Multiparametric assessment of treatment response in high-grade soft-tissue sarcomas with anatomic and functional MR imaging sequences

Theodoros Soldatos, Shivani Ahlawat, Elizabeth Montgomery, Majid Chalian, Michael Jacobs, Laura M Fayad

Research output: Contribution to journalArticle

Abstract

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% 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.

Original languageEnglish (US)
Pages (from-to)831-840
Number of pages10
JournalRadiology
Volume278
Issue number3
DOIs
StatePublished - Mar 1 2016

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Sarcoma
Magnetic Resonance Imaging
Neoadjuvant Therapy
ROC Curve
Therapeutics
Granulation Tissue
Residual Neoplasm
Contrast Media
Area Under Curve
Neoplasms

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Multiparametric assessment of treatment response in high-grade soft-tissue sarcomas with anatomic and functional MR imaging sequences. / Soldatos, Theodoros; Ahlawat, Shivani; Montgomery, Elizabeth; Chalian, Majid; Jacobs, Michael; Fayad, Laura M.

In: Radiology, Vol. 278, No. 3, 01.03.2016, p. 831-840.

Research output: Contribution to journalArticle

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abstract = "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{\%} 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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AU - Jacobs, Michael

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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% 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% 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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