Interdisziplinäre Besprechungen <span class="so-article-trans-title" dir="auto"> Translated title: Interdisciplinary case discussions </span>

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

Hintergrund

Interdisziplinäre Fallbesprechungen, insbesondere Tumorboards, stellen einen großen Anteil der täglichen Arbeit des klinischen Radiologen dar. Die Radiologie nimmt im Tumorboard eine Schlüsselrolle ein, da bildgebend erhobene Befunde direkten Einfluss auf Therapieentscheidungen haben.

Methodik und Zielsetzung

Dieser Artikel soll die Anforderungen an den Radiologen bei der Vorbereitung und Durchführung von Tumorboards erörtern. Weiter werden Rahmenbedingungen und Durchführungsformen von Tumorboards beleuchtet. IT-Tools zur Prozessautomatisierung und verschiedene Systeme zur Verlaufsbeurteilung von Tumorerkrankungen werden vorgestellt.

Ergebnisse

Eine ausführliche Vorbereitung des Tumorboards und eine klare Kommunikation von Befunden ist unerlässlich. Durch die radiologische Expertise im Tumorboard kommt es oft zu Änderungen oder Anpassungen von initial geplanten Therapien. Neben klassischen Präsenzveranstaltungen haben sich Hybridlösungen bei der Durchführung von Tumorboards etabliert, bei denen das Kernteam vor Ort ist und weitere Teilnehmer (externe Zuweiser, interne Teilnehmer außerhalb des Kernteams) per Videokonferenz zugeschaltet sind. Zur Verlaufsbeurteilung von Tumorerkrankungen sind verschiedene Systeme etabliert. Aufgrund der breiten Anwendbarkeit wird vor allem RECIST 1.1. genutzt. IT-Tools ermöglichen es, zuvor markierte Tumorherde im zeitlichen Verlauf in einer Matrixansicht darzustellen (Läsionsnachverfolgung). Durch den Einsatz künstlicher Intelligenz (KI) können Herde zudem automatisch erkannt und volumetriert werden.

Diskussion

Die Vorbereitung und Durchführung von Tumorboards sind für den Radiologen zeitaufwändig. IT-Tools können dabei die Abläufe automatisieren und somit vereinfachen. Hybridlösungen aus Präsenzveranstaltungen und Videokonferenzen vereinfachen es externen Zuweisern, ihre Patienten im Tumorboard vorzustellen.

Translated abstract

Background

Interdisciplinary case discussions, especially tumor conferences, represent a large part of the clinical radiologist’s daily work. Radiology plays a key role in tumor conferences, since imaging findings have a direct influence on therapy decisions.

Methods and objectives

This article discusses the requirements for the radiologist in preparing and conducting tumor conferences. Furthermore, the general conditions and forms of implementation of tumor conferences will be highlighted. Information technology (IT) tools for process automation and systems for assessing the course of tumor diseases will be presented.

Results

Detailed preparation of tumor conferences and clear communication of findings is essential. The radiological expertise in tumor conferences often leads to changes or adjustments of initially planned therapies. In addition to traditional face-to-face meetings, hybrid solutions have become established for tumor conferences in which the core team is on site and other participants (external referring physicians, internal participants outside the core team) are connected via video conference. Various systems have been established for assessing the course of tumor diseases. Due to its broad applicability, RECIST 1.1. is the most widely used. IT tools enable previously marked lesions to be displayed over time in a matrix view (lesion tracking). Artificial intelligence (AI) can also be used to automatically detect lesions and assess their volumes.

Conclusion

Preparing and conducting tumor conferences is time-consuming for radiologists. IT tools can automate and thus facilitate the processes. Hybrid solutions combining face-to-face meetings and video conferences make it easier for external referring physicians to present their patients in tumor conferences.

Related collections

Most cited references 20

Record: found
Abstract: found
Article: not found

New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1).

E A Eisenhauer, P Therasse, J Bogaerts … (2009)

