A Position Statement on the Utility of Interval Imaging in Standard of Care Brain Tumour Management: Defining the Evidence Gap and Opportunities for Future Research

Frontiers in Oncology

James Powell¹  Marc Modat¹  Jack Kreindler¹  Colin Watts¹  Thomas C. Booth¹  David Jenkinson¹  Aysha Luis²  Catherine McBain³  Nick Morley⁴  Caroline Murphy⁵  Sebastian Ourselin⁶  David Summers⁷  Adam D. Waldman⁸  Matthew Williams⁹  Robin Grant^1,10  Helen Bulbeck^1,13  Michael D. Jenkinson^1,13  Gerard Thompson^1,14  Craig Buckley^1,16  Florien Boele^1,17  Liane Dos Santos Canas^1,18  Keyoumars Ashkan^1,18  Samantha J. Mills^1,18  Mark Pennington^1,18  Jorge Cardoso^1,19  Nicky Huskens^2,20 

[1] Imaging Sciences, King’s College London, London, United Kingdom;0ACT for Cancer, London, United Kingdom;1The Tessa Jowell Brain Cancer Mission, London, United Kingdom;2Lysholm Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, London, United Kingdom;3Department of Oncology, Christie Hospital NHS Foundation Trust, Manchester, United Kingdom;4Department of Neuroradiology, The Walton Centre NHS Foundation Trust, Liverpool, United Kingdom;5Department of Radiology, Wales Research and Diagnostic PET Imaging Centre, Cardiff University School of Medicine, Cardiff, United Kingdom;6King’s College Trials Unit, King’s College London, London, United Kingdom;7King’s Health Economics, King’s College London, London, United Kingdom;8Department of Oncology, Velindre Cancer Centre, Cardiff, United Kingdom;9Department of Neuroradiology, Western General Hospital, Edinburgh, United Kingdom;Brainstrust, Cowes, United Kingdom;Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom;Department of Neuroradiology, King’s College Hospital NHS Foundation Trust, London, United Kingdom;Department of Neurosurgery, King’s College Hospital NHS Foundation Trust, London, United Kingdom;Faculty of Medicine and Health, Leeds Institute of Health Sciences, University of Leeds, Leeds, United Kingdom;Leeds Institute of Medical Research at St James’s, St James’s University Hospital, Leeds, United Kingdom;;School of Biomedical Engineering &Siemens Healthineers, Frimley, United Kingdom;The Brain Tumour Charity, Fleet, United Kingdom;

关键词: glioblastoma;    high grade glioma;    glioma;    meningioma;    interval imaging;    magnetic resonance imaging;   

DOI  :  10.3389/fonc.2021.620070

来源: DOAJ

【 摘 要 】

Objectiv eTo summarise current evidence for the utility of interval imaging in monitoring disease in adult brain tumours, and to develop a position for future evidence gathering while incorporating the application of data science and health economics.MethodsExperts in ‘interval imaging’ (imaging at pre-planned time-points to assess tumour status); data science; health economics, trial management of adult brain tumours, and patient representatives convened in London, UK. The current evidence on the use of interval imaging for monitoring brain tumours was reviewed. To improve the evidence that interval imaging has a role in disease management, we discussed specific themes of data science, health economics, statistical considerations, patient and carer perspectives, and multi-centre study design. Suggestions for future studies aimed at filling knowledge gaps were discussed.ResultsMeningioma and glioma were identified as priorities for interval imaging utility analysis. The “monitoring biomarkers” most commonly used in adult brain tumour patients were standard structural MRI features. Interval imaging was commonly scheduled to provide reported imaging prior to planned, regular clinic visits. There is limited evidence relating interval imaging in the absence of clinical deterioration to management change that alters morbidity, mortality, quality of life, or resource use. Progression-free survival is confounded as an outcome measure when using structural MRI in glioma. Uncertainty from imaging causes distress for some patients and their caregivers, while for others it provides an important indicator of disease activity. Any study design that changes imaging regimens should consider the potential for influencing current or planned therapeutic trials, ensure that opportunity costs are measured, and capture indirect benefits and added value.ConclusionEvidence for the value, and therefore utility, of regular interval imaging is currently lacking. Ongoing collaborative efforts will improve trial design and generate the evidence to optimise monitoring imaging biomarkers in standard of care brain tumour management.

【 授权许可】

Unknown