Comparative intervention analysis

From the measured week-156 imaging state, ABP compares chemoradiation, surgery and combined treatment for a selected objective and horizon. It identifies a leading option only when support is adequate and the calculated outcomes are separable; otherwise it reports no leading option.

—

Drag to rotate

Enhancing tumorNecrotic coreEdema / FLAIRDashed circle: size reference

1 · Objective

Horizon12 weeks

2 · ABP assessment

3 · Outcomes by option

	Wk 156	Chemoradiation	Surgery	Surgery + chemoradiation
Enhancing
Necrotic
Edema
Total
Treatment-burden penalty	—
Support	—

Volumes in cm³. Chemoradiation: 60 Gy with chemotherapy exposure 0.70 (demo 2). Surgery: near-total resection, depth 0.90, via the clearest approach (demo 3). Surgery + chemoradiation: both.

Observed course

Week 156: progressive disease, . She underwent resection; the week 157 post-operative scan measured . By week 167 the disease was progressing again at . The table compares alternative intervention choices from the same measured week-156 starting state; the patient's recorded postoperative course is shown separately for context.

Method and provenance

What the ratings do not include. RANO requires a stable or decreasing corticosteroid dose for a response to count. RANO 2.0 requires confirmation of objective response (after at least four weeks) and requires or recommends confirmation of progression in specified settings, particularly within 12 weeks of radiotherapy because of pseudoprogression. LUMIERE records neither steroid dose nor confirmation status. The ratings shown are the source dataset’s expert RANO labels and have not been re-adjudicated under RANO 2.0; read them as imaging assessments only.
Patient anatomy. The 3-D view uses Patient-067's measured week-156 tumor compartments and brain surface reconstructed from LUMIERE's atlas-space DeepBraTumIA segmentation; each intervention calculation updates compartment volumes around those measured centroids. The Geometry control provides an equivalent-volume comparison view.
Zoom and cut-away (pinch, the + and − buttons, or the mouse wheel after clicking the view; ◐ slices the tumor open) enlarge the current 3-D view to show how its compartments nest. They do not reveal detail finer than the MRI, whose resolution is on the millimetre scale.
Cells (✺ switches between cells and measurement dots) are illustrative renderings in the style of fluorescence microscopy, not imaged cells. Magenta cells are tumor cells: rounded in the tumor body, elongated where they infiltrate the surrounding edema, and shown dividing at a rate that rises when the enhancing tumor is growing. Grey, fragmenting cells are dying; they increase when the enhancing tumor shrinks or the necrotic core grows. Pale blue cells with branching processes are healthy brain cells around and among the infiltrating tumor cells. Infiltrating cells spread outward faster when edema is growing. The rates come from the displayed volumes (observed between scans, or calculated in the intervention analyses); the line under the legend states them. Zooming in brings the cells forward and fades the outlines.
All three options start from the measured week 156 compartments of LUMIERE Patient-067 and use the same response functions as demos 2 and 3.
Goal scores (lower is better): enhancing volume; total volume; or total volume with an intervention-burden weighting. For the burden-weighted objective, treatment-related necrosis or infiltration contributes to chemoradiation, the surgical term is 0.24, and combined treatment uses the larger component plus 0.08.
Support is 82% for chemoradiation, 72% for surgery and 64% for combined treatment under the current comparison. A leading option is named only when support is at least 60% and the selected objective is separated from the next option by at least 6%; otherwise ABP reports no leading option.
"Leading option" identifies the lowest supported value for the selected objective and horizon within this comparison. The patient's observed clinical course remains displayed separately.