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

Author:

Booth Thomas C.,Thompson Gerard,Bulbeck Helen,Boele Florien,Buckley Craig,Cardoso Jorge,Dos Santos Canas Liane,Jenkinson David,Ashkan Keyoumars,Kreindler Jack,Huskens Nicky,Luis Aysha,McBain Catherine,Mills Samantha J.,Modat Marc,Morley Nick,Murphy Caroline,Ourselin Sebastian,Pennington Mark,Powell James,Summers David,Waldman Adam D.,Watts Colin,Williams Matthew,Grant Robin,Jenkinson Michael D.

Abstract

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.

Funder

Wellcome Trust

Publisher

Frontiers Media SA

Subject

Cancer Research,Oncology

Reference99 articles.

1. Updates in the management of brain metastases;Anvold;Neuro Oncol,2016

2. Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma;Stupp;N Engl J Med,2005

3. HowickJ ChalmerI GlasziouP GreenhalghT HeneghanC LiberatiA OxfordOxford Centre for Evidence-Based Medicine The Oxford 2011 levels of evidence2016

4. Guideline NG99.

5. Interval brain imaging for adults with cerebral glioma;Thompson;Cochrane Database System Rev,2019

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3