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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
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...
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| Published in: | Pediatric radiology 2023-11, Vol.53 (12), p.2539-2551 |
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| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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| container_title | Pediatric radiology |
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| creator | van Ewijk, Roelof Chatziantoniou, Cyrano Adams, Madeleine Bertolini, Patrizia Bisogno, Gianni Bouhamama, Amine Caro-Dominguez, Pablo Charon, Valerie Coma, Ana Dandis, Rana Devalck, Christine De Donno, Giulia Ferrari, Andrea Fiocco, Marta Gallego, Soledad Giraudo, Chiara Glosli, Heidi ter Horst, Simone A. J. Jenney, Meriel Klein, Willemijn M. Leemans, Alexander Leseur, Julie Mandeville, Henry C. McHugh, Kieran Merks, Johannes H. M. Minard-Colin, Veronique Moalla, Salma Morosi, Carlo Orbach, Daniel Ording Muller, Lil-Sofie Pace, Erika Di Paolo, Pier Luigi Perruccio, Katia Quaglietta, Lucia Renard, Marleen van Rijn, Rick R. Ruggiero, Antonio Sirvent, Sara I. De Luca, Alberto Schoot, Reineke A. |
| description | 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 (E
p
SSG) 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.
Graphical Abstract |
| doi_str_mv | 10.1007/s00247-023-05745-z |
| format | article |
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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 (E
p
SSG) 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.
Graphical Abstract</description><identifier>ISSN: 1432-1998</identifier><identifier>ISSN: 0301-0449</identifier><identifier>EISSN: 1432-1998</identifier><identifier>DOI: 10.1007/s00247-023-05745-z</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adolescents ; Alveoli ; Chemotherapy ; Diagnosis ; Diffusion coefficient ; Hemorrhage ; Heterogeneity ; Histology ; Imaging ; Magnetic resonance imaging ; Medical imaging ; Medicine ; Medicine & Public Health ; Necrosis ; Neuroradiology ; Nuclear Medicine ; Oncology ; Original Article ; Patients ; Pediatrics ; Radiology ; Rhabdomyosarcoma ; Sarcoma ; Soft tissue sarcoma ; Soft tissues ; Tumors ; Ultrasound ; Young adults</subject><ispartof>Pediatric radiology, 2023-11, Vol.53 (12), p.2539-2551</ispartof><rights>The Author(s) 2023</rights><rights>The Author(s) 2023. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c347t-9bacf8b4ef06f0214c7cff3fdd7307a341bdfe1835c408a17150b00405bfc4b3</cites><orcidid>0000-0002-7765-4868 ; 0000-0001-9769-734X ; 0000-0002-4354-8979 ; 0000-0002-5057-0154 ; 0000-0002-8838-981X ; 0000-0001-7659-1028 ; 0000-0003-4940-2185 ; 0000-0003-1153-4131 ; 0000-0003-0339-6031 ; 0000-0001-6891-5213 ; 0000-0002-2520-139X ; 0000-0003-4002-1386 ; 0000-0001-8319-8312 ; 0000-0002-6052-3511 ; 0000-0001-5641-6169 ; 0000-0002-9306-6126 ; 0000-0003-4309-533X ; 0000-0003-0655-6678 ; 0000-0003-1762-9967 ; 0000-0003-0924-5883 ; 0000-0001-6820-8578 ; 0000-0002-4724-0517 ; 0000-0001-6529-4984 ; 0000-0003-4849-5826 ; 0000-0002-8876-6515 ; 0000-0003-4462-5523 ; 0000-0001-8290-9717 ; 0000-0002-4712-9624 ; 0000-0002-2553-7299 ; 0000-0003-3540-6580 ; 0000-0001-5588-0277 ; 0000-0002-8671-2580 ; 0000-0002-0296-5207</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,783,787,27936,27937</link.rule.ids></links><search><creatorcontrib>van