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Aneurysm TU, TR and RS modeling Concept

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TAA and AAA Concept Map 4- TU/TR
TAA and AAA Concept Map 4- TU/TR

Case 1 - Subject has both TAA and AAA

The subject had a chest CT scan and an abdominal CT scan.

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titleQuestions and Thoughts

The results for TU, TUORRES = target, non-target, or new target. This convention was designed for tumor assessment. Target and non-target have very specific definitions depending on the tumor under study. Generally for solid tumor, according to RECIST:

Measurable lesions - lesions that can be accurately measured in at least one dimension with longest diameter  20 mm using conventional techniques or 10 mm with spiral CT scan.

  • All measurable lesions up to a maximum of five lesions per organ and 10 lesions in total, representative of all involved organs should be identified as target lesions and recorded and measured at baseline.

Non-measurable lesions - all other lesions, including small lesions (longest diameter <20 mm with conventional techniques or <10 mm with spiral CT scan), i.e., bone lesions, leptomeningeal disease, ascites, pleural/pericardial effusion, inflammatory breast disease, lymphangitis cutis/pulmonis, cystic lesions, and also abdominal masses that are not confirmed and followed by imaging techniques.

  • All other lesions (or sites of disease) should be identified as non-target lesions and should also be recorded at baseline. Measurements of these lesions are not required, but the presence or absence of each should be noted throughout follow-up.

Since TU is also shared by Lesion Identification, to have a result as "target" is misleading and doesn't always apply to non-tumor settings. When you say there is a target aneurysm, what does that mean? Target for treatment and response evaluation? what is the criteria that makes it a target? Usually an aneurysm larger than 5cm requires surgery. Does that mean the ones that are smaller than 5 cm are considered "non-target"? and non-target for what? surgery not needed? The values for TU responses right now, doesn't make sense for non-tumor lesion identification process.

Case 2 - Subject has AAA but TAA is not found

The subject had a MRI that scanned his torso, from chest to abdomen. Should PRLOC be "torso", or "chest" and "abdomen"? The places where you point the probe to, are they locations of the procedure?

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Dataset wrap
titlecv.xpt
NameTU


Rowcaps


Row 1:An aneurysm is present in the left renal artery.
Row 2:An aneurysm is present in the Infrarenal Aorta



Dataset2


Row

STUDYID

DOMAIN

USUBJID

TUSEQTULNKID

TUTEST

TUORRES

TULOC

TULAT

TUMETHOD

VISITNUM

VISIT

TUDTC

1ABCTUABC-4561Aneurysm 1Aneurysm Identification

Target

Renal ArteryLeftMRI1BASELINE2020-04-27
2ABCTUABC-4562Aneurysm 2Aneurysm IdentificationTargetInfrarenal Aorta
MRI1BASELINE2020-04-27




What goes into TULOC?

After all this, i struggle with what values should go into TULOC. When a CT scans the chest, it produces cross-sectional images of the chest/thorax and everything in it. You can view the images in three angles: a) axial view (you are looking at the picture of the thorax from the direction of head to toe), b) the coronal view (you are looking at the images of the thorax as if you are standing in front of the person),  c) sagittal view (you are looking at the picture of the thorax from the side). Hence TULOCs are populated with Thoracic Region and Abdominal Region for now. Especially in the axial view, as you move from cross-sectional images of the thorax to images of the abdomen, you are looking at sectioned images of the thoracic region to abdominal region, there is no mistake about which region you are looking at because the anatomy of both regions are so different and clearly sperpated. I think it is not wrong to populate TULOC with chest and abdomen as well, they are just not the most precise anatomical terms.

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