TY - JOUR
T1 - Multiparametric assessment of treatment response in high-grade soft-tissue sarcomas with anatomic and functional MR imaging sequences
AU - Soldatos, Theodoros
AU - Ahlawat, Shivani
AU - Montgomery, Elizabeth
AU - Chalian, Majid
AU - Jacobs, Michael A.
AU - Fayad, Laura M.
N1 - Publisher Copyright:
© RSNA, 2015.
PY - 2016/3
Y1 - 2016/3
N2 - Purpose: To determine the added value of quantitative diffusionweighted and dynamic contrast material-enhanced imaging to conventional magnetic resonance (MR) imaging for assessment of the response of soft-tissue sarcomas to neoadjuvant therapy. Materials and Methods: MR imaging examinations in 23 patients with soft-tissue sarcomas who had undergone neoadjuvant therapy were reviewed by two readers during three sessions: conventional imaging (T1-weighted, fluid-sensitive, static postcontrast T1-weighted), conventional with diffusion-weighted imaging, and conventional with diffusion-weighted and dynamic contrast-enhanced imaging. For each session, readers recorded imaging features and determined treatment response. Interobserver agreement was assessed and receiver operating characteristic analysis was performed to evaluate the accuracy of each session for determining response by using results of the histologic analysis as the reference standard. Good response was defined as less than or equal to 5% residual viable tumor. Results: Of the 23 sarcomas, four (17.4%) showed good histologic response (three of four with >95% granulation tissue and <5% necrosis, one of four with 95% necrosis and >5% viable tumor) and 19 (82.6%) showed poor response (viable tumor range, 10%-100%). Interobserver agreement was substantial or excellent for imaging features in all sequences (k = 0.789-1.000). Receiver operating characteristic analysis showed an increase in diagnostic performance with the addition of diffusion-weighted and dynamic contrast-enhanced MR imaging for prediction of response compared with that for conventional imaging alone (areas under the curve, 0.500, 0.676, 0.821 [reader 1] and 0.506, 0.704, 0.833 [reader 2], respectively). Conclusion: Adding functional sequences to the conventional MR imaging protocol increases the sensitivity of MR imaging for determining treatment response in soft-tissue sarcomas.
AB - Purpose: To determine the added value of quantitative diffusionweighted and dynamic contrast material-enhanced imaging to conventional magnetic resonance (MR) imaging for assessment of the response of soft-tissue sarcomas to neoadjuvant therapy. Materials and Methods: MR imaging examinations in 23 patients with soft-tissue sarcomas who had undergone neoadjuvant therapy were reviewed by two readers during three sessions: conventional imaging (T1-weighted, fluid-sensitive, static postcontrast T1-weighted), conventional with diffusion-weighted imaging, and conventional with diffusion-weighted and dynamic contrast-enhanced imaging. For each session, readers recorded imaging features and determined treatment response. Interobserver agreement was assessed and receiver operating characteristic analysis was performed to evaluate the accuracy of each session for determining response by using results of the histologic analysis as the reference standard. Good response was defined as less than or equal to 5% residual viable tumor. Results: Of the 23 sarcomas, four (17.4%) showed good histologic response (three of four with >95% granulation tissue and <5% necrosis, one of four with 95% necrosis and >5% viable tumor) and 19 (82.6%) showed poor response (viable tumor range, 10%-100%). Interobserver agreement was substantial or excellent for imaging features in all sequences (k = 0.789-1.000). Receiver operating characteristic analysis showed an increase in diagnostic performance with the addition of diffusion-weighted and dynamic contrast-enhanced MR imaging for prediction of response compared with that for conventional imaging alone (areas under the curve, 0.500, 0.676, 0.821 [reader 1] and 0.506, 0.704, 0.833 [reader 2], respectively). Conclusion: Adding functional sequences to the conventional MR imaging protocol increases the sensitivity of MR imaging for determining treatment response in soft-tissue sarcomas.
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U2 - 10.1148/radiol.2015142463
DO - 10.1148/radiol.2015142463
M3 - Article
C2 - 26390048
AN - SCOPUS:84959450604
SN - 0033-8419
VL - 278
SP - 831
EP - 840
JO - RADIOLOGY
JF - RADIOLOGY
IS - 3
ER -