CLINICAL VALUE OF VOLUMETRY COMPARED TO RECIST CRITERIA 1. 1 IN EVALUATING RESPONSE TO TREATMENT OF LIVER METASTASES IN PATIENTS WITH COLORECTAL CANCER
DOI:
https://doi.org/10.11603/2414-4533.2025.3.15654Keywords:
colorectal cancer, liver metastases, RECIST 1.1, volumetry, computed tomography, treatment response assessmentAbstract
The aim of the work: to compare the informative value and diagnostic sensitivity of RECIST 1.1 and volumetry methods in assessing the dynamics of metastatic liver lesions in patients with colorectal cancer, to determine the correlation between linear and volumetric indicators of the tumour process and to justify the feasibility of their combined use to improve the accuracy of monitoring the effectiveness of systemic therapy.
Materials and Methods. The study included 14 patients (8 men and 6 women, aged 47–73 years) with metastatic liver lesions against the background of colorectal cancer, who were under dynamic observation in 2020–2025. Treatment efficacy was assessed using RECIST 1.1 criteria (sum of the largest diameters of target lesions) and volumetry (calculation of the total volume of metastases using semi-automatic segmentation of CT images). Comparisons were made using Pearson's correlation analysis between linear and volumetric parameters, with determination of the consistency of results in subgroups by age and gender.
Results. Among 14 patients, partial response (PR) was recorded in 5 cases, stable disease (SD) in 3, and progression (PD) in 6. The correlation coefficient between RECIST and volumetry was r = 0.48, indicating a moderate positive relationship between the methods. In a number of cases (patients No. 2, 8, 12), discrepancies were observed when minimal linear changes were accompanied by significant volume fluctuations. Volumetry was found to be more sensitive to early structural transformations, such as necrosis or decreased density of metastases, while RECIST may underestimate the therapeutic response.
Conclusions. RECIST 1.1 remains the standardised criterion for response assessment, but does not take into account the three-dimensional structure of lesions. Volumetry provides an objective quantitative characterisation of tumour burden and detects early morphological changes. The combined use of RECIST and volumetry improves the accuracy of treatment monitoring and the soundness of clinical decisions.
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