Radiologist Engagement as a Potential Barrier to the Clinical Translation of Quantitative Imaging for the Assessment of Tumor Heterogeneity

Publication date: Available online 3 February 2018
Source:Academic Radiology
Author(s): Kenneth Alan Miles, Julia Squires, Michelle Murphy
Rationale and ObjectiveThis study aims to identify potential barriers to the clinical implementation of quantitative imaging for the assessment of tumor heterogeneity.Materials and MethodsAn 18-month prospective observational study was undertaken in which the clinical implementation of computed tomography texture analysis (CTTA) as a technique for quantifying tumor heterogeneity in patients with non–small cell lung cancer was assessed using the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework.ResultsAdopters of the technology comprised five specialists with dual accreditation in radiology and nuclear medicine supervising two trainees. Tumor heterogeneity information was extracted and reported in 190 of 322 eligible cases (59%) and presented at the multidisciplinary team meeting in 124 of 152 patients (82%) for whom CTTA had been performed. The maximum proportion of eligible cases in which heterogeneity information had been extracted and reported in any quarter was 80%, but fell in the latter half of the study. The maximum frequency with which available CTTA results were presented at the multidisciplinary team meeting in any quarter was 92% and was maintained in the latter part of the study. Significant differences in survival were observed for patients categorized using the two reported CTTA values (P = 0.004 and P = 0.0057, respectively).ConclusionsRadiologist engagement is a potential barrier to the effective translation of quantitative imaging assessments of tumor heterogeneity into clinical practice and will need to be addressed before tumor heterogeneity information can successfully contribute to clinical decision making in oncology.



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