{"doi":"10.1007/s11547-024-01937-1","title":"Quantifying morphologic variations as an alternate to standard response criteria for unresectable primary liver tumors after checkpoint inhibition therapy","abstract":"PURPOSE: The aim of this study was to assess the feasibility of quantifying morphologic changes in tumors during immunotherapy, as a reflection of response or survival. METHODS AND MATERIALS: A retrospective single-center analysis was performed in patients with unresectable liver cancer previously enrolled in clinical trials combining immunotherapy (tremelimumab ± durvalumab) and locoregional treatment (either ablation or transarterial chemoembolization). Conventional response (RECIST 1.1) was assessed at 6-month follow-up. For morphologic assessment, the largest target lesion was manually segmented on axial slices in two dimensions using contrast-enhanced CT. Solidity and circularity of tumors were calculated at baseline, 3-month follow-up, and at 6-months follow-up. Survival analysis was performed. RESULTS: From the 68 patients enrolled in clinical trials, 28 did not have target lesions separate from lesions treated by locoregional therapies, and 3 had no follow-up imaging. Thirty-seven patients (9 with biliary cancer and 28 with hepatocellular carcinoma) were included. Shape features and shape variation were not correlated with RECIST 1.1 status at 6-month follow-up. However, patients with low solidity tumors at 6-month follow-up showed poorer prognosis compared with patients with high solidity tumors at 6-month follow-up (p = 0.01). Solidity variation analysis confirmed that a decrease of tumor solidity at 6-month follow-up was associated with poorer prognosis (p = 0.01). No association was found between shape features at baseline or shape features at 3-month follow-up with overall survival. CONCLUSION: Evolution and variation of tumor morphology during treatment may reflect or correlate with outcomes and contribute toward adapted response criteria.","journal":"La radiologia medica","year":2024,"id":462531,"datarank":0.16479184330021646,"base_score":1.0986122886681096,"endowment":1.0986122886681096,"self_citation_contribution":0.16479184330021646,"citation_network_contribution":0.0,"self_endowment_contribution":0.16479184330021646,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":2,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9471,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":110315,"name":"Nicole Varble","orcid":"0000-0003-2273-7962","position":1,"is_corresponding":false},{"id":445311,"name":"Tabea Borde","orcid":"0000-0003-3019-5470","position":2,"is_corresponding":false},{"id":411799,"name":"Andrew S. Mikhail","orcid":"0000-0001-9206-5765","position":3,"is_corresponding":false},{"id":316710,"name":"Michael Kassin","orcid":"0000-0001-6065-8523","position":4,"is_corresponding":false},{"id":464856,"name":"Elliot Levy","orcid":null,"position":5,"is_corresponding":false},{"id":1292394,"name":"Sheng Xu","orcid":"0000-0002-1595-5382","position":6,"is_corresponding":false},{"id":948449,"name":"Lindsey Hazen","orcid":"0000-0003-4013-8226","position":7,"is_corresponding":false},{"id":1252410,"name":"Ifechi Ukeh","orcid":null,"position":8,"is_corresponding":false},{"id":1292852,"name":"Cyndi Vasco","orcid":null,"position":9,"is_corresponding":false},{"id":62896,"name":"Austin G. Duffy","orcid":"0000-0001-9277-0157","position":10,"is_corresponding":false},{"id":208823,"name":"Changqing Xie","orcid":null,"position":11,"is_corresponding":false},{"id":727086,"name":"Cecilia Monge","orcid":"0000-0002-5558-2744","position":12,"is_corresponding":false},{"id":845318,"name":"Donna Mabry","orcid":null,"position":13,"is_corresponding":false},{"id":62895,"name":"Tim F. Greten","orcid":"0000-0002-0806-2535","position":14,"is_corresponding":false},{"id":110338,"name":"Bradford J. Wood","orcid":"0000-0002-4297-0051","position":15,"is_corresponding":false},{"id":1252015,"name":"Laetitia Saccenti","orcid":"0000-0002-9765-0039","position":0,"is_corresponding":true}],"reference_count":29,"raw_metadata":{"citation_network_status":"fetched"},"created_at":"2026-07-19T02:04:24.680035Z","pmid":"39656418","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}