Article says radiologists need to solidify position on cancer teams

July 27, 2016

Leesburg, VA, July 26, 2016-- Given the anticipated increase in cancer imaging over the next decade [1, 2], radiologists need to solidify their position as central members of the cancer team by identifying toxicity early and understanding the implications of their findings.

In an article titled, "A New Look at Toxicity in the Era of Precision Oncology: Imaging Findings, Their Relationship With Tumor Response, and Effect on Metastasectomy," a team of radiologists and researchers led by Stephanie A. Holler Howard, of the Department of Radiology at the Dana Farber Cancer Institute in Boston, aims to broaden the radiologist's understanding of imaging-evident toxicity.

The review article, published in the July 2016 issue of the American Journal of Roentgenology, is available through open access on the American Roentgen Ray Society's website at http://www.arrs.org.

Oncologists are increasingly using combinations of cytotoxic agents, molecular-targeted therapies, and immune checkpoint inhibitors to achieve disease control. Although numerous articles have examined how to optimize tumor response criteria for patients treated with these new agents, little has been written about how a radiologist's approach to imaging findings of toxicity should evolve.

"This article attempts to expand the radiologist's view of the effect of imaging-evident toxicity by delineating how oncologists grade toxicity, highlighting the potential relationship between toxicity and drug efficacy, discussing how toxicity affects patients who may ultimately undergo metastasectomy, and exploring the effect of combining multiple drug classes on severity of adverse events," Howard said.

Combinations of drug classes may amplify toxicity, yet acceptable levels of toxicity may be welcomed as a biomarker of treatment response in selected settings. Toxicity in organs that could benefit from future metastasectomies may be less acceptable as the role of surgical resection in advanced disease increases.

Newer drugs often work across many tumor types, and oncologists are increasingly experimenting with drug combinations. Toxicity with drugs in combination, however, has been unpredictable and often far more severe than when drugs are used in isolation.

"Radiologists must understand the language and multifaceted nuances of toxicity to contribute to optimized care of cancer patients and remain relevant effective members of the oncologic team," Howard said.
-end-
The study may be viewed here http://www.ajronline.org/doi/full/10.2214/AJR.15.15480, while the July 2016 issue of AJR may be accessed here http://www.ajronline.org/toc/ajr/current.

References


1. Mariotto AB, Yabroff KR, Shao Y, Feuer EJ, Brown ML. Projections of the cost of cancer care in the United States: 2010-2020. J Natl Cancer Inst 2011; 103:117-128

2. Howard SA, Krajewski KM, Weissman BN, Seltzer SE, Ramaiya NH, Van den Abbeele AD. Cancer imaging training in the 21st century: an overview of where we are, and where we need to be. J Am Coll Radiol 2015; 12:714-720

Founded in 1900, ARRS is the first and oldest radiology society in the United States, and is an international forum for progress in radiology. The Society's mission is to improve health through a community committed to advancing knowledge and skills in radiology. ARRS achieves its mission through an annual scientific and educational meeting, publication of the American Journal of Roentgenology (AJR) and InPractice magazine, topical symposia and webinars, and print and online educational materials. ARRS is located in Leesburg, VA.

American Roentgen Ray Society

Related Radiologists Articles from Brightsurf:

Electronic consultations between primary providers and radiologists improve patient care
According to ARRS' American Journal of Roentgenology (AJR), the eConsult electronic consultation system allowed primary care providers to easily consult with radiologists, was perceived as high value by primary care providers, resulted in altered patient management, and avoided unnecessary imaging tests.

Interventional radiologists modify protocol for coronavirus disease (COVID-19) pandemic
Radiologists who perform cross-sectional interventional procedures can take several steps to minimize the risks to patients and radiology personnel, including screening referred patients to decide which procedures can be postponed, using appropriate personal protective equipment (PPE), minimizing the number of people involved in procedures, preserving PPE when possible, and applying proper room and equipment cleaning measures.

Artificial intelligence could serve as backup to radiologists' eyes
Deploying artificial intelligence could help radiologists to more accurately classify lung diseases.

What interventional radiologists need to know about frostbite and amputation
An ahead-of-print article in the April issue of the American Journal of Roentgenology (AJR) reviewing various techniques and clinical management paradigms to treat severe frostbite injuries -- relevant for interventional radiology, especially--showed promising results using both intraarterial and intravenous tissue plasminogen activator to reduce amputation.

Radiologists describe coronavirus imaging features
In a special report published today in the journal Radiology, researchers describe CT imaging features that aid in the early detection and diagnosis of Wuhan coronavirus.

Nuclear radiologists 'outsmart' prostate cancer with an apparently ineffective drug
Patients with advanced metastatic prostate cancer often have few treatment options.

AI rivals expert radiologists at detecting brain hemorrhages
An algorithm developed by scientists at UC San Francisco and UC Berkeley did better than two out of four expert radiologists at finding tiny brain hemorrhages in head scans -- an advance that one day may help doctors treat patients with traumatic brain injuries (TBI), strokes and aneurysms.

Combination of AI & radiologists more accurately identified breast cancer
An artificial intelligence (AI) tool accurately identified breast cancer when combined with analysis by radiologists.

Diagnostic radiologists with lifetime ABR certificates less likely to participate in MOC
An ahead-of-print article from AJR discovers lifetime-certified diagnostic radiologists whose Maintenance of Certification was not mandated by the American Board of Radiology were far less likely to participate in ABR MOC programs--especially general radiologists and those working in smaller, nonacademic practices in states with lower population densities 'Many opinions have been expressed regarding MOC in radiology, but there is actually very little public data on the matter,' says Andrew Rosenkrantz, ARRS Leonard Berlin Scholar.

AJR publishes gender affirmation surgery primer for radiologists
Since gender incongruence is now categorized as a sexual health condition, an ahead-of-print article published in the December issue of the American Journal of Roentgenology (AJR) contends that all subspecialties must be prepared to identify radiologic correlates and distinguish key postoperative variations in the three major categories of gender affirmation surgery: genital reconstruction, body contouring, and maxillofacial contouring.

Read More: Radiologists News and Radiologists Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.