Ewijk, Roelof</creatorcontrib><creatorcontrib>Chatziantoniou, Cyrano</creatorcontrib><creatorcontrib>Adams, Madeleine</creatorcontrib><creatorcontrib>Bertolini, Patrizia</creatorcontrib><creatorcontrib>Bisogno, Gianni</creatorcontrib><creatorcontrib>Bouhamama, Amine</creatorcontrib><creatorcontrib>Caro-Dominguez, Pablo</creatorcontrib><creatorcontrib>Charon, Valerie</creatorcontrib><creatorcontrib>Coma, Ana</creatorcontrib><creatorcontrib>Dandis, Rana</creatorcontrib><creatorcontrib>Devalck, Christine</creatorcontrib><creatorcontrib>De Donno, Giulia</creatorcontrib><creatorcontrib>Ferrari, Andrea</creatorcontrib><creatorcontrib>Fiocco, Marta</creatorcontrib><creatorcontrib>Gallego, Soledad</creatorcontrib><creatorcontrib>Giraudo, Chiara</creatorcontrib><creatorcontrib>Glosli, Heidi</creatorcontrib><creatorcontrib>ter Horst, Simone A. J.</creatorcontrib><creatorcontrib>Jenney, Meriel</creatorcontrib><creatorcontrib>Klein, Willemijn M.</creatorcontrib><creatorcontrib>Leemans, Alexander</creatorcontrib><creatorcontrib>Leseur, Julie</creatorcontrib><creatorcontrib>Mandeville, Henry C.</creatorcontrib><creatorcontrib>McHugh, Kieran</creatorcontrib><creatorcontrib>Merks, Johannes H. M.</creatorcontrib><creatorcontrib>Minard-Colin, Veronique</creatorcontrib><creatorcontrib>Moalla, Salma</creatorcontrib><creatorcontrib>Morosi, Carlo</creatorcontrib><creatorcontrib>Orbach, Daniel</creatorcontrib><creatorcontrib>Ording Muller, Lil-Sofie</creatorcontrib><creatorcontrib>Pace, Erika</creatorcontrib><creatorcontrib>Di Paolo, Pier Luigi</creatorcontrib><creatorcontrib>Perruccio, Katia</creatorcontrib><creatorcontrib>Quaglietta, Lucia</creatorcontrib><creatorcontrib>Renard, Marleen</creatorcontrib><creatorcontrib>van Rijn, Rick R.</creatorcontrib><creatorcontrib>Ruggiero, Antonio</creatorcontrib><creatorcontrib>Sirvent, Sara I.</creatorcontrib><creatorcontrib>De Luca, Alberto</creatorcontrib><creatorcontrib>Schoot, Reineke A.</creatorcontrib><title>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</title><title>Pediatric radiology</title><addtitle>Pediatr Radiol</addtitle><description>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 (E
p
SSG) 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.
Graphical Abstract</description><subject>Adolescents</subject><subject>Alveoli</subject><subject>Chemotherapy</subject><subject>Diagnosis</subject><subject>Diffusion coefficient</subject><subject>Hemorrhage</subject><subject>Heterogeneity</subject><subject>Histology</subject><subject>Imaging</subject><subject>Magnetic resonance imaging</subject><subject>Medical imaging</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Necrosis</subject><subject>Neuroradiology</subject><subject>Nuclear Medicine</subject><subject>Oncology</subject><subject>Original Article</subject><subject>Patients</subject><subject>Pediatrics</subject><subject>Radiology</subject><subject>Rhabdomyosarcoma</subject><subject>Sarcoma</subject><subject>Soft tissue sarcoma</subject><subject>Soft tissues</subject><subject>Tumors</subject><subject>Ultrasound</subject><subject>Young adults</subject><issn>1432-1998</issn><issn>0301-0449</issn><issn>1432-1998</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><recordid>eNp9kcFu1DAQhiNEJUrpC_RkiQuXwDh21lluaFXKSkWItvfIcca7rhI7eBzQ9gn7WHU3SCAOnGY0-r7_MH9RXHB4zwHUBwKopCqhEiXUStblw4vilEtRlXy9bl7-tb8qXhPdA4CouTgtHr_P2ieXdHI_kfXO2plc8OUvdLt9wp59vdmyiDQFT8g0ERKN6BNznsW97vowHgLpaMKoPzLt8z1h9DkueD1kM8VAE5pjPKW5P7DgWYd7PVgWLEt7ZJdzDBNmd9LYO52iM-w22MSSI5qztsSz26N-FcM8se2od87v2CaMo0sJ8U1xYvVAeP57nhV3ny_vNl_K629X282n69IIqVK57rSxTSfRwspCxaVRxlph-14JUFpI3vUWeSNqI6HRXPEaOgAJdWeN7MRZ8W6JnWL4MSOldnRkcBi0xzBTWzUrIUCsapnRt_-g92HOrxmeqUYpUJyLTFULZfKjKKJtp-hGHQ8th_a523bpts3dtsdu24csiUWiDPsdxj_R_7GeAI6Arg0</recordid><startdate>20231101</startdate><enddate>20231101</enddate><creator>van