Quantitative diffusion-weighted MRI response assessment in rhabdomyosarcoma: an international retrospective study on behalf of the European paediatric Soft tissue sarcoma Study Group Imaging Committee

Roelof Van Ewijk, Cyrano Chatziantoniou, Madeleine Adams, Patrizia Bertolini, Gianni Bisogno, Amine Bouhamama, Pablo Caro-Dominguez, Valerie Charon, Ana Coma, Rana Dandis, Christine Devalck, Giulia De Donno, Andrea Ferrari, Marta Fiocco, Soledad Gallego, Chiara Giraudo, Heidi Glosli, Simone A. J. Ter Horst, Meriel Jenney, Willemijn M. KleinAlexander Leemans, Julie Leseur, Henry C. Mandeville, Kieran Mchugh, Johannes H. M. Merks, Veronique Minard-Colin, Salma Moalla, Carlo Morosi, Daniel Orbach, Lil-Sofie Ording Muller, Erika Pace, Pier Luigi Di Paolo, Katia Perruccio, Lucia Quaglietta, Marleen Renard, Rick R. Van Rijn, Antonio Ruggiero, Sara I. Sirvent, Alberto De Luca, Reineke A. Schoot

Risultato della ricerca: Contributo in rivistaArticolo in rivistapeer review

Abstract

Objective To investigate the feasibility of diffusion-weighted magnetic resonance imaging (DW-MRI) as a predictive imaging marker after neoadjuvant chemotherapy in patients with rhabdomyosarcoma.Material and methods We performed a multicenter retrospective study including pediatric, adolescent and young adult patients with rhabdomyosarcoma, Intergroup Rhabdomyosarcoma Study group III/IV, treated according to the European paediatric Soft tissue sarcoma Study Group (EpSSG) RMS2005 or MTS2008 studies. DW-MRI was performed according to institutional protocols. We performed two-dimensional single-slice tumor delineation. Areas of necrosis or hemorrhage were delineated to be excluded in the primary analysis. Mean, median and 5th and 95th apparent diffusion coefficient (ADC) were extracted.Results Of 134 included patients, 82 had measurable tumor at diagnosis and response and DW-MRI scans of adequate quality and were included in the analysis. Technical heterogeneity in scan acquisition protocols and scanners was observed. Mean ADC at diagnosis was 1.1 (95% confidence interval [CI]: 1.1-1.2) (all ADC expressed in * 10(-3) mm(2)/s), versus 1.6 (1.5-1.6) at response assessment. The 5th percentile ADC was 0.8 (0.7-0.9) at diagnosis and 1.1 (1.0-1.2) at response. Absolute change in mean ADC after neoadjuvant chemotherapy was 0.4 (0.3-0.5). Exploratory analyses for association between ADC and clinical parameters showed a significant difference in mean ADC at diagnosis for alveolar versus embryonal histology. Landmark analysis at nine weeks after the date of diagnosis showed no significant association (hazard ratio 1.3 [0.6-3.2]) between the mean ADC change and event-free survival.Conclusion A significant change in the 5th percentile and the mean ADC after chemotherapy was observed. Strong heterogeneity was identified in DW-MRI acquisition protocols between centers and in individual patients.[GRAPHICS].
Lingua originaleEnglish
pagine (da-a)2539-2551
Numero di pagine13
RivistaPediatric Radiology
Volume53
DOI
Stato di pubblicazionePubblicato - 2023

Keywords

  • Biomarker
  • Diffusion magnetic resonance imaging
  • Rhabdomyosarcoma
  • Sarcoma
  • Surrogate marker

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