Radiological and pathological response following pre-operative radiotherapy for soft-tissue sarcoma

Roberge, David; Skamene, T.; Nahal, Ayoub; Turcotte, Robert; Powell, T.; Freeman, Carolyn R.

doi:10.1016/j.radonc.2010.10.007

Cited by 110 publications

(91 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The treatment-induced histologic response at the time of definitive surgery best reflects treatment effectiveness and is highly associated with the patient's prognosis (2). However, the amount of remaining viable tumor can be determined only at surgical resection and histologic analysis after completion of neoadjuvant treatment (3). Furthermore, to be considered effective and indicative of a good prognosis for the patient, a neoadjuvant treatment regimen requires 95% tumor response with only 5% viable tumor remaining (2 Reader Procedures: Conventional Imaging On T1-weighted and fluid-sensitive images, readers evaluated the signal intensity (hypointense, isointense, hyperintense relative to muscle) and heterogeneity of the neoplasms on a scale of 1-4 (1,  25% heterogeneity; 2, 26%-50% heterogeneity; 3, 51%-75% heterogeneity; 4, .75% heterogeneity).…”

Section: Fundingmentioning

confidence: 99%

Multiparametric Assessment of Treatment Response in High-Grade Soft-Tissue Sarcomas with Anatomic and Functional MR Imaging Sequences

Soldatos¹,

Ahlawat²,

Montgomery³

et al. 2016

Radiology

View full text Add to dashboard Cite

).q RSNA, 2015 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. Conclusion:Adding functional sequences to the conventional MR imaging protocol increases the sensitivity of MR imaging for determining treatment response in soft-tissue sarcomas.q RSNA, 2015

show abstract

Section: Fundingmentioning

confidence: 99%

Multiparametric Assessment of Treatment Response in High-Grade Soft-Tissue Sarcomas with Anatomic and Functional MR Imaging Sequences

Soldatos¹,

Ahlawat²,

Montgomery³

et al. 2016

Radiology

View full text Add to dashboard Cite

show abstract

“…With conventional MR imaging, size and signal intensity changes are most commonly used to predict treatment response but have not been shown to be reliable for determining the effects of treatment (112). The limitations of conventional pulse sequences are related to the multiple scenarios that can occur after neoadjuvant therapy: A mass can remain stable in size due to nonresponse or it may increase in size due to nonresponse; alternatively, it may increase in size due to hemorrhage or it may decrease in size due to response.…”

Section: Prediction Of Treatment Response Following Neoadjuvant Therapymentioning

confidence: 99%

“…Although the static contrast-enhanced study appears to show nonenhancement in many patients who have not responded to treatment, the static study can be misleading, because it has been observed that sarcomas show pathologic treatment response in the form of hyaline fibrosis, necrosis, and granulation tissue (112). As such, differentiation of viable tumor from fibrosis and granulation tissue can be difficult on static contrast-enhanced images, given that fibrosis and granulation tissue usually also enhance with intravenous contrast agent administration.…”

Section: Prediction Of Treatment Response Following Neoadjuvant Therapymentioning

confidence: 99%

Musculoskeletal Tumors: How to Use Anatomic, Functional, and Metabolic MR Techniques

Jacobs²,

et al. 2012

View full text Add to dashboard Cite

“…In terms of pathogenesis, lymphedema is the result of the accumulation of protein-rich fluid in the soft tissues secondary to inadequate lymphatic drainage. The alterations in lymphatic drainage may result from pathological changes, namely radionecrosis and granulation of small lymphatic vessels, lymph nodes, and soft tissue surrounding the vessels (16). These changes develop long after radiotherapy, which results in the longer latency of lymphedema appearance.…”

Section: Discussionmentioning

confidence: 99%

Recurrent scrotal edema in a patient with radiation enteritis: A case report

Fan

Chen

Wang

et al. 2016

Molecular and Clinical Oncology

View full text Add to dashboard Cite

Abstract. Since its introduction as an alternative treatment technique, radiotherapy has been increasingly used as the medical treatment of choice for patients with malignant tumors. However, radiotherapy is associated with a number of common, well-described side effects, which may compromise the quality of life of the patients. Scrotal edema is an infrequent complication in patients who undergo pelvic irradiation, which is suspected to be due to lymphatic obstruction. An extensive literature search found no previous case report describing this complication in patients receiving pelvic radiotherapy. Herein, we present a case of recurrent scrotal edema in a 59-year-old man with prostate cancer and radiation enteritis. Conservative therapy was applied and was successful in relieving the symptoms. To the best of our knowledge, this is the first case report of scrotal edema in a patient with radiation enteritis.

show abstract

Radiological and pathological response following pre-operative radiotherapy for soft-tissue sarcoma

Cited by 110 publications

References 16 publications

Multiparametric Assessment of Treatment Response in High-Grade Soft-Tissue Sarcomas with Anatomic and Functional MR Imaging Sequences

Multiparametric Assessment of Treatment Response in High-Grade Soft-Tissue Sarcomas with Anatomic and Functional MR Imaging Sequences

Musculoskeletal Tumors: How to Use Anatomic, Functional, and Metabolic MR Techniques

Recurrent scrotal edema in a patient with radiation enteritis: A case report

Contact Info

Product

Resources

About