TY - JOUR
T1 - Evaluation of the Prognostic Value of Pretherapeutic Magnetic Resonance Imaging in Predicting Soft Tissue Sarcoma Radiation Response
T2 - A Retrospective Study from a Large Institutional Sarcoma Imaging Database
AU - Vogin, Guillaume
AU - Lepage, Matthias
AU - Salleron, Julia
AU - Cuenin, Mathilde
AU - Blum, Alain
AU - Gondim Teixeira, Pedro Augusto
N1 - Publisher Copyright:
© 2024 by the authors.
PY - 2024/2/22
Y1 - 2024/2/22
N2 - Background: RT-induced hyalinization/fibrosis was recently evidenced as a significant independent predictor for complete response to neoadjuvant radiotherapy (RT) and survival in patients with soft tissue sarcoma (STS). Purpose: Non-invasive predictive markers of histologic response after neoadjuvant RT of STS are expected. Materials and Methods: From May 2010 to April 2017, patients with a diagnosis of STS who underwent neoadjuvant RT for limb STS were retrieved from a single center prospective clinical imaging database. Tumor Apparent Diffusion Coefficients (ADC) and areas under the time-intensity perfusion curve (AUC) were compared with the histologic necrosis ratio, fibrosis, and cellularity in post-surgical specimens. Results: We retrieved 29 patients. The median ADC value was 134.3 × 10−3 mm2/s. ADC values positively correlated with the post-treatment tumor necrosis ratio (p = 0.013). Median ADC values were lower in patients with less than 50% necrosis and higher in those with more than 50% (120.3 × 10−3 mm2/s and 202.0 × 10−3 mm2/s, respectively (p = 0.020). ADC values higher than 161 × 10−3 mm2/s presented a 95% sensitivity and a 55% specificity for the identification of tumors with more than 50% tumor necrosis ratio. Tumor-to-muscle AUC ratios were associated with histologic fibrosis (p = 0.036). Conclusions: ADC and perfusion AUC correlated, respectively, with radiation-induced tumor necrosis and fibrosis.
AB - Background: RT-induced hyalinization/fibrosis was recently evidenced as a significant independent predictor for complete response to neoadjuvant radiotherapy (RT) and survival in patients with soft tissue sarcoma (STS). Purpose: Non-invasive predictive markers of histologic response after neoadjuvant RT of STS are expected. Materials and Methods: From May 2010 to April 2017, patients with a diagnosis of STS who underwent neoadjuvant RT for limb STS were retrieved from a single center prospective clinical imaging database. Tumor Apparent Diffusion Coefficients (ADC) and areas under the time-intensity perfusion curve (AUC) were compared with the histologic necrosis ratio, fibrosis, and cellularity in post-surgical specimens. Results: We retrieved 29 patients. The median ADC value was 134.3 × 10−3 mm2/s. ADC values positively correlated with the post-treatment tumor necrosis ratio (p = 0.013). Median ADC values were lower in patients with less than 50% necrosis and higher in those with more than 50% (120.3 × 10−3 mm2/s and 202.0 × 10−3 mm2/s, respectively (p = 0.020). ADC values higher than 161 × 10−3 mm2/s presented a 95% sensitivity and a 55% specificity for the identification of tumors with more than 50% tumor necrosis ratio. Tumor-to-muscle AUC ratios were associated with histologic fibrosis (p = 0.036). Conclusions: ADC and perfusion AUC correlated, respectively, with radiation-induced tumor necrosis and fibrosis.
KW - Apparent Diffusion Coefficient (ADC)
KW - Magnetic Resonance Imaging (MRI)
KW - neoadjuvant radiotherapy
KW - posttreatment necrosis
KW - soft tissue sarcoma
UR - http://www.scopus.com/inward/record.url?scp=85187654438&partnerID=8YFLogxK
U2 - 10.3390/cancers16050878
DO - 10.3390/cancers16050878
M3 - Article
C2 - 38473238
AN - SCOPUS:85187654438
SN - 2072-6694
VL - 16
JO - Cancers
JF - Cancers
IS - 5
M1 - 878
ER -