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@ARTICLE{Lauer:282900,
author = {E. M. Lauer and E. Riegler and J. A. Mutter and S. K. Alig
and S. Bleul and J. Kuehn and L. Ranganathan and C. Klingler
and T. Demerath and U. Würtemberger and A. Rau and J. Weiß
and M. Eisenblaetter and F. Bamberg and M. Prinz and J.
Finke and J. Duyster and G. Illerhaus and M. Diehn and A. A.
Alizadeh and E. Schorb and P. C. Reinacher and F.
Scherer$^*$},
title = {{I}mproved early outcome prediction by {MRI}-based 3{D}
tumor volume assessment in patients with {CNS} lymphomas.},
journal = {Neuro-Oncology},
volume = {26},
number = {2},
issn = {1522-8517},
address = {Oxford},
publisher = {Oxford Univ. Press},
reportid = {DKFZ-2023-01893},
pages = {374–386},
year = {2024},
note = {26(2), pp. 374–386, 2024},
abstract = {Central nervous system lymphomas (CNSL) display remarkable
clinical heterogeneity, yet accurate prediction of outcomes
remains challenging. The IPCG criteria are widely used in
routine practice for the assessment of treatment response.
However, the value of the IPCG criteria for ultimate outcome
prediction is largely unclear, mainly due to the uncertainty
in delineating complete from partial responses during and
after treatment.We explored various MRI features including
semi-automated 3D tumor volume measurements at different
disease milestones and their association with survival in 93
CNSL patients undergoing curative-intent treatment.At
diagnosis, patients with more than three lymphoma lesions,
periventricular involvement, and high 3D tumor volumes
showed significantly unfavorable PFS and OS. At first
interim MRI during treatment, the IPCG criteria failed to
discriminate outcomes in responding patients. Therefore, we
randomized these patients into training and validation
cohorts to investigate whether 3D tumor volumetry could
improve outcome prediction. We identified a 3D tumor volume
reduction of $≥97\%$ as the optimal threshold for risk
stratification (=3D early response, $3D_ER).$ Applied to the
validation cohort, patients achieving $3D_ER$ had
significantly superior outcomes. In multivariate analyses,
$3D_ER$ was independently prognostic of PFS and OS. Finally,
we leveraged prognostic information from 3D MRI features and
circulating biomarkers to build a composite metric that
further improved outcome prediction in CNSL.We developed
semi-automated 3D tumor volume measurements as strong and
independent early predictors of clinical outcomes in CNSL
patients. These radiologic features could help improve risk
stratification and help guide future treatment approaches.},
keywords = {CNS lymphoma (Other) / Circulating tumor DNA (Other) /
Composite biomarker (Other) / Improved early outcome
prediction (Other) / MRI-based 3D volumetry (Other)},
cin = {FR01},
ddc = {610},
cid = {I:(DE-He78)FR01-20160331},
pnm = {899 - ohne Topic (POF4-899)},
pid = {G:(DE-HGF)POF4-899},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:37713267},
doi = {10.1093/neuonc/noad177},
url = {https://inrepo02.dkfz.de/record/282900},
}