Computer Evaluation May Help Guide Mesothelioma Treatment

A computer program designed to help doctors analyze tumors in three dimensions could be a valuable tool for guiding treatment of malignant pleural mesothelioma.

Malignant pleural mesothelioma is a virulent cancer that attacks the membrane surrounding the lungs.  Because it is highly resistant to conventional treatments, an effective method for evaluating the efficacy of a given treatment is vital.  Diagnostic scans that can measure the volume of the tumor over three dimensions are an improvement over measures that only examine two dimensions.

Currently, doctors often use a one- or two-dimensional linear method to examine and measure mesothelioma tumors for treatment response.  But a team from the radiology department at the University of Chicago calls that method “insufficient” for mesothelioma and has developed a computerized method for segmenting and measuring tumors by focusing on volumetric analysis that they believe will improve tumor tracking.

To test the method, the researchers used a database of 31 computed tomography (CT) scans from 31 patients with confirmed malignant pleural mesothelioma.  They then asked three observers to evaluate five randomly selected sections in each scan outlining and measuring the tumors.  The same mesothelioma tumor scans were also outlined and evaluated by a computer.  The study found no significant difference between the results.  Both methods effectively picked up important subtleties in the scans.  However, the computer was able to evaluate the mesothelioma tumor images much more quickly and also made it possible to more easily track the changing volume of a tumor (volumetric measurement) by measuring multiple scans at once.

The study authors write, “This method requires minimal initialization by the user and demonstrated good agreement with manually drawn outlines and area measurement.  This method will allow volumetric tracking of tumor progression and may improve the evaluation of novel malignant pleural mesothelioma treatments.”

A similar study in 2010 determined that the volumetric method of tumor evaluation was most effective for determining chemotherapy response in mesothelioma cases because of mesothelioma’s non-spherical growth pattern.

Sources:

Sensakovic, WF et al, “Computerized segmentation and measurement of malignant pleural mesothelioma”, January, 2011, Medical Physics, pp. 238-44.
Ak, G et al, “Three-dimensional evaluation of chemotherapy response in malignant pleural mesothelioma”, April 2010, European Journal of Radiology, pp 130-135.