Assessment of the change in tumour burden is an important feature of the clinical evaluation of cancer therapeutics: both tumour shrinkage (objective response) and disease progression are useful endpoints in clinical trials. Since RECIST was published in 2000, many investigators, cooperative groups, industry and government authorities have adopted these criteria in the assessment of treatment outcomes. However, a number of questions and issues have arisen which have led to the development of a revised RECIST guideline (version 1.1). Evidence for changes, summarised in separate papers in this special issue, has come from assessment of a large data warehouse (>6500 patients), simulation studies and literature reviews. HIGHLIGHTS OF REVISED RECIST 1.1: Major changes include: Number of lesions to be assessed: based on evidence from numerous trial databases merged into a data warehouse for analysis purposes, the number of lesions required to assess tumour burden for response determination has been reduced from a maximum of 10 to a maximum of five total (and from five to two per organ, maximum). Assessment of pathological lymph nodes is now incorporated: nodes with a short axis of 15 mm are considered measurable and assessable as target lesions. The short axis measurement should be included in the sum of lesions in calculation of tumour response. Nodes that shrink to <10mm short axis are considered normal. Confirmation of response is required for trials with response primary endpoint but is no longer required in randomised studies since the control arm serves as appropriate means of interpretation of data. Disease progression is clarified in several aspects: in addition to the previous definition of progression in target disease of 20% increase in sum, a 5mm absolute increase is now required as well to guard against over calling PD when the total sum is very small. Furthermore, there is guidance offered on what constitutes 'unequivocal progression' of non-measurable/non-target disease, a source of confusion in the original RECIST guideline. Finally, a section on detection of new lesions, including the interpretation of FDG-PET scan assessment is included. Imaging guidance: the revised RECIST includes a new imaging appendix with updated recommendations on the optimal anatomical assessment of lesions. A key question considered by the RECIST Working Group in developing RECIST 1.1 was whether it was appropriate to move from anatomic unidimensional assessment of tumour burden to either volumetric anatomical assessment or to functional assessment with PET or MRI. It was concluded that, at present, there is not sufficient standardisation or evidence to abandon anatomical assessment of tumour burden. The only exception to this is in the use of FDG-PET imaging as an adjunct to determination of progression. As is detailed in the final paper in this special issue, the use of these promising newer approaches requires appropriate clinical validation studies.

0 comments Cited 6566 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Recommendations for initial evaluation, staging, and response assessment of Hodgkin and non-Hodgkin lymphoma: the Lugano classification.

Bruce D. Cheson, Richard I. Fisher, Sally F. Barrington … (2014)

The purpose of this work was to modernize recommendations for evaluation, staging, and response assessment of patients with Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL). A workshop was held at the 11th International Conference on Malignant Lymphoma in Lugano, Switzerland, in June 2011, that included leading hematologists, oncologists, radiation oncologists, pathologists, radiologists, and nuclear medicine physicians, representing major international lymphoma clinical trials groups and cancer centers. Clinical and imaging subcommittees presented their conclusions at a subsequent workshop at the 12th International Conference on Malignant Lymphoma, leading to revised criteria for staging and of the International Working Group Guidelines of 2007 for response. As a result, fluorodeoxyglucose (FDG) positron emission tomography (PET)–computed tomography (CT) was formally incorporated into standard staging for FDG-avid lymphomas. A modification of the Ann Arbor descriptive terminology will be used for anatomic distribution of disease extent, but the suffixes A or B for symptoms will only be included for HL. A bone marrow biopsy is no longer indicated for the routine staging of HL and most diffuse large B-cell lymphomas. However, regardless of stage, general practice is to treat patients based on limited (stages I and II, nonbulky) or advanced (stage III or IV) disease, with stage II bulky disease considered as limited or advanced disease based on histology and a number of prognostic factors. PET-CT will be used to assess response in FDG-avid histologies using the 5-point scale. The product of the perpendicular diameters of a single node can be used to identify progressive disease. Routine surveillance scans are discouraged. These recommendations should improve evaluation of patients with lymphoma and enhance the ability to compare outcomes of clinical trials.

0 comments Cited 1380 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: not found
Article: not found

New Guidelines to Evaluate the Response to Treatment in Solid Tumors

P Therasse, S G Arbuck, E A Eisenhauer … (2000)

0 comments Cited 383 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Contributors

Tobias Jorg: tobias.jorg@unimedizin-mainz.de

Journal

Journal ID (nlm-ta): Radiologie (Heidelb)

Journal ID (iso-abbrev): Radiologie (Heidelb)

Title: Radiologie (Heidelberg, Germany)

Publisher: Springer Medizin (Heidelberg )

ISSN (Print): 2731-7048

ISSN (Electronic): 2731-7056

Publication date (Electronic): 11 January 2023

Pages: 1-6

Affiliations

GRID grid.410607.4, Klinik und Poliklinik für diagnostische und interventionelle Radiologie, , Universitätsmedizin der Johannes Gutenberg-Universität Mainz, ; Langenbeckstr. 1, 55151 Mainz, Deutschland

Article

Publisher ID: 1114

DOI: 10.1007/s00117-023-01114-x

PMC ID: 9838417

PubMed ID: 36629884

SO-VID: 429212d3-5da8-49e5-8731-6084820a69a9

License:

This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.

History

Date accepted : 3 January 2023

Comments

Comment on this article

scite_

Smart Citations

Citing PublicationsSupportingMentioningContrasting

View Citations

See how this article has been cited at scite.ai

scite shows how a scientific paper has been cited by providing the context of the citation, a classification describing whether it supports, mentions, or contrasts the cited claim, and a label indicating in which section the citation was made.