Ewijk, Roelof</creator><creator>Chatziantoniou, Cyrano</creator><creator>Adams, Madeleine</creator><creator>Bertolini, Patrizia</creator><creator>Bisogno, Gianni</creator><creator>Bouhamama, Amine</creator><creator>Caro-Dominguez, Pablo</creator><creator>Charon, Valerie</creator><creator>Coma, Ana</creator><creator>Dandis, Rana</creator><creator>Devalck, Christine</creator><creator>De Donno, Giulia</creator><creator>Ferrari, Andrea</creator><creator>Fiocco, Marta</creator><creator>Gallego, Soledad</creator><creator>Giraudo, Chiara</creator><creator>Glosli, Heidi</creator><creator>ter Horst, Simone A. 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J. ; Jenney, Meriel ; Klein, Willemijn M. ; Leemans, Alexander ; Leseur, Julie ; Mandeville, Henry C. ; McHugh, Kieran ; Merks, Johannes H. M. ; Minard-Colin, Veronique ; Moalla, Salma ; Morosi, Carlo ; Orbach, Daniel ; Ording Muller, Lil-Sofie ; Pace, Erika ; Di Paolo, Pier Luigi ; Perruccio, Katia ; Quaglietta, Lucia ; Renard, Marleen ; van Rijn, Rick R. ; Ruggiero, Antonio ; Sirvent, Sara I. ; De Luca, Alberto ; Schoot, Reineke A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c347t-9bacf8b4ef06f0214c7cff3fdd7307a341bdfe1835c408a17150b00405bfc4b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Adolescents</topic><topic>Alveoli</topic><topic>Chemotherapy</topic><topic>Diagnosis</topic><topic>Diffusion coefficient</topic><topic>Hemorrhage</topic><topic>Heterogeneity</topic><topic>Histology</topic><topic>Imaging</topic><topic>Magnetic resonance imaging</topic><topic>Medical imaging</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Necrosis</topic><topic>Neuroradiology</topic><topic>Nuclear Medicine</topic><topic>Oncology</topic><topic>Original Article</topic><topic>Patients</topic><topic>Pediatrics</topic><topic>Radiology</topic><topic>Rhabdomyosarcoma</topic><topic>Sarcoma</topic><topic>Soft tissue sarcoma</topic><topic>Soft tissues</topic><topic>Tumors</topic><topic>Ultrasound</topic><topic>Young adults</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>van Ewijk, Roelof</creatorcontrib><creatorcontrib>Chatziantoniou, Cyrano</creatorcontrib><creatorcontrib>Adams, Madeleine</creatorcontrib><creatorcontrib>Bertolini, Patrizia</creatorcontrib><creatorcontrib>Bisogno, Gianni</creatorcontrib><creatorcontrib>Bouhamama, Amine</creatorcontrib><creatorcontrib>Caro-Dominguez, Pablo</creatorcontrib><creatorcontrib>Charon, Valerie</creatorcontrib><creatorcontrib>Coma, Ana</creatorcontrib><creatorcontrib>Dandis, Rana</creatorcontrib><creatorcontrib>Devalck, Christine</creatorcontrib><creatorcontrib>De Donno, Giulia</creatorcontrib><creatorcontrib>Ferrari, Andrea</creatorcontrib><creatorcontrib>Fiocco, Marta</creatorcontrib><creatorcontrib>Gallego, Soledad</creatorcontrib><creatorcontrib>Giraudo, Chiara</creatorcontrib><creatorcontrib>Glosli, Heidi</creatorcontrib><creatorcontrib>ter Horst, Simone A. J.</creatorcontrib><creatorcontrib>Jenney, Meriel</creatorcontrib><creatorcontrib>Klein, Willemijn M.</creatorcontrib><creatorcontrib>Leemans, Alexander</creatorcontrib><creatorcontrib>Leseur, Julie</creatorcontrib><creatorcontrib>Mandeville, Henry C.</creatorcontrib><creatorcontrib>McHugh, Kieran</creatorcontrib><creatorcontrib>Merks, Johannes H. M.