Abnormal vascularization of soft-tissue sarcomas on conventional MRI: Diagnostic and prognostic values

Ledoux, Pauline; Kind, Michèle; Loarer, François Le; Stoeckle, Eberhard; Italiano, Antoîne; Tirode, Franck; Buy, Xavier; Crombé, Amandine

doi:10.1016/j.ejrad.2019.06.007

Cited by 8 publications

(3 citation statements)

References 35 publications

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“…The authors found that peritumoral flow voids might be associated with a higher risk of metastatic relapse and poorer OS. They hypothesize that abnormal vascularization might favor the occurrence of hematogenous metastasis through the formation of endovascular thrombi of tumor cells [26,29]. In the current study, we report that patients with a vascular pedicle, defined as either a real clump of peritumoral vessels or as abnormal feeding peri-tumoral vascularization, are at increased risk of developing recurrent disease after nRT.…”

Section: Discussionmentioning

confidence: 49%

“…A vascular pedicle was defined as abnormal tortuous feeding extra-tumoral vessels, whether or not coalescing as a clump, at one site along the lesion periphery. This peri-tumoral neoangiogenesis can be identified as prominent flow voids (i.e., signal loss) [25,26]. The percentage of tumor necrosis was evaluated using T1w sequences with fat saturation after Gd contrast enhancement on a semi-quantitative base (<50.0% or ≥50.0%).…”

Section: Magnetic Resonance Imagingmentioning

confidence: 99%

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The Prognostic Relevance of MRI Characteristics in Myxofibrosarcoma Patients Treated with Neoadjuvant Radiotherapy

van Ravensteijn,

Nederkoorn,

Wal

et al. 2023

Cancers

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To improve local control, neoadjuvant radiotherapy (nRT) followed by surgery is the standard of care in myxofibrosarcoma (MFS) because of its infiltrative growth pattern. Nevertheless, local recurrence rates are high. Data on prognostic factors for poor clinical outcomes are lacking. This retrospective study thus investigates the prognostic relevance of magnetic resonance imaging (MRI) characteristics before and after nRT in 40 MFS patients, as well as their association with disease-free survival (DFS) and overall survival (OS). A vascular pedicle, defined as extra-tumoral vessels at the tumor periphery, was observed in 12 patients (30.0%) pre-nRT and remained present post-nRT in all cases. Patients with a vascular pedicle had worse DFS (HR 5.85; 95% CI 1.56–21.90; p = 0.009) and OS (HR 9.58; 95% CI 1.91–48.00; p = 0.006). An infiltrative growth pattern, referred to as a tail sign, was observed in 22 patients (55.0%) pre-nRT and in 19 patients (47.5%) post-nRT, and was associated with worse DFS post-nRT (HR 6.99; 95% CI 1.39–35.35; p = 0.019). The percentage of tumor necrosis estimated by MRI was increased post-nRT, but was not associated with survival outcomes. The presence of a tail sign or vascular pedicle on MRI could support the identification of patients at risk for poor clinical outcomes after nRT.

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Section: Discussionmentioning

confidence: 49%

Section: Magnetic Resonance Imagingmentioning

confidence: 99%

The Prognostic Relevance of MRI Characteristics in Myxofibrosarcoma Patients Treated with Neoadjuvant Radiotherapy

van Ravensteijn,

Nederkoorn,

Wal

et al. 2023

Cancers

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“…In our study, a wide variety of STS tumor subtypes was included. A difference between tumor types is for example the vasculature of the tumor [ 32 , 33 ]. As described before, tumor vasculature could influence the distribution of pazopanib to the tumor.…”

Section: Discussionmentioning

confidence: 99%

Intra-Tumoral Pharmacokinetics of Pazopanib in Combination with Radiotherapy in Patients with Non-Metastatic Soft-Tissue Sarcoma

Molenaar-Kuijsten

Meekeren

Verheijen

et al. 2021

Cancers

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There is a lack of understanding whether plasma levels of anticancer drugs (such as pazopanib) correlate with intra-tumoral levels and whether the plasma compartment is the best surrogate for pharmacokinetic and pharmacodynamic evaluation. Therefore, we aimed to quantify pazopanib concentrations in tumor tissue, to assess the correlation between tumor concentrations and plasma concentrations and between tumor concentrations and efficacy. In this clinical trial, non-metastatic STS patients were treated with neo-adjuvant concurrent radiotherapy and pazopanib. Plasma samples and tumor biopsies were collected, and pazopanib concentrations were measured using liquid chromatography-tandem mass spectrometry. Twenty-four evaluable patients were included. The median pazopanib tumor concentration was 19.2 µg/g (range 0.149–200 µg/g). A modest correlation was found between tumor concentrations and plasma levels of pazopanib (ρ = 0.41, p = 0.049). No correlation was found between tumor concentrations and percentage of viable tumor cells (p > 0.05); however, a trend towards less viable tumor cells in patients with high pazopanib concentrations in tumor tissue was observed in a categorical analysis. Possible explanations for the lack of correlation might be heterogeneity of the tumors and timing of the biopsy procedure.

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Soft tissue solitary fibrous tumors of the musculoskeletal system: spectrum of MRI appearances and characteristic imaging features

et al. 2021

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Abnormal vascularization of soft-tissue sarcomas on conventional MRI: Diagnostic and prognostic values

Cited by 8 publications

References 35 publications

The Prognostic Relevance of MRI Characteristics in Myxofibrosarcoma Patients Treated with Neoadjuvant Radiotherapy

The Prognostic Relevance of MRI Characteristics in Myxofibrosarcoma Patients Treated with Neoadjuvant Radiotherapy

Intra-Tumoral Pharmacokinetics of Pazopanib in Combination with Radiotherapy in Patients with Non-Metastatic Soft-Tissue Sarcoma

Soft tissue solitary fibrous tumors of the musculoskeletal system: spectrum of MRI appearances and characteristic imaging features

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