Assessing treatment response of osteolytic lesions by manual volumetry, automatic segmentation, and RECIST in experimental bone metastases

Acad Radiol. 2014 Sep;21(9):1177-84. doi: 10.1016/j.acra.2014.04.011. Epub 2014 Jul 4.

Abstract

Rationale and objectives: Aim of the study was to compare between volumetric and unidimensional approaches for treatment response monitoring in a nude rat model of experimental bone metastases. For the volumetric approach, an automated segmentation algorithm of osteolytic lesions was introduced and compared to manual volumetry.

Material and methods: Nude rats bearing osteolytic metastases were treated with zoledronate and sunitinib and compared to controls. Treatment response was assessed longitudinally in vivo using flat-panel volumetric computed tomography at days 30, 35, 45, and 55 after tumor cell inoculation. The mean sizes and volumes of osteolytic lesions were determined according to response evaluation criteria in solid tumors (RECIST) and by automated and manual volumetry (software: MITK [The Medical Imaging Interaction Toolkit, Heidelberg, Germany] and VIRTUOS, Heidelberg, Germany).

Results: In contrary to RECIST, the manual volumetric approach indicated a significant decrease in osteolytic lesion volume in response to treatment. The presented automatic segmentation algorithm for treatment monitoring identified bone metastases adequately and assessed changes in the osteolytic lesion volume over time according to manual volumetry.

Conclusions: In an animal model, volumetric treatment response assessment of osteolytic bone metastases is superior to unidimensional measurements, and automated volumetric segmentation may be a valuable alternative to manual volume determination.

Keywords: Bone metastases; CT; RECIST (response evaluation criteria in solid tumors); therapy response; volumetric analysis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Algorithms
  • Animals
  • Antineoplastic Agents / therapeutic use
  • Bone Density Conservation Agents / therapeutic use
  • Bone Neoplasms / diagnostic imaging*
  • Bone Neoplasms / drug therapy*
  • Cone-Beam Computed Tomography / methods*
  • Diphosphonates / therapeutic use*
  • Disease Models, Animal
  • Follow-Up Studies
  • Imidazoles / therapeutic use*
  • Indoles / therapeutic use*
  • Pyrroles / therapeutic use*
  • Radiographic Image Interpretation, Computer-Assisted / methods*
  • Rats
  • Rats, Nude
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Sunitinib
  • Treatment Outcome
  • Zoledronic Acid

Substances

  • Antineoplastic Agents
  • Bone Density Conservation Agents
  • Diphosphonates
  • Imidazoles
  • Indoles
  • Pyrroles
  • Zoledronic Acid
  • Sunitinib