</creatorcontrib><creatorcontrib>Minard-Colin, Veronique</creatorcontrib><creatorcontrib>Moalla, Salma</creatorcontrib><creatorcontrib>Morosi, Carlo</creatorcontrib><creatorcontrib>Orbach, Daniel</creatorcontrib><creatorcontrib>Ording Muller, Lil-Sofie</creatorcontrib><creatorcontrib>Pace, Erika</creatorcontrib><creatorcontrib>Di Paolo, Pier Luigi</creatorcontrib><creatorcontrib>Perruccio, Katia</creatorcontrib><creatorcontrib>Quaglietta, Lucia</creatorcontrib><creatorcontrib>Renard, Marleen</creatorcontrib><creatorcontrib>van Rijn, Rick R.</creatorcontrib><creatorcontrib>Ruggiero, Antonio</creatorcontrib><creatorcontrib>Sirvent, Sara I.</creatorcontrib><creatorcontrib>De Luca, Alberto</creatorcontrib><creatorcontrib>Schoot, Reineke A.</creatorcontrib><collection>Springer_OA刊</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Neurosciences Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Database (1962 - current)</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection (Proquest) (PQ_SDU_P3)</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Biological Sciences</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biological Science Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>Pediatric radiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>van Ewijk, Roelof</au><au>Chatziantoniou, Cyrano</au><au>Adams, Madeleine</au><au>Bertolini, Patrizia</au><au>Bisogno, Gianni</au><au>Bouhamama, Amine</au><au>Caro-Dominguez, Pablo</au><au>Charon, Valerie</au><au>Coma, Ana</au><au>Dandis, Rana</au><au>Devalck, Christine</au><au>De Donno, Giulia</au><au>Ferrari, Andrea</au><au>Fiocco, Marta</au><au>Gallego, Soledad</au><au>Giraudo, Chiara</au><au>Glosli, Heidi</au><au>ter Horst, Simone A. J.</au><au>Jenney, Meriel</au><au>Klein, Willemijn M.</au><au>Leemans, Alexander</au><au>Leseur, Julie</au><au>Mandeville, Henry C.</au><au>McHugh, Kieran</au><au>Merks, Johannes H. M.</au><au>Minard-Colin, Veronique</au><au>Moalla, Salma</au><au>Morosi, Carlo</au><au>Orbach, Daniel</au><au>Ording Muller, Lil-Sofie</au><au>Pace, Erika</au><au>Di Paolo, Pier Luigi</au><au>Perruccio, Katia</au><au>Quaglietta, Lucia</au><au>Renard, Marleen</au><au>van Rijn, Rick R.</au><au>Ruggiero, Antonio</au><au>Sirvent, Sara I.</au><au>De Luca, Alberto</au><au>Schoot, Reineke A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>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</atitle><jtitle>Pediatric radiology</jtitle><stitle>Pediatr Radiol</stitle><date>2023-11-01</date><risdate>2023</risdate><volume>53</volume><issue>12</issue><spage>2539</spage><epage>2551</epage><pages>2539-2551</pages><issn>1432-1998</issn><issn>0301-0449</issn><eissn>1432-1998</eissn><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 (E
p
SSG) 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.
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| fulltext | fulltext |
| identifier | ISSN: 1432-1998 |
| ispartof | Pediatric radiology, 2023-11, Vol.53 (12), p.2539-2551 |
| issn | 1432-1998 0301-0449 1432-1998 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2863303654 |
| source | Springer Nature |
| subjects | Adolescents Alveoli Chemotherapy Diagnosis Diffusion coefficient Hemorrhage Heterogeneity Histology Imaging Magnetic resonance imaging Medical imaging Medicine Medicine & Public Health Necrosis Neuroradiology Nuclear Medicine Oncology Original Article Patients Pediatrics Radiology Rhabdomyosarcoma Sarcoma Soft tissue sarcoma Soft tissues Tumors Ultrasound Young adults |
| title | 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 |
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