Quantitative Radiology Reporting in Oncology: Survey of Oncologists and Radiologists.

OBJECTIVE: Tumor quantification is essential for determining the clinical efficacy and response to established and evolving therapeutic agents in cancer trials. The purpose of this study was to seek the opinions of oncologists and radiologists about quantitative interactive and multimedia reporting. SUBJECTS AND METHODS: Questionnaires were distributed to 253 oncologists and registrars and to 35 radiologists at our institution through an online survey application. Questions were asked about current reporting methods, methods for Response Evaluation Criteria in Solid Tumors (RECIST) tumor measurement, and preferred reporting format. RESULTS: The overall response rates were 43.1% (109/253) for oncologists and 80.0% (28/35) for radiologists. The oncologists treated more than 40 tumor types. Most of the oncologists (65.7% [67/102]) and many radiologists (44.4% [12/27]) (p = 0.020) deemed the current traditional qualitative radiology reports insufficient for reporting tumor burden and communicating measurements. Most of the radiologists (77.8% [21/27]) and oncologists (85.5% [71/83]) (p = 0.95) agreed that key images with measurement annotations helped in finding previously measured tumors; however, only 43% of radiologists regularly saved key images. Both oncologists (64.2% [70/109]) and radiologists (67.9% [19/28]) (p = 0.83) preferred the ability to hyperlink measurements from reports to images of lesions as opposed to text-only reports. Approximately 60% of oncologists indicated that they handwrote tumor measurements on RECIST forms, and 40% used various digital formats. Most of the oncologists (93%) indicated that managing tumor measurements within a PACS would be superior to handwritten data entry and retyping of data into a cancer database. CONCLUSION: Oncologists and radiologists agree that quantitative interactive reporting would be superior to traditional text-only qualitative reporting for assessing tumor burden in cancer trials. A PACS reporting system that enhances and promotes collaboration between radiologists and oncologists improves quantitative reporting of tumors.

Importance of the heavier singlet neutrinos in leptogenesis.

We argue that fast interactions of the lightest singlet neutrino N1 would project part of a preexisting lepton asymmetry L{p} onto a direction that is protected from N1 washout effects, thus preventing it from being erased. In particular, we consider an asymmetry generated in N2 decays, assuming that N1 interactions are fast enough to bring N1 into full thermal equilibrium. If N1 decays occur at T > or = 10{9} GeV, that is, before the muon Yukawa interactions enter into thermal equilibrium, then generically part of L{p} survives. In this case some of the constraints implied by the standard N1 leptogenesis scenario hold only if L{p} approximately 0. For T < or = 10{9} GeV, L{p} is generally erased, unless special alignment or orthogonality conditions in flavor space are realized.