superimposed on baseline scan images for direct visual comparison.

 

Figure 2
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  		Fig. 2 —Representative baseline CT scan section of 77-year-old man with tumor thickness measurements acquired by initial radiologist shown as tumorspanning line segments (white lines) superimposed for direct visual comparison.

 

Figure 3
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  		Fig. 3A —66-year-old man. Baseline scan measurements are shown superimposed on one section of baseline CT scans.

 

Figure 4
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  		Fig. 3B —66-year-old man. Tumor thickness measurements acquired by observer on corresponding follow-up scan section (as selected by that observer) based on written report of baseline scan measurements (black line segments) and with benefit of visual aid (white line segments). Baseline measurements were not superimposed during implementation of written-report approach.